bcl-2、p53和PCNA子宫内膜增生与内膜癌的表达

[目的]探讨bcl-2、p53蛋白和增殖细胞核抗原（PCNA）表达与子宫内膜增生性病变和内膜癌的关系。[方法]应用免疫组织化学ABC法对子宫内膜场50例，不典型子宫内股增生、复杂型子宫内膜增生和单纯型内膜增生各15例，进行bcl－2、p53蛋白和PCNA的检测。[结果]bcl－2、p53在内膜癌、不典型子宫内膜增生、复杂型子宫内膜增生的表达分别为64．0％和52.0％，40．0％和20．0％，13．3％和0，单纯型子宫内膜增生表达均为阴性。内膜癌、内膜不典型增生及复杂型单纯型增生三者之间差异有显著性（P＜0．01）。PCNA在子宫内膜癌、不典型子宫内膜增生表达为100．0%和73.3%，显著高于复杂型及单纯型子宫内膜增生（26．7%和20.0％，P＜0．05）。本实验发现p53和PCNA与内膜癌分化程度，转移扩散有关（P＜0．05），与临床分期，肌层浸润之间无显著相关性（P＞0．05）。bcol－2与内膜癌分化程度有关，与转移、扩散、分期及肌层浸润之间无显著相关性。[结论]p53和PCNA联合检测可以作为子宫内膜癌预后判断的良好指标。bcl－2与PCNA在不典型内膜增生内有较高表达，是癌变危险因素，联合检测有较高价值。

Expressions of bcl-2, p53 and PCNA in Endometrial Hyperplasia and Endometrial Carcinoma

[Purpose]To investigate bcl-2, p53 protein and proliferating cell nuclear antigen(PCNA) expressions in endometrial hyperplasia andendometrial carcinoma.[Methods]The expressions of bcl-2, p53 and PCNA were examined by ABC immunohistochemical method in 50 cases withendometrial carcinoma,15 cases with atypical endometrial hyperplasia,15 cases with complex endometrial hyperplasia and 15 cases with simpleendometrial hyperplasia.[Results]Positive bcl-2 expression was 64.0% in endometrial carcinoma and 40.0% in atypical endometrial hyperplasia,and 13.3% in complex endometrial hyperplasia.Positive p53 expression was 52. 0% in endometrial carcinoma,20.0% in atypical endometrialhyperplasia, and zero in complex and simple hyperplasia.There were signicant difference in the expressions among 3 groups(P<0.01). Theexpression of PCNA was found in 100% endomtrial carcinoma and 73. 3% in atypical endometrial hyperplasia.The expression of PCNA for bothendometrial carcinoma and atypical hyperplasia was sigmificantly higher than that lof complex hyperplasia(26.7% )and simple hyperplasia(20.0O%,P < 0. 05). Expression of p53 protein and PCNA was correlated with degree of differentiation,metastasis and spread(P <0. 05), but not correlatedwith clinical and muscular invasion (P > 0.05). [Conclusions]Combined examination of p53 and PCNA may be used as prognostic markersin endometrial carcinoma.bcl-2 and PCNA are higher expression in atypical endonmetrial hyperplasia,are high risk factors to cancerous change.