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目的:研究PTEN与HER-2在子宫内膜样腺癌中的表达、临床意义及相互关系。方法:利用免疫组织化学技术检测15例正常增生期子宫内膜、45例子宫内膜增殖症及48例子宫内膜样腺癌组织中PTEN、HER-2的表达。结果:与正常增生期子宫内膜及子宫内膜增殖症组织相比较,子宫内膜样腺癌组织PTEN阳性表达率明显降低,差异有极显著性(χ2=10.732,P<0.01);HER-2阳性表达率明显升高,差异有极显著性(χ2=7.269,P<0.01)。PTEN与组织学分级有关(χ2=4.075,P<0.05),与肌层侵润及临床分期无关(均P>0.05);HER-2与组织学分级、肌层侵润有关(χ2=12.306,P<0.05;χ2=15.791,P<0.01),与临床分期无关(χ2=0.000,P>0.05)。PTEN的阳性表达与HER-2的过度表达呈负相关(r=-0.9,P<0.05)。结论:PTEN的表达缺失及HER-2的过度表达在子宫内膜样腺癌的发生、发展中具有一定意义。PTEN表达缺失是早期诊断子宫内膜样腺癌的标记物;HER-2的过度表达是子宫内膜样腺癌预后不良的指征;PTEN的失表达与HER-2的过度表达在子宫内膜样腺癌的发生、发展过程中可能存在某种协同效应。
Objective: To investigate the expression, clinical significance and correlation of PTEN and HER-2 in endometrial adenocarcinoma. Methods: Immunohistochemistry was used to detect the expression of PTEN and HER-2 in 15 cases of normal proliferative endometrium, 45 cases of endometrial hyperplasia and 48 cases of endometrial adenocarcinoma. Results: The positive expression rate of PTEN in endometrial adenocarcinoma was significantly lower than that in normal proliferative endometrium and endometrial hyperplasia (χ2 = 10.732, P <0.01); HER- 2 positive expression rate was significantly higher, the difference was significant (χ2 = 7.269, P <0.01). PTEN was associated with histological grade (χ2 = 4.075, P <0.05), but not with invasion and clinical stage of myometrial invasion (all P> 0.05). The expression of HER-2 was correlated with histological grade and myometrial invasion (χ2 = P <0.05; χ2 = 15.791, P <0.01), but not related to clinical stage (χ2 = 0.000, P> 0.05). The positive expression of PTEN was negatively correlated with the overexpression of HER-2 (r = -0.9, P <0.05). CONCLUSION: The loss of PTEN expression and the overexpression of HER-2 have some significance in the development and progression of endometrial adenocarcinoma. Loss of PTEN expression is an early marker of endometrial adenocarcinoma; overexpression of HER-2 is an indication of poor prognosis in endometrioid adenocarcinoma; overexpression of PTEN and overexpression of HER-2 in endometrial Like adenocarcinoma, the development process may have some synergistic effect.