P53、ER、PR在卵巢浆液性癌与子宫内膜样癌中的表达及临床病理学意义

发布时间：2018-06-19 06:00

  本文选题：浆液性癌 + 子宫内膜样癌　； 参考：《山西医科大学》2014年硕士论文

【摘要】：目的：卵巢癌是女性最为常见的生殖系统恶性肿瘤之一,由于缺乏早期诊断手段,卵巢癌的死亡率居妇科恶性肿瘤之首。本实验主要研究P53、ER, PR在卵巢浆液性癌和子宫内膜样癌的免疫组化表达情况,了解在卵巢癌发生发展中的作用,探讨其表达及临床病理学意义,进一步为临床诊断、鉴别诊断及治疗、预后提供确切的实验室依据。 方法：收集山西省肿瘤医院病理科2011-2013年卵巢癌组织标本33例,其中浆液性癌20例,子宫内膜样癌13例,以上所有病例术前均未行放疗、化疗、免疫治疗及激素治疗。应用免疫组化EnVision二步法对研究对象进行检测,检测P53、雌激素受体(ER)及孕激素受体(PR)在实验标本组织中的表达情况,计数结果应用SPSS16.0统计软件进行数据分析,X2检验及pearson相关分析,α=0.05为检验水准,p0.05,具有统计学意义,分析P53、 ER、PR在卵巢浆液性癌与子宫内膜样癌中的表达情况。 结果：1.P53在卵巢癌中的表达：病理分型中,浆液性癌P53的阳性表达率(80%)高于子宫内膜样癌(38.5%)(p0.05)；组织学分级中,低分化癌P53的阳性表达率(81%)高于中、高分化癌(33.3%)(p0.05)；临床分期中,Ⅲ-Ⅳ期P53的阳性表达率(87.5%)高于Ⅰ-Ⅱ期(41.2%)(p0.05)。 2.ER在卵巢癌中的表达：病理分型中,子宫内膜样癌ER的阳性表达率(76.9%)高于浆液性癌(20%)(p0.05)；组织学分级中,中、高分化癌与低分化癌ER的阳性表达率分别为(58.3%、33.3%)(p0.05)；临床分期中,Ⅰ-Ⅱ期ER的阳性表达率(64.7%)高于Ⅲ-Ⅳ期(18.8%)(p0.05)。 3.PR在卵巢癌中的表达：病理分型中,子宫内膜样癌PR的阳性表达率(69.2%)高于浆液性癌(15%)(p0.05)；组织学分级中,中、高分化癌与低分化癌PR的阳性表达率分别为(50%、28.6%)(p0.05)；临床分期中,Ⅰ-Ⅱ期PR的阳性表达率(58.8%)高于Ⅲ-Ⅳ期(12.5%)(p0.05)。 4.ER与PR之间具有相关性,经pearson相关性检验,相关系数r=0.632,p0.001。 结论：综上述研究结果,我们得出以下结论： 1.P53表达与卵巢癌病理分型、组织学分级、临床分期有关,在浆液性癌中表达率高、在分化程度低、晚期卵巢癌中表达率高。 2. ER、PR表达与卵巢组织学分级无关,与病理分型、临床分期有关,在子宫内膜样癌中表达率高,卵巢癌临床分期越晚,ER, PR阳性表达率越低。 3. P53、ER、PR在卵巢浆液性癌与子宫内膜样癌中的表达不同,差异有统计学意义,联合检测P53、ER、PR的表达有助于非典型卵巢癌病变的诊断与鉴别诊断。 4.ER与PR之间呈正相关,检测ER、PR在早期卵巢癌中的表达较晚期阳性率高,有助于临床判断预后,指导治疗。
[Abstract]:Objective: ovarian cancer is one of the most common malignant tumors of the reproductive system in women. The present study was designed to investigate the expression of P53 ERR and PR in ovarian serous carcinoma and endometrioid carcinoma, to understand the role of P53 ERR and PR in the carcinogenesis and development of ovarian cancer, and to explore the expression and clinicopathological significance of P53, PR for further clinical diagnosis. Differential diagnosis, treatment and prognosis provide accurate laboratory basis. Methods: 33 cases of ovarian cancer were collected from the Department of Pathology of Shanxi Cancer Hospital from 2011 to 2013, including 20 cases of serous carcinoma and 13 cases of endometrial carcinoma. All cases were not treated with radiotherapy, chemotherapy, immunotherapy and hormone therapy before operation. Immunohistochemical envision two-step method was used to detect the expression of p53, estrogen receptor ERR and progesterone receptor prednisone. The count results were analyzed by SPSS 16.0 statistical software for data analysis X _ 2 test and pearson correlation analysis. 伪 -0. 05 was the test level (p0.05), which had statistical significance. The expression of p53, ERP PR in ovarian serous carcinoma and endometrioid carcinoma was analyzed. Results 1. Expression of p53 in ovarian cancer: the positive expression rate of p53 in serous carcinoma was 80% higher than that in endometrial carcinoma (38.5%). In histological grade, the positive rate of p53 expression in poorly differentiated carcinoma was higher than that in moderately differentiated carcinoma (33. 3% p0. 05). The positive expression rate of p53 in stage 鈪，

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