子宫内膜癌中c-Myc和cyclin E的表达及临床意义

目的 探讨c-Myc和细胞周期素E（cyclin E）蛋白在子宫内膜癌（EC）中的表达及其与临床病理特征的关系。方法 采用免疫组织化学法分别检测c-Myc、cyclin E蛋白在正常增生期子宫内膜、非典型增生子宫内膜和EC中的表达，并分析两种蛋白在子宫内膜不同病变中表达的相关性。结果 c-Myc蛋白在正常子宫增生期内膜、非典型增生子宫内膜和EC中的阳性表达率分别为20.0％（3／15）、73.3％（22／30）和81.0％（47／58），cyclin E蛋白的阳性表达率分别为13.3％（2／15）、56.7％（17／30）和84.5％（49／58）。EC中c-Myc蛋白表达与组织分化、临床分期和浸润深度相关（P＜0.05），而cyclin E蛋白表达与各临床病理参数均无关。EC中c-Myc蛋白与cyclin E蛋白表达呈正相关（r=0.400，P=0.002）。c-Myc、cyclin E蛋白在轻度与重度非典型增生子宫内膜中的表达差异均有统计学意义（P=0.021，P=0.002）。结论c-Myc 和cyclin E在激素依赖型的EC的发生、发展中有协同作用，c-Myc和 cyclin E蛋白在重度非典型增生子宫内膜和EC中的异常表达可能成为癌前病变筛查指标之一。

The expressions of c-Myc and cyclin E in endometrial carcinoma and their clinical significances

Objective To investigate the expressions of c-Myc and cyclin E protein in endometrial carcinoma and their association with clinicopathologic features.Methods The specimens from 15 normal endometrial tissue,30 atypical endometrial hyperplasia and 58 endometrial carcinoma were collected.Immunohistochemical methods were used to detect the expressions of c-Myc and cyclin E protein.Results The postive rates of c-Myc protein in the normal endometrial,atypical endometrial hyperplasia and endometrial carcinomas tissues were 20.0% （3/15）,73.3 % （22/30）and 81.0% （47/58）,respectively.The postive rates of cylin E protein in the normal endometrial,atypical endometrial hyperplasia and endometrial carcinomas tissues were 13.3% （2/15）,56.7% （17/30）and 84.5% （49/58）,respectively.The expression of c-Myc protein in endometrial carcinoma was associated with histologic grade,clinical stage,and the depth of myometrial tumor（P 〈 0.05）.There was no correlation between the expression of cyclin E protein and all of clinicopathologic characteristics.In the endometrial carcinoma,a positive relationship was found between the expressions of c-Myc and cyclin E protein.The differences between the expression of c-Myc and cyclin E protein in the low grade atypical endometrial hyperplasia and that of high grade atypical endometrial hyperplasia were statistically significant （P =0.021,P =0.002）.Conclusion c-Myc and cyclin E protein may cooperate in the occurrence and development of hormone-dependent endometrial carcinoma.The abnormal expressions of c-Myc and cyclin E protein in the high grade atypical endometrial hyperplasia and endometrial carcinoma should be treated as one of screening indices of precancerous lesions.