微血管密度、细胞增殖指数与子宫肉瘤生存分析探讨

目的:通过检测原始造血细胞抗原(CD34)和DNA拓扑异构酶IIα(TopoⅡα)的表达水平,反映子宫肉瘤生长、转移、复发的临床特点,探讨两种标记物用于监测子宫肉瘤病情及判断预后的意义。方法:应用免疫组织化学(IHC)法检测子宫肉瘤中CD34、TopoⅡα的表达水平。结果:除病理类型及分期外,CD34和TopoⅡα表达与患病年龄、初潮年龄、孕产次、月经周期及经期、是否绝经无关。低微血管密度(MVD)组和低细胞增殖指数(LI)组患者经不同范围的手术治疗,生存期有差别。手术治疗+辅助治疗组的两种标记物低值组与高值组对生存期的影响无统计学意义。高值组总体生存率低于低值组,Log-Rank检验,P分别为0.0035和0.0039。Cox模型多因素回归分析示:子宫肉瘤预后与病理类型、分期、是否切除双侧卵巢、TopoⅡα、CD34表达有关,与其它临床病理特征无关。结论:CD34-MVD可能是反映子宫肉瘤侵袭转移的特异性指标。TopoⅡα有望作为子宫肉瘤细胞增殖的特异性标记物。

Microvessel density and cell proliferation index in the approach of survival analysis in uterine sarcoma

Objective：By detecting the expression levels ofthe antigens of CD34 and toposimerase Ⅱα （Topo Ⅱα）, we evaluate the biological behaviour about invasive growth, anglogenesis and cell proliferation of sarcoma of uterus, exploring the significance of pathogenetic condition＇s mortoring and judging the prognosis of patient. Methods：The expression of Topo Ⅱα and CD34 were detected using immunohistochemistry （IHC）. Results：The expression of CD34 and Topo Ⅱα were not correlated with patients ＇ age, menarche age, gravidity and parity, condition of menstruation and menopause, being correlated with pathological category and staging. The survival time of low LI group of Topo Ⅱα and low MVD group of CD34 in different operational extents was different. The survival time of low value group in different therapic manner was not conspicuous different. The result of high value group was same. Overall survival rate of high value group was lower than one of low value group noticeablly. Probability value was 0. 0035 and 0.0039 by Log-Rank Test. The result of multiple factor analysis of Cox model was correlated with pathological category, pathological staging, bilateral oophorectomy and the expressions of Topo Ⅱα and CD34, being not correlated with other clinical and pathological features. Conclusions： CD34-MVD is specific marker in reflecting about invasive and metabasis behaviour in sarcoma of uterus. Topo Ⅱα can be specifice marker in reflecting cell proliferation state in uterine sarcoma.