TMSG-1蛋白在子宫内膜腺癌中的表达及其临床意义

发布时间：2018-02-06 00:02

本文关键词： TMSG-1 子宫内膜癌免疫组织化学方法　出处：《昆明医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的本研究通免疫组织化学方法检查子宫内膜腺癌中TMSG-1蛋白的表达情况,分析其与子宫内膜腺癌的手术—病理分期、组织学分级、肌层浸润深度、淋巴结转移及年龄之间的关系,研究TMSG-1在子宫内膜腺癌中的发生、发展、浸润、转移中的作用及其对于临床诊断、治疗及预后评估的指导意义。方法随机选取昆明医科大学第一附属医院2010年2月——2013年8月妇科住院患者行子宫切除的正常子宫内膜及宫腔镜检查获得的正常子宫内膜15例(包括增殖期8例,分泌期7例)；子宫内膜增生症组27例(包括单纯增生12例,复杂增生10例,非典型性增生5例)；子宫内膜腺癌65例：根据国际妇产科联盟(FIGO2009)手术-病理分期标准进行分期,I期39例,II期11例,ⅡI和Ⅳ期共15例；病理分级：高分化(G1期)23例,中分化(G2期)28例,低分化(G3期)14例；肌层浸润1/238例,≥1/227例；有淋巴转移者10例,无淋巴转移者55例；患者年龄50岁者22例,≥50岁者43例。所有标本均经昆明医科大学第一附属医院病理科-手术病理确诊,术前均未接受放疗、化疗或任何激素治疗。采用免疫组织化学的方法测定TMSG-1蛋白在正常子宫内膜、子宫内膜增生症、子宫内膜腺癌组织中表达的情况,从而分析TMSG-1与子宫内膜腺癌的手术—病理分期、组织学分级、肌层浸润深度、淋巴结转移及年龄之间的关系,探讨TMSG-1与子宫内膜腺癌的发生、发展、浸润及转移的关系。结果1、经免疫组化检查证实TMSG-1蛋白在各组的子宫内膜组织中均有表达,其主要表达在胞质、少量表达于胞核。2、TMSG-1蛋白在正常子宫内膜组、子宫内膜增生症组、子宫内膜腺癌组中的阳性表达率逐渐降低,在子宫内膜腺癌中的阳性表达率(67.70%)明显低于子宫内膜增生症组(96.30%)及正常子宫内膜组(100%),有统计学意义(p0.05,p0.05)。在正常子宫内膜和子宫内膜增生症组中的阳性表达率,差异无统计学意义(P=0.05)。3、TMSG-1蛋白在子宫内膜增生症组中非典型增生的阳性表达率(80.00%)低于复杂性增生(100.00%)及单纯性增生(100.00%),差异均无统计学意义(P0.05)。4、TMSG-1蛋白在子宫内膜腺癌组中的阳性表达率与组织学分级、肌层浸润深度及淋巴结转移密切相关,差异有统计学意义,p均0.05。低分化组的阳性表达率(28.57%)明显低于中分化组的阳性表达率(60.71%)及高分化组的阳性表达率(95.66%),子宫内膜腺癌深肌层浸润组(≥1/2)中的阳性表达率(28.6%)明显低于无肌层浸润及浅肌层浸润组(1/2)的阳性表达率(55.6%)。有淋巴结转移组中的TMSG-1蛋白的阳性表达率(20.00%)明显低于无淋巴结转移组(76.37%)。5、TMSG-1蛋白在子宫内膜腺癌组中的阳性表达率与手术-病理分期及患者年龄无明显相关性,差异无统计学意义,p0.05。Ⅲ和Ⅳ期病例中的阳性表达率(46.67%),II期病例的阳性表达率(54.56%),I期病例阳性表达率(79.49%)。患者年龄50岁的阳性表达率(68.19%),年龄≥50岁的阳性表达率(67.44%) 结论TMSG-1蛋白在正常子宫内膜组织、子宫内膜增生症组织和子宫内膜腺癌组织中存在差异性表达。TMSG-1蛋白在子宫内膜腺癌的恶性进展中表达逐渐下调,提示TMSG-1蛋白的低表达在子宫内膜腺癌的发生发展中起着重要作用。这将为子宫内膜癌的治疗提供新的临床治疗靶点,有望成为子宫内膜癌恶性程度评估,转移预测和判断预后的有效指标。
[Abstract]:Objective To study the relationship between the expression of TMS - 1 protein in endometrial adenocarcinoma by immunohistochemical method and to analyze its relationship with the operation - pathological stage , histological grade , muscular layer invasion depth , lymph node metastasis and age of endometrial adenocarcinoma , and to study the role of TMS320C6G - 1 in the pathogenesis , development , invasion and metastasis of endometrial adenocarcinoma and its significance for clinical diagnosis , treatment and prognosis evaluation . Methods A total of 15 cases of normal endometrium ( including 8 cases of proliferative phase , 7 cases of secretory phase ) and 15 cases of endometriosis ( including 12 cases of hyperplasia stage , 10 cases of complicated hyperplasia , 5 cases of atypical hyperplasia ) were randomly selected in the first affiliated hospital of Kunming Medical University . Results 1 . The positive expression rate ( 67.70 % ) in endometrial adenocarcinoma was significantly lower than that in the normal endometrium ( 96.30 % ) and the normal endometrium ( 100 % ) , which was significantly lower than that in the normal endometrium ( P < 0.05 , p < 0.05 ) . There was no significant difference between the positive rate of expression and histological grade , the positive expression rate and the positive expression rate in the patients with endometrial adenocarcinoma than that in the group without lymph node metastasis ( P 0.05 ) . The positive rate of expression of the protein in the endometrial adenocarcinoma was significantly lower than that in the non - lymph node metastasis group ( P 0.05 ) . Conclusion The expression of TMS G - 1 protein in the malignant progression of endometrial adenocarcinoma is gradually down regulated , suggesting that the low expression of TMS320C646 plays an important role in the development of endometrial adenocarcinoma . This will provide a new target for the treatment of endometrial carcinoma , which is expected to be an effective index for the assessment , metastasis prediction and prognosis of endometrial carcinoma .

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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