AdipoR1、AdipoR2和IRS-1在子宫内膜样腺癌中的表达及临床意义

发布时间：2018-04-26 21:33

本文选题：子宫内膜样腺癌 + 脂联素受体　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨脂联素受体(AdipoR1、Adipo R2)和胰岛素受体底物1(IRS-1)在子宫内膜样腺癌组织中的表达与临床病理特征的关系及临床意义。方法:应用免疫组织化学Max Vision法检测80例子宫内膜腺癌组织、26例不典型增生组织、23例正常子宫内膜组织中AdipoR1、Adipo R2和IRS-1的表达情况,并分析AdipoR1、AdipoR2和IRS-1与子宫内膜腺癌临床病理特征的关系。统计学上计数资料采用卡方检验或四格表Fisher确切概率法及Spearman等级相关分析。结果:AdipoR1在子宫内膜腺癌、不典型增生、正常子宫内膜组织中均有表达,阳性表达率分别为62.5%、73.1%和91.3%,子宫内膜腺癌组阳性率低于正常子宫内膜组(P0.05),内膜癌组与不典型增生组阳性表达率差异无统计学意义。Adipo R2在子宫内膜腺癌、不典型增生、正常子宫内膜组织中阳性表达率分别为67.5%、76.9%和95.7%,子宫内膜腺癌组阳性率低于正常子宫内膜组(P0.05),内膜癌组与不典型增生组阳性表达率差异无统计学意义。IRS-1在子宫内膜腺癌、不典型增生、正常子宫内膜组织阳性表达率分别为72.5%、80.7%和69.6%,三组间相互比较差异无统计学意义。在子宫内膜腺癌中,AdipoR1的低表达与FIGO分期、病理分级、肌层浸润深度、淋巴结转移、淋巴脉管受累有关。AdipoR2的低表达与组织分化程度有关,与其他临床病理特征无明显相关性。IRS-1的高表达与FIGO分期、病理分级、淋巴结转移有关。相关性分析显示,AdipoR1与PR的表达呈正相关;AdipoR1、AdipoR2与P53的表达呈负相关,而与ER、Ki-67的表达无明显相关性。IRS-1与P53、Ki-67的表达呈正相关。AdipoR1与AdipoR2的表达呈正相关,AdipoR1、AdipoR2与IRS-1的表达呈负相关。结论:AdipoR在正常子宫内膜、不典型增生、子宫内膜腺癌组织中的表达呈递减趋势,IRS-1表达无明显差异,AdipoR与子宫内膜样腺癌的发生有关。AdipoR表达下降、IRS-1表达增高可能与子宫内膜腺癌的发展、浸润、转移有关,AdipoR起抑制作用,而IRS-1可能起促进作用,其中主要作用可能是通过AdipoR尤其是Adipo R1来实现。检测AdipoR和IRS-1的表达对预测肿瘤的生物学行为具有一定的意义。
[Abstract]:Objective: to investigate the relationship between the expression of adiponectin receptor AdipoR1 (Adipo R2) and insulin receptor substrate 1 (IRS-1) in endometrial adenocarcinoma and its clinical significance. Methods: immunohistochemical Max Vision method was used to detect the expression of AdipoR1 Adipo R2 and IRS-1 in 23 normal endometrial tissues from 26 cases of atypical hyperplasia in 80 cases of endometrial adenocarcinoma. The relationship between AdipoR _ 2 and IRS-1 and clinicopathological features of endometrial adenocarcinoma was analyzed. Statistically counting data were analyzed by chi-square test or Fisher exact probability method and Spearman rank correlation analysis. Results in endometrial adenocarcinoma, atypical hyperplasia and normal endometrial tissues, the expression of 1% AdipoR1 was found in normal endometrium. The positive expression rates were 62.5% and 91.3%, respectively. The positive rate of endometrial adenocarcinoma was lower than that of normal endometrium (P 0.05). There was no significant difference between endometrial carcinoma group and atypical hyperplasia group. Adipo R2 had no significant difference in endometrial adenocarcinoma and atypical hyperplasia. The positive rate of positive expression in normal endometrium was 67.5% and 95.77.The positive rate of endometrial adenocarcinoma was lower than that of normal endometrium (P 0.05). There was no significant difference in positive expression of IRS-1 between endometrial carcinoma group and atypical hyperplasia group. The positive expression rates of atypical hyperplasia and normal endometrium were 72.5% and 69.6% respectively. There was no significant difference among the three groups. The low expression of AdipoR1 in endometrial adenocarcinoma was related to FIGO stage, pathological grade, depth of myometrial invasion, lymph node metastasis and lymphatic vascular involvement. There was no significant correlation with other clinicopathological features. The high expression of IRS-1 was related to FIGO stage, pathological grade and lymph node metastasis. Correlation analysis showed that the expression of AdipoR1 and PR was positively correlated with the expression of AdipoR1AdipoR2 and p53, but not with the expression of ERPKi-67. IRS-1 was positively correlated with the expression of P53 Ki-67. AdipoR1 was positively correlated with the expression of AdipoR2. AdipoR1AdipoR2 was negatively correlated with the expression of IRS-1. ConclusionAdipoR is atypical hyperplasia in normal endometrium. There was no significant difference in the expression of IRS-1 between endometrial adenocarcinoma and endometrial adenocarcinoma. The decrease of IRS-1 expression in endometrial adenocarcinoma may be related to the development, invasion and metastasis of endometrial adenocarcinoma. IRS-1 may play a catalytic role, and the main role may be achieved through AdipoR, especially Adipo R1. Detection of the expression of AdipoR and IRS-1 may be helpful to predict the biological behavior of tumor.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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