子宫内膜增生及子宫内膜腺癌中PTEN、P16蛋白的表达及临床意义

目的:研究子宫内膜增生组织及内膜癌组织中PTEN、P16蛋白的异常表达,探讨其与子宫内膜癌变的关系和作为早期癌变生物学标志及评判预后的可能性。方法:应用免疫组化S-P法对20例正常子宫内膜组织、40例子宫内膜增生症组织、30例内膜腺癌组织中PTEN、P16蛋白的表达进行研究。结果:在正常增生期子宫内膜、子宫内膜增生症(单纯型增生、复杂型增生、不典型增生)、子宫内膜腺癌组织中PTENP16蛋白的阳性表达率呈递减趋势,子宫内膜腺癌与除不典型增生外的子宫内膜增生症组织及正常子宫内膜组织的PTEN蛋白表达差异有显著性(P<0.05),正常子宫内膜、单纯型增生与不典型增生组织的PTEN蛋白表达差异有显著性(P<0.05),子宫内膜腺癌与正常子宫内膜及单纯型增生子宫内膜P16蛋白表达差异有显著性(P<0.05),正常子宫内膜与增生症子宫内膜差异无显著性(P>0.05)增生症子宫内膜各组间P16蛋白表达无显著性差异(P>0.05),PTEN P16蛋白的表达与子宫内膜癌的手术分期、组织学分级,肌层浸润有关(P>0.05)。PTEN、P16蛋白表达存在正相关性(r=0.978,P<0.01)。结论:PTEN、P16蛋白的异常表达与子宫内膜的癌变过程相关,PTEN基因表达异常及细胞周期调控失常致细胞增殖与子宫内膜的早期癌变有关,PTEN基因异常可促使子宫内膜细胞增殖及恶变。两者有可能成为评判预后及子宫内膜组织早期癌变的分子标记物。

Expression of PTEN and P16 in endometrial hyperplasia and endometrial adenoearcinoma

Objective:To investigate alterations in expression of PTEN and P16 proteins in endometrial carcin-ogenesis.Methods:The expression of PTEN and P16 proteins was detected by immunohistochemical staining S-P method in 20 cases of normal proliferative endometrium and 40 cases of endometrial hyperplasia and 30 cases of metrial adenocarcinoma.Results:The positive expression rates of PTEN and P16 in normal proliferative endometr-ium,endometrial hyperplasia and endometrial carcinoma were gradually decreased,There was significant difference in the expression of PTEN between normal proliferative endometrium,dometrial hyperplasia(except for a-typical hyperplasia) and endometrial adenocarcinoma(P<0.05).There was significant difference in the expression of P16 between normal proliferative endometrium,simple hyperplasia and endometrial adenocarcinoma(P<0.05),The expression of PTEN and P16 protein was significantly associated with surgical stage,histologic grades and myometrial invasion of endometrial adenocarcinoma.Positive correlation was also found between PTEN and P16 expression(r= 0.978,P<0.01).Conclusion:Abnormal expression of PTEN and P16 proteins is associated with carcinogenesis of endmotrium.There are early events in endometria carcinogenesis and useful biomarkers for early detection and judging prognosis.