p53、Ki67和CA125表达在宫颈微偏腺癌与普通宫颈腺癌鉴别中的价值

目的:探讨不同肿瘤标记物的表达在宫颈微偏腺癌（minimal deviation adenocarcinoma,MDA）与普通宫颈腺癌（adenocarcinoma of the uterine cervix,AUC)鉴别诊断中的意义。方法:收集2001年7月至 2013年6月间于中国医科大学附属盛京医院、沈阳市妇婴医院、辽宁省肿瘤医院妇科病房进行手术治疗的19例MDA、同期的50例普通AUC（分化程度:高分化16例，中分化20例，低分化14例）病理标本，采用免疫组化的方法检测Ki67、SMA、p53、PCNA、Vimentin、CEA、ER、CA125和PR的表达。结果:MDA中p53和大于50%细胞核染Ki67（Ki67/50+）的阳性率分别是84%和68%，明显高于普通AUC（分别是38%和18%，P＜0.01），MDA中CA 125的阳性率为21%，明显低于普通AUC中的58%（P＜0.01）。CEA、PR、Vimentin、ER、PCNA和SMA在两组比较中没有差异（P＞0.05）。所有标记物的表达在普通AUC的高、中、低分化组别中没有明显差异（P＞0.05）。结论:p53和Ki67/50+的阳性表达及CA125的阴性表达有助于MDA与普通AUC的鉴别，从而有利于MDA的早期诊断及治疗。

Expression of p53,Ki67 and CA125 can assist the differential diagnosis between minimal deviation adenocarcinoma and common adenocarcinoma of the uterine cervix

Objective:To investigate the significance of the expression of different tumor markers in differential diagnosis between minimal deviation adenocarcinoma (MDA) and common adenocarcinoma of the uterine cervix(AUC).Methods:The expressions of Ki67,SMA,p53,PCNA,Vimentin,CEA,ER,CA125 and PR were detected by an immunohistochemical method in cervical tissues from 19 cases of MDA and 50 cases of AUC (differentiation rank:high 16,moderate 20,low 14) in Shengjing Hospital of China Medical University,Shenyang Woman and Children Hospital and Liaoning Cancer Hospital and Institute from July 2001 to June 2013.Results:The positive immunostaining rates for p53 and Ki67 in>50% of the cell nuclei (Ki67/50+) were 84% and 68% in MDA respectively,significantly higher than common AUC (38%,18%,P＜0.01).CA125 was 21% in MDA,being clearly lower than common AUC(58%,P＜0.01).There was no difference between MDA and common AUC for CEA,PR,Vimentin,ER,PCNA and SMA (P＞0.05).No significant difference was noticed among the high,moderate and low differentiation groups in common AUC (P＞0.05).Conclusion:Positive immunohistochemical staining for p53,Ki67/50+ and negative for CA125 can assist differential diagnosis for MDA from common AUC,thus to improve the early stage diagnosis and treatment for MDA.