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目的:检测正常子宫内膜、子宫内膜增生症及子宫内膜腺癌组织中Annexin A1、P16及CDK4蛋白的表达,探讨其与子宫内膜腺癌发生、发展的关系。方法:应用免疫组化S-P法检测30例正常子宫内膜组织、31例单纯型增生过长、29例子宫内膜腺瘤型增生过长、32例子宫内膜不典型增生过长、66例子宫内膜腺癌组织中Annexin A1、P16及CDK4蛋白表达。结果:在正常子宫内膜(增生期)、子宫内膜增生症(单纯型增生过长、腺瘤型增生过长、不典型增生过长)、子宫内膜腺癌组织中Annexin A1(χ2=50.421,P=0.000)、P16蛋白(χ2=25.929,P=0.000)的阳性表达率依次递减,差异有统计学意义;CDK4蛋白的阳性表达率依次递增,差异有统计学意义(χ2=35.219,P=0.000)。Fisher精确概率检验显示不同肌层浸润组、不同手术病理分期、不同组织病理分级及淋巴结是否转移组的AnnexinA1、P16及CDK4蛋白的表达差异无统计学意义,而Annex-inA1阴性、P16阴性并CDK4阳性者的比例随手术病理分期、组织病理分级的升高而增加,差异有统计学意义(χ2=8.736,P=0.013,χ2=8.071,P=0.018)。Spearman等级相关分析显示Annexin A1和P16蛋白在内膜癌组织中表达呈正相关(r=0.895,P<0.001);Annexin A1和CDK4蛋白在内膜癌组织中表达呈负相关(r=-0.935,P<0.001);P16和CDK4蛋白在内膜癌组织中表达呈负相关(r=-0.912,P<0.001)。结论:Annexin A1、P16及CDK4蛋白表达与子宫内膜腺癌的发生相关,An-nexin A1可能成为子宫内膜组织早期癌变的分子标记物。
OBJECTIVE: To detect the expression of Annexin A1, P16 and CDK4 in normal endometrium, endometrial hyperplasia and endometrial adenocarcinoma, and to explore its relationship with the occurrence and development of endometrial adenocarcinoma. Methods: Thirty cases of normal endometrium were examined by immunohistochemical SP method, 31 cases of simple hyperplasia, 29 cases of endometrial adenoma hyperplasia, 32 cases of endometrial dysplasia, 66 cases Expression of Annexin A1, P16 and CDK4 in Endometrial. Results: In normal endometrium (proliferative stage), endometrial hyperplasia (simple hyperplasia, adenoma hyperplasia, atypical hyperplasia), endometrial adenocarcinoma Annexin A1 (χ2 = 50.421, P = 0.000). The positive expression rates of P16 protein (χ2 = 25.929, P = 0.000) decreased gradually with the difference statistically significant. The positive expression rates of CDK4 protein increased in turn with statistical significance (χ2 = 35.219, P = 0.000). Fisher exact test showed that there was no significant difference in the expression of Annexin A1, P16 and CDK4 between different myometrial invasion groups, different surgical pathological stages, histological grading and lymph node metastasis, while Annex-inA1 negative, P16 negative and CDK4 The positive ratio increased with the pathological stage and histopathological grade (χ2 = 8.736, P = 0.013, χ2 = 8.071, P = 0.018). Spearman rank correlation analysis showed that there was a positive correlation between the expression of Annexin A1 and P16 in endometrial carcinoma (r = 0.895, P <0.001). The expression of Annexin A1 and CDK4 in endometrial carcinoma was negatively correlated (r = -0.935, P <0.001). The expression of P16 and CDK4 protein in endometrial carcinoma was negatively correlated (r = -0.912, P <0.001). Conclusion: The expressions of Annexin A1, P16 and CDK4 are correlated with the occurrence of endometrial adenocarcinoma. An-nexin A1 may be the molecular marker of early carcinogenesis of endometrial tissue.