CIP2A在子宫内膜样腺癌中的表达及临床意义

目的:探究蛋白磷酸酶2A(CIP2A)在子宫内膜样腺癌中的表达情况及临床意义。方法:选取2011年1月至2014年3月行手术切除并经病理证实的50例子宫内膜样腺癌(EAC)及同期行门诊刮宫术获取的40例正常增生期子宫内膜(NE)组织标本。应用RT-PCR、Western blot法检测EAC和NE组织中CIP2A mRNA及蛋白水平，免疫组化法检测CIP2A阳性表达情况。分析CIP2A在EAC和NE组织中的表达差异及与子宫内膜样腺癌临床病理特征的关系。采用Kaplan-Meier法分析CIP2A不同表达水平对患者预后生存的影响，通过COX分析预后独立危险因素。结果:免疫组化染色显示:CIP2A在子宫内膜样腺癌中呈高表达，阳性着色定位于细胞浆和细胞核中，EAC组织中CIP2A阳性表达率显著高于NE组织(P＜0.01)。RT-PCR和Western blot检测显示EAC组织中CIP2A mRNA及蛋白表达水平高于NE组织(P＜0.01)。CIP2A表达与EAC的组织学分级、FIGO分期、宫颈管受累情况、p53表达及Ki-67增殖指数有关（P＜0.05）。Kaplan-Meier法生存分析显示EAC患者5年无病生存率为92.0%、总生存率为88.0%；CIP2A表达、组织学分级、FIGO分期、肌层浸润深度、附件转移、脉管内癌栓及Ki-67增殖指数与患者预后不良相关（P＜0.05）。多因素分析显示，组织学分级、FIGO分期及脉管内癌栓是影响子宫内膜样腺癌患者预后生存的独立危险因素（P＜0.05）。结论:CIP2A在子宫内膜样腺癌中呈高表达，与患者总生存率下降相关，并非影响患者预后的独立危险因素。

Expression and clinical significance of CIP2A in endometrioid adenocarcinoma

Objective:To investigate the expression of CIP2A in endometrioid adenocarcinoma and its clinical significance.Methods:From January 2011 to March 2014,50 cases of endometrial adenocarcinoma (EAC),which were surgically excised and confirmed by pathology,and 40 cases of endometrial tissue samples of normal hyperplasia (NE) obtained by outpatient curettage were selected.CIP2A mRNA and protein levels in EAC and NE tissues were detected by RT-PCR and Western blot,and CIP2A positive expression was detected by immunohistochemistry.The difference of CIP2A expression in EAC and NE tissues and its correlation with the clinicopathological characteristics of endometrioid adenocarcinoma were analysed.Kaplan-Meier method was used to analyze the effect of different expression levels of CIP2A on the prognosis and survival of patients,and independent prognostic risk factors were analyzed by COX.Results:Immunohistochemical staining showed that CIP2A was highly expressed in endometrioid adenocarcinoma.Positive staining was localized in cytoplasm and nucleus,and the positive expression rate of CIP2A in EAC tissues was significantly higher than that in NE tissues (P＜0.01).RT-PCR and Western blot showed that the expression level of CIP2A mRNA and protein in EAC tissues was higher than that in NE tissues (P＜0.01).CIP2A expression was correlated with the clinicopathological characteristics of EAC,indicating that CIP2A expression was significantly correlated with EAC histological grade,FIGO stage,cervical canal involvement,p53 expression and Ki-67 proliferation index (P＜0.05).Kaplan-Meier prognostic analysis showed that the 5-year disease-free survival rate of EAC patients was 92.0% and the overall survival rate was 88.0%.CIP2A expression,histological grade,FIGO stage,muscle invasion depth,adnexal metastasis,intravascular thrombus and Ki-67 proliferation index were associated with poor prognosis (P＜0.05).Multivariate analysis showed that histological grade,FIGO stage and intravascular thrombus were independent risk factors affecting the prognosis and survival of endometrioid adenocarcinoma patients (P＜0.05).Conclusion:CIP2A is highly expressed in endometrioid adenocarcinoma and is associated with decreased overall survival,rather than an independent risk factor for prognosis.