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目的研究卵巢上皮性癌(卵巢癌)和交界性上皮性肿瘤的临床病理特征及其细胞周期素 D1(cyclin D1)和 p53蛋白表达的情况,探讨卵巢癌和交界性上皮性肿瘤在发病机制上的联系。方法分析45例卵巢癌(卵巢癌组)和54例卵巢交界性上皮性肿瘤(交界性肿瘤组)的临床病理资料,采用免疫组化法检测两组组织中 cyclin D1、p53蛋白的表达情况,并分析其与临床病理特征的相关性。结果 (1)临床病理特征:①年龄:交界性肿瘤组平均年龄为42.5岁(14～82岁),中位数年龄41岁;卵巢癌组平均年龄为53.5岁(26～80岁),中位数年龄51岁。②分期:按国际妇产科联盟(FIGO)分期标准,交界性肿瘤组Ⅰ期48例、Ⅱ期3例、Ⅲ期3例;卵巢癌组Ⅰ期6例、Ⅱ期8例、Ⅲ期26例、Ⅳ期5例。③病理类型:交界性肿瘤组以黏液型为主[占56%(30/54)],其次为浆液型[其中普通型11例,微乳头型5例;占30%(16/54)];卵巢癌组以浆液型(其中低度恶性19例,高度恶性3例)为主[占49%(22/45)]。④病理分化程度:卵巢癌组高分化5例,中分化17例,低分化或未分化23例。⑤预后:交界性肿瘤组5年生存率为98%,卵巢癌组为51%,两组比较,差异有统计学意义(P=0.000)。(2)cyclin D1和 p53蛋白的表达及其与卵巢癌和交界性肿瘤临床病理特征的相关性:卵巢癌组 cyclin D1和 p53蛋白的阳性表达率分别为31%(14/45)和56%(25/45),p53蛋白表达强度与病理分化程度呈正相关(r=0.320,P=0.032);交界性肿瘤组 cyclin D1和 p53蛋白的阳性表达率分别为69%(37/54)和6%(3/54)。其中,普通型浆液性交界性肿瘤与高度恶性浆液性癌比较(两者cyclin D1蛋白阳性表达率分别为91%和26%,p53蛋白分别为0和58%),差异有统计学意义(P<0.01);而微乳头型浆液性交界性肿瘤与低度恶性浆液癌比较(两者 cyclin D1蛋白阳性表达率分别为3/5和2/3,p53蛋白分别为1/5和1/3),差异则无统计学意义(P>0.05)。结论 cyclin D1蛋白的过度表达常见于卵巢浆液性交界性肿瘤及低度恶性浆液性癌组织中,而 p53蛋白的过度表达更多见于高度恶性浆液性癌组织中。卵巢浆液性交界性肿瘤与高度恶性浆液性癌具有不同的发病机制,而微乳头型浆液性交界性肿瘤与低度恶性浆液性癌的关系可能更为密切。
Objective To investigate the clinicopathological features and the expressions of cyclin D1 and p53 protein in epithelial ovarian cancer and borderline epithelial ovarian cancer and to explore the pathogenesis of ovarian cancer and borderline epithelial tumor Contact. Methods The clinicopathological data of 45 cases of ovarian cancer (ovarian cancer) and 54 cases of borderline ovarian borderline tumor (borderline tumor) were analyzed. The expressions of cyclin D1 and p53 in the two groups were detected by immunohistochemistry, And analyze its correlation with clinicopathological features. Results (1) Clinicopathological features: ①Age: The average age of the borderline tumor group was 42.5 years (range, 14-82 years) with a median age of 41 years. The mean age of the ovarian cancer group was 53.5 years (range 26-80 years) Median age 51 years old. ② stage: According to the International Union of Obstetrics and Gynecology (FIGO) staging criteria, borderline tumor group Ⅰ 48 cases, Ⅱ 3 cases, Ⅲ 3 cases; ovarian cancer group Ⅰ 6 cases, Ⅱ 8 cases, Ⅲ 26 Cases, Ⅳ period in 5 cases. Pathological type: The majority of borderline tumors were mucoid (56% (30/54)), followed by serous type (11 cases of common type and 5 cases of micro-papillae, accounting for 30% (16/54)) ; Ovarian cancer group in the serous type (including 19 cases of low-grade malignant, 3 cases of highly malignant) [49% (22/45)]. ④ pathological differentiation: ovarian cancer group of 5 cases of well-differentiated, moderately differentiated in 17 cases, poorly differentiated or undifferentiated in 23 cases. ⑤ Prognosis: The 5-year survival rate of borderline tumor was 98% and that of ovarian cancer was 51%. There was significant difference between the two groups (P = 0.000). (2) The correlation between the expression of cyclin D1 and p53 protein and the clinicopathological features of ovarian cancer and borderline tumors: The positive rates of cyclin D1 and p53 in ovarian cancer were 31% (14/45) and 56% (25/45). There was a positive correlation between the expression of p53 protein and pathological differentiation (r = 0.320, P = 0.032). The positive rates of cyclin D1 and p53 protein in borderline tumors were 69% (37/54) % (3/54). Among them, the common serous borderline tumors were compared with high grade serous carcinoma (the positive rates of cyclin D1 protein were 91% and 26%, and the p53 proteins were 0 and 58% respectively) (P <0.01). The positive rate of cyclin D1 was 3/5 and 2/3, respectively, and the protein of p53 was 1/5 and 1/3 respectively ), The difference was not statistically significant (P> 0.05). Conclusion Overexpression of cyclin D1 protein is common in serous borderline ovarian tumors and low-grade serous carcinomas, whereas overexpression of p53 protein is found in more advanced malignant serous cancerous tissues. Ovarian serous borderline tumors and high-grade serous carcinoma have different pathogenesis, and the relationship between the sub-papillary serous borderline tumors and low-grade serous carcinoma may be more closely.