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目的:探讨MDM2和TBX2基因在正常增殖期子宫内膜、子宫内膜增殖症和子宫内膜样腺癌组织中的表达和临床意义。方法:采用免疫组织化学链菌素亲生物素基因过氧化物酶连接法(SP法)和组织芯片技术检测20例增殖期子宫内膜、41例子宫内膜增生性病变和45例子宫内膜样腺癌中MDM2和TBX2基因的表达情况。结果:MDM2在增殖期子宫内膜和单纯性增生子宫内膜中均无强阳性表达,复杂性增生子宫内膜和子宫内膜样腺癌中MDM2强阳性表达率分别为23.81%和51.11,明显高于增殖期子宫内膜和单纯性增生子宫内膜(P<0.05)。子宫内膜样腺癌中MDM2的强阳性表达率为51.11%(23/45),明显高于复杂性增生子宫内膜和复杂性非典型增生中的子宫内膜(P<0.05)。子宫内膜样腺癌中MDM2强阳性表达与肿瘤分化程度和TNM分期密切相关,Ⅱ、Ⅲ级子宫内膜样腺癌的强阳性表达率明显高于I级(72.41%vs 13.33%,P<0.05),而与淋巴结转移无相关性(P>0.05)。TBX2在增殖期子宫内膜,单纯性增生子宫内膜,复杂性增生子宫内膜,子宫内膜样腺癌中的阳性表达率分别为30%,35%,45%和72.7%。子宫内膜样腺癌中TBX2基因的阳性表达明显高于其它各组(P<0.05)。TBX2与子宫内膜样腺癌分化程度、TNM分期均有相关性(P<0.05),与有无淋巴结转移均无相关性(P>0.05)。结论:MDM2、TBX2基因在复杂性增生宫内膜和子宫内膜样腺癌中表达明显增强,提示两者在子宫内膜样腺癌发生中起到一定作用。
Objective: To investigate the expression and clinical significance of MDM2 and TBX2 gene in normal proliferative phase of endometrium, endometrial hyperplasia and endometrioid adenocarcinoma. Methods: 20 cases of proliferative endometrium, 41 cases of endometrial hyperplastic lesions and 45 cases of endometrial carcinoma were detected by immunohistochemical streptavidin biotin peroxidase (SP method) and tissue microarray technique Expression of MDM2 and TBX2 genes in adenoid carcinomas. Results: MDM2 had no strong positive expression in proliferating endometrium and simple hyperplasia endometrium. The strong positive rates of MDM2 in complex proliferative endometrium and endometrioid adenocarcinoma were 23.81% and 51.11 respectively Higher than proliferative endometrium and simple proliferative endometrium (P <0.05). The strong positive expression rate of MDM2 in endometrioid adenocarcinoma was 51.11% (23/45), which was significantly higher than that in complex endometrial hyperplasia and complex atypical hyperplasia (P <0.05). The strong positive expression of MDM2 in endometrioid adenocarcinoma was closely related to the degree of tumor differentiation and TNM stage. The strong positive expression rate of endometrial adenocarcinoma of grade II and III was significantly higher than that of grade I (72.41% vs 13.33%, P < 0.05), but no correlation with lymph node metastasis (P> 0.05). The positive rates of TBX2 in proliferating endometrium, simple hyperplasia endometrium, complex hyperplasia endometrium and endometrioid adenocarcinoma were 30%, 35%, 45% and 72.7% respectively. The positive expression of TBX2 gene in endometrioid adenocarcinoma was significantly higher than that in other groups (P <0.05). There was no significant correlation between the expression of TBX2 and the degree of differentiation of endometrioid adenocarcinoma and TNM staging (P <0.05), with or without lymph node metastasis (P> 0.05). Conclusion: The expression of MDM2 and TBX2 genes in complex proliferative endometrium and endometrioid adenocarcinoma was significantly increased, suggesting that both play a role in the pathogenesis of endometrial adenocarcinoma.