ING4、ER、PR、Ki-67在子宫内膜腺癌中的表达及临床意义

发布时间：2018-03-01 21:23

本文关键词： 子宫内膜腺癌 ER PR Ki-67 ING4 免疫组织化学　出处：《石河子大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:检测ING4、ER、PR、Ki-67在不同子宫内膜组织中的表达,分析其与子宫内膜腺癌临床特征及预后的关系,探讨在子宫内膜腺癌发生、发展过程中的意义,为子宫内膜腺癌的早期诊断、临床治疗方案的选择提供理论依据。方法:回顾性分析2008年1月-2013年1月在石河子大学医学院第一附属医院妇科行手术治疗并有病理诊断的子宫内膜腺癌患者的组织蜡块,根据术后病理诊断进行分组,其中对照组为非瘤子宫内膜组织,共20例,病例组为非典型增生子宫内膜组织39例及子宫内膜腺癌组织76例。分别分析ING4、ER、PR、Ki-67的表达水平与子宫内膜腺癌临床特征之间的关系,对其生存率进行回访,并分析各蛋白在子宫内膜腺癌中表达的相关关系。采用SPSS 21.0进行统计分析。结果:1.子宫内膜腺癌组织ER表达阳性率为48.7%(37/76),低于不典型增生型子宫内膜组织76.3%(29/38)和非瘤子宫内膜组织95.0%(19/20),在不同组织学分级、病理分型、临床分期的子宫内膜腺癌患者组织中ER的表达差异有统计学意义(P0.05)。ER阳性者的生存率明显高于ER表达阴性的患者,差异有统计学意义(P0.05)。2.PR在子宫内膜腺癌组织中阳性率为53.9%(41/76),低于不典型增生型子宫内膜组织71.1%(27/38)和非瘤子宫内膜组织90.0%(18/20),在不同组织学分级、病理分型、临床分期、肿瘤大小、肿瘤肌层浸润深度的子宫内膜腺癌患者组织中PR的表达差异有统计学意义(P0.05)。PR阳性者的生存率明显高于PR阴性者,差异有统计学意义(P0.05)。3.Ki-67在子宫内膜腺癌组织中阳性表达率为69.7%(53/76),高于不典型增生型子宫内膜组织34.2%(13/38)和非瘤子宫内膜组织10.0%(2/20),在不同组织学分级、临床分期的子宫内膜腺癌患者组织中Ki-67的表达差异有统计学意义(P0.05)。Ki-67阳性者的生存率与Ki-67阴性者无明显差异,差异没有统计学意义(P0.05)。4.子宫内膜腺癌组织ING4表达阳性率为55.3%(42/76),低于不典型增生型子宫内膜组织89.5%(34/38)和非瘤子宫内膜组织100%(20/20),ING4蛋白在不同组织学分级、病理分型、临床分期的子宫内膜腺癌组织中的表达差异有统计学意义(P0.05)。ING4阳性者的生存率与ING4阴性者无明显差异,差异没有统计学意义(P0.05)。5.子宫内膜腺癌组织中ER与PR的表达呈正相关(r=0.425,P=0.000),ER与ING4的表达呈正相关(r=0.241,P=0.036)。结论:1.ER、PR及ING4在子宫内膜腺癌组织中呈低表达;而Ki-67在子宫内膜腺癌组织中高表达,表明四者的表达均参与了子宫内膜腺癌的发生、发展过程。2.ER、PR、Ki-67及ING4在子宫内膜腺癌的表达在一定程度上反映出肿瘤的进展及恶性程度,对肿瘤的临床诊断及治疗方案的选择可以起到一定程度的指导作用。3.ER、PR与子宫内膜腺癌的生存率呈显著相关。
[Abstract]:Objective: to detect the expression of PRKI-67 in different endometrial tissues, analyze its relationship with the clinical features and prognosis of endometrial adenocarcinoma, and explore its significance in the occurrence and development of endometrial adenocarcinoma, which is the early diagnosis of endometrial adenocarcinoma. Methods: from January 2008 to January 2013, the tissue wax masses of patients with endometrial adenocarcinoma who underwent surgical treatment and pathological diagnosis in the first affiliated Hospital of Shihezi University Medical College were retrospectively analyzed. According to the postoperative pathological diagnosis, 20 cases were divided into two groups: the control group (n = 20) was nontumorous endometrial tissue. There were 39 cases of atypical hyperplasia endometrium and 76 cases of endometrial adenocarcinoma. The relationship between the expression of PRKi-67 and clinical characteristics of endometrial adenocarcinoma was analyzed, and the survival rate was reviewed. The positive rate of ER expression in endometrial adenocarcinoma was 48.7 / 37 / 76, which was lower than that in atypical hyperplasia endometrial tissue (76.33 / 29 / 38) and non-neoplastic endometrial tissue (P < 0.01). The endometrial tissue, 95.0 / 20, is graded in different histology. The difference of ER expression in patients with endometrial adenocarcinoma was statistically significant. The survival rate of patients with positive P0.05 or ER was significantly higher than that of patients with negative expression of ER. The difference was statistically significant in the positive rate of P0.05, PR in endometrial adenocarcinoma tissues was 53.9%, which was lower than that in atypical hyperplasia endometrial tissues (71.1% 27 / 38) and non-tumorous endometrial tissues (90.018% 20%), and in different histological grades, pathological types, clinical stages, tumor size. There was significant difference in the expression of PR in endometrial adenocarcinoma with the depth of myometrial invasion. The survival rate of patients with positive P0.05 or PR was significantly higher than that of patients with negative PR. The positive expression rate of Ki-67 in endometrial adenocarcinoma was 69.7%, which was higher than that in atypical hyperplasia endometrial tissue (34.2x 13 / 38) and non-neoplastic endometrial tissue (10.0% / 20%), and was graded in different histological grades. There was no significant difference in the expression of Ki-67 between the patients with positive P0.05 and Ki-67 and those with negative Ki-67. The positive rate of ING4 expression in endometrial adenocarcinoma was 55.3%, which was lower than that in atypical hyperplasia endometrial tissue (89.55 / 34 / 38) and non-neoplastic endometrial tissue (100% 20 / 20% 20 / 20% ING4) in different histological grade and pathological type. The positive rate of ING4 expression in endometrial adenocarcinoma was 55.3%, which was significantly lower than that in atypical hyperplasia endometrial tissue (89.55 / 34 / 38) and non-neoplastic endometrial tissue (100% 20% 20% ING4). There was no significant difference in the survival rate between the patients with positive P0.05N. ING4 and those with negative ING4 in clinical staging of endometrial adenocarcinoma. There was no significant difference in the expression of ER and PR in endometrial adenocarcinoma tissues. There was a positive correlation between ER and PR expression in endometrial adenocarcinoma tissues. There was a positive correlation between ER and ING4 expression in endometrial adenocarcinoma tissues. Conclusion: 1. The expression of PR and ING4 in endometrial adenocarcinoma tissues is low, while Ki-67 is highly expressed in endometrial adenocarcinoma tissues. The expression of PRKI-67 and ING4 in endometrial adenocarcinoma reflects to some extent the progression and malignancy of endometrial adenocarcinoma. The selection of clinical diagnosis and treatment of tumor may play a guiding role to some extent. 3. ERP has a significant correlation with the survival rate of endometrial adenocarcinoma.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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