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目的 研究卵巢粘液性肿瘤的神经内分泌分化与肿瘤病理组织学分型、分级、临床分期以及P5 3蛋白表达的关系。方法 应用免疫组织化学技术对 76例卵巢粘液性肿瘤 (良性 :2 0例 ,交界性 :2 4例 ,恶性 32例 )中的神经内分泌细胞的检出率、形态特点、分布方式以及P5 3蛋白表达进行了观察。结果 CgA检出率 ,良性、交界性和恶性肿瘤 ,分别是 4 5 0 %、83 3%、81 3% ,癌和交界瘤的阳性率显著大于良性瘤 (P <0 0 1) ,交界瘤和癌无差异 (P >0 0 5 ) ,囊腺癌各分级之间、不同临床分期之间无差异 (P >0 0 5 ) ,宫颈内膜样型和肠型之间无差异(P >0 0 5 )。P5 3蛋白表达阳性组 2 1例 ,阴性组 5 5例 ,CgA检出率分别是 85 7%、5 4 5 % ,P5 3蛋白阳性组的CgA阳性率显著大于阴性组 (P <0 0 2 5 )。CgA阳性细胞绝大多数与肿瘤细胞排列一致 ,形态相似。结论 卵巢粘液性肿瘤由良性向恶性转化过程中 ,神经内分泌细胞的检出率逐渐增加。神经内分泌细胞的检出率与P5 3蛋白的表达关系密切 ,表明在卵巢粘液性肿瘤中P5 3抑制基因的变化可能是影响神经内分泌细胞分化过程的重要因素。
Objective To investigate the relationship between neuroendocrine differentiation and the histopathological classification, classification, clinical stage and P53 protein expression in ovarian mucinous neoplasms. Methods Immunohistochemistry was used to detect the neuroendocrine cells in 76 cases of ovarian mucinous neoplasm (benign: 20 cases, borderline: 24 cases, malignant 32 cases), the morphological characteristics, distribution pattern and the expression of P53 protein Expression was observed. Results The positive rates of CgA, benign, borderline and malignant tumors were 45.0%, 83.3% and 81.3% respectively. The positive rates of carcinomas and borderline tumors were significantly higher than those of benign tumors (P <0.01) (P> 0.05). There was no difference between the different stages of the cystadenocarcinoma (P> 0.05), between the endometrial type and the intestinal type (P> 0 0 5). The positive rate of CgA in P5 3 protein positive group was significantly higher than that in negative group (P <0 02) 5). The majority of CgA positive cells were arranged in the same manner as the tumor cells with similar morphology. Conclusions The detection rate of neuroendocrine cells gradually increases from benign to malignant transformation in ovarian mucinous neoplasms. The detection rate of neuroendocrine cells is closely related to the expression of P53 protein, indicating that the change of P53 suppressor gene in ovarian mucinous neoplasms may be an important factor affecting the neuroendocrine cell differentiation process.