BRCA1与EGFR在子宫内膜癌中的表达及意义

发布时间：2018-04-29 13:39

本文选题：子宫内膜癌 + BRCAl　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：检测乳腺癌易感基因1（BRCAl）及表皮生长因子（EGFR）在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌中（Endometrial Cancer,EC）的表达，探讨它们与子宫内膜癌发生发展的关系。方法：采用免疫组化链霉菌抗生物素蛋白-过氧化物酶(Streptavidin-peroxidase,S-P)法检测BRCAl、EGFR在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌组织中的表达情况,并结合年龄、绝经与否、手术病理分期、组织学分级、淋巴结转移、肌层浸润深度等临床病理特征及随访资料进行分析。结果：（1）BRCAl在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌组织中的阳性表达率分别为90％(36/40)；66.7%(20/30)；31.7%(19/60)，各组间差异有统计学意义(P0.05)；EGFR在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌组织中的阳性表达率分别为30％(12/40)；36.7%(11/30)；73.3%(44/60)。各组间差异有统计学意义(P0.05)。（2）子宫内膜癌中BRCAl基因的阳性表达率在不同年龄组间，绝经与否组间差异有统计学意义(P0.05)。BRCA1阳性表达与组织学分级、手术病理分期、淋巴结转移、肌层浸润深度有关（P0.05）。随着组织学分级的增加，BRCAl的表达降低(P0.05)。（3）EGFR的阳性表达与绝经与否、手术病理分期、淋巴结转移、肌层浸润深度有关（P均0.05），而与年龄、组织学分级无关（P＞0.05）。（4）子宫内膜癌中BRCAl、EGFR之间的表达呈负相关(r=-0.319,P=0.013＜0.05)。（5）Kplan-Meier生存分析： BRCA1、EGFR的表达及组织学分级与子宫内膜癌预后有关(P0.05)。（6）Cox回归模型分析显示： EGFR与组织学分级为影响子宫内膜癌预后的因素(P0.05)。结论： 1. BRCA1在子宫内膜癌中呈低表达，与子宫内膜癌的组织学分级、手术病理分期、浸润深度、淋巴结转移有关，可能可以作为预测肿瘤的恶性程度及不良预后的指标。 2.EGFR在子宫内膜癌中呈高表达，与子宫内膜癌的手术病理分期、浸润深度、淋巴结转移有关，可能可以作为评估肿瘤的恶性程度及预后的指标。 3.BRCA1和EGFR在子宫内膜癌中的表达呈负相关，EGFR阳性表达越高，BRCA1阳性表达则越低。两者可能共同参与了子宫内膜癌的疾病恶性进展过程及不良预后，，对子宫内膜癌的预后及术后的治疗可能有一定的指导作用。
[Abstract]:Objective: To detect the expression of breast cancer susceptibility gene (BRCAl) and epidermal growth factor (EGFR) in normal endometrium, endometrial atypical hyperplasia and endometrial carcinoma, and to explore the relationship between them and the occurrence and development of endometrial carcinoma. Methods: The expression of BRCAl-EGFR in normal endometrium, endometrial atypical hyperplasia, endometrial carcinoma and age, menopausal or not was detected by immunohistochemical streptavidin-peroxidaseS-Phosphorimetric method. The expression of BRCAl-EGFR in normal endometrium, endometrial atypical hyperplasia and endometrial carcinoma was determined by age, menopause or not, and the stage of operation and pathology. Histological grade, lymph node metastasis, depth of myometrial invasion and other clinicopathological features and follow-up data were analyzed. Results: The positive expression rates of BRCAl in normal endometrium, endometrial atypical hyperplasia, endometrial carcinoma and endometrial carcinoma were 90 / 36 / 40 / 66.7 and 20 / 30 / 31.7 / 19 / 60, respectively. There were significant differences between the two groups in the expression of EGFR in normal endometrium and endometrial atypical hyperplasia. The positive expression rates in endometrial carcinoma were 30 / 12 / 40 / 36.7 / 11 / 30 / 73.3 / 40 / 60 respectively. The difference among the groups was statistically significant (P 0.05). (2) the positive expression rate of BRCAl gene in endometrial carcinoma was significantly different between postmenopausal and postmenopausal groups. The positive expression of BRCAl gene was correlated with histological grade, surgical stage, lymph node metastasis and depth of myometrium invasion. With the increase of histological grade, the expression of BRCAl decreased (P 0.05). The positive expression of EGFR was correlated with menopausal stage, pathological stage, lymph node metastasis and depth of myometrial invasion (P < 0.05), but had no correlation with age and histological grade (P > 0.05). (4) there was a negative correlation between the expression of BRCAlN and EGFR in endometrial carcinoma. Kplan-Meier survival analysis: the expression and histological grade of EGFR in BRCA1 were related to the prognosis of endometrial carcinoma (P 0.05). EGFR and histological grade were the factors influencing the prognosis of endometrial carcinoma (P 0.05). Conclusion: 1. The low expression of BRCA1 in endometrial carcinoma is related to histological grade, pathological stage, depth of invasion and lymph node metastasis, which may be used as an index to predict the malignant degree and poor prognosis of endometrial carcinoma. The high expression of 2.EGFR in endometrial carcinoma is related to the pathological stage, depth of invasion and lymph node metastasis of endometrial carcinoma. It may be used as an index to evaluate the malignant degree and prognosis of endometrial carcinoma. The expression of 3.BRCA1 and EGFR in endometrial carcinoma was negatively correlated. The higher the positive expression of 3.BRCA1 and EGFR was, the lower the positive expression of BRCA1 was. Both of them may be involved in the malignant progression and poor prognosis of endometrial carcinoma, which may be helpful to the prognosis and postoperative treatment of endometrial carcinoma.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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