子宫内膜癌DNA错配修复基因hMLH_1表达的研究

目的:探讨DNA错配修复基因hMLH1的表达与子宫内膜癌的关系。方法:选取1981年1月至2001年12月在天津医科大学总医院住院手术子宫内膜癌104例和正常子宫内膜35例(其中增生期17例,分泌期18例)及子宫内膜不典型增生8例,用免疫组化SABC法检测组织中hMLH1基因蛋白产物的表达,并对hMLH1蛋白表达与子宫内膜癌临床病理特征的关系进行了分析。结果:子宫内膜癌、子宫内膜不典型增生、正常子宫内膜增生期和分泌期hMLH1表达缺失率分别为64.4%、37.5%、11.8%和5.6%。子宫内膜癌组织中hMLH1的表达缺失率明显高于正常子宫内膜组织(P=0.0001);子宫内膜样腺癌、腺癌伴鳞状上皮分化、透明细胞癌和浆液性癌hMLH1表达缺失率分别为68.9%、50%、25%和0,在子宫内膜样腺癌中hMLH1基因表达缺失率明显高于其他组织学类型(P=0.02,P=0.003)。hMLH1基因表达缺失者5年生存率明显高于阳性表达者(P=0.012),遗传性子宫内膜癌、非特异肿瘤聚集性子宫内膜癌及散发性子宫内膜癌hMLH1蛋白表达缺失率分别为100%、94.1%及55%,遗传性及非特异肿瘤聚集性子宫内膜癌hMLH1基因表达缺失率明显高于散发性子宫内膜癌(P=0.02,P=0.003)。结论:hMLH1基因表达缺失与子宫内膜癌和子宫内膜不典型增生发生有关。hMLH1基因表达缺失与子宫内膜癌组织学类型中的子宫内膜样腺癌有关,hMLH1基因表达缺失者预后较好,且在遗传性子宫内膜癌患者中表达缺失率明显高于散发病例。

Study on the expression of hMLH1 gene in endometrial carcinoma

Objective:To study the relationship between the expression of hMLH_1 and endometrial carcinoma.Method:The expression of hMLH_1 gene with 104 cases endometrial carcinoma,35 cases normal endometrium(17 cases in proliferative,18 cases in secretary phase) and 8 cases atypical hyperplasia was measured by immunohistochemical technique.The relationship between the expression of hMLH_1 and clinicopathologic characteristics of endometrial carcinoma and hereditary endometrial carcinoma was analyzed.Results:Loss of hMLH_1 expression was 11.8% in normal proliferative endometrium,5.6% in nomal secretary endometrium,37.5%in atypical hyperplasia and 64.4% in endometrial carcinoma respectively.Loss of hMLH_1 expression in endometrial carcinoma was higher than that in normal endometrium(P=0.0001).Loss expression of hMLH_1 was significantly higher in endometriod carcinoma than that in other histologic types(P<0.05).Survival rate was higher in 5-year patients with negative expression of hMLH_1 than that with positive expression(P=0.012).The expression of hMLH_1was lower in hereditary endometrial carcinoma and aspecific cancer aggregates carcinoma than that in normal endometrial carcinoma(P=0.02,P=0.003 respectively).Conclusion:Loss of hMLH_1 expression may be related with the development of endometrial carcinoma and the rate of expression of hMLH_1 was lower in endometriod carcinoma.The prognosis of patients with negative expression of hMLH_1 is better.