子宫内膜癌中PTEN与错配修复基因hMLH1的表达及其与临床病理学特征的关系

目的探讨抑癌基因PTEN及错配修复基因hMLH1在子宫内膜癌中的表达及其与子宫内膜癌的临床病理学特征的关系。方法采用免疫组化SP法，检测36例散发性子宫内膜癌、22例子宫内膜不典型增生、23例正常子宫内膜组织中PTEN及hMLH1的表达。结果hMLH1基因在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌中的表达分别为83％（19／23）、64％（14／22）、11％（4／36），hMLH1基因在子宫内膜不典型增生及正常子宫内膜中的表达与其在子宫内膜癌中的表达差异有显著性（P〈0．01）；hMLH1基因表达与子宫内膜癌的淋巴结转移、肌层侵润、手术分期、病理类型无统计学差异（P〉0．05），与子宫内膜癌病理分化程度有关（P〈0．01）：PTEN基因在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌中的表达分别100％（23／23）、73％（16／22）、56％（20／36），PTEN基因在子宫内膜不典型增生、子宫内膜癌中的表达与其在正常子宫内膜中的表达差异有显著性（P〈0．01）；PTEN基因表达与子宫内膜癌的分化程度、淋巴结转移、手术分期、病理类型、肌层是否侵润无统计学相关（P〉O．05）；PTEN与hMLH1两种基因蛋白在子宫内膜癌变过程中的表达有相关性（相关系数r=0．28；P〈O．05）。结论hMLH1及PTEN均是子宫内膜的保护性基因，在子宫内膜的癌变过程中表达逐渐减少，可能与早期子宫内膜癌癌变的启动有关，且二者有显著的相关性；免疫组化法测定PTEN的表达有可能成为筛选子宫内膜癌变的早期指标；测定hMLH1的表达有可能成为预测子宫内膜癌预后的指标。

Relationship of expression of PTEN and hMLH1 gene and clinicopathological features in endometrial carcinoma

[Objective] To evaluate the significance of PTEN and mismatch repair gene hMLH1 expression in endometrial carcinoma and explore the relationship of them and clinicopathological features.[Methods] The expression of PTEN and hMLH1 in 36 cases of sporadic endometrial carcinoma?22 cases of atypical hyperplasia of endometrium and 23 cases of normal endometrium were examined by immunohistochemistry SP method.[Results] The positive rate of hMLH1 expression in atypical hyperplasia of endometrium(14/22,64%)and normal endometrium(19/23,83%)was significantly higher than that in endometrial carcinoma(4/36,11%),(P <0.01);there was no significant difference between the former two groups(P >0.05);the positive rate of PTEN expression in normal endometrium(23/23,100%)was significantly higher than that in atypical hyperplasia of endometrium(16/22,73%)and endometrial carcinoma(20/36,56%),(P <0.01).There was no significant difference between the latter two groups(P >0.05);the expression of hMLH1 was correlated with histological grade(P <0.01);there was significant correlation between PTEN and hMLH1 expression in endometrial carcinogenesis(P <0.05).[Conclusions] PTEN and hMLH1 were protective genes in endometrium.They were concerned with endometrial carcinogenesis.To determine the expression of PTEN by immunohistochemistry SP method would found endometrial carcinogenesis earlier,and the expression of hMLH1 by immunohistochemistry SP method would be an index in prognosis of endometrial carcinoma.