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Livin、XIAP在子宫内膜样腺癌中的表达及相关性研究

发布时间:2018-08-03 14:25
【摘要】:目的:子宫内膜癌(Endometrial Carcinoma)为女性生殖系统中常见的恶性肿瘤,和宫颈癌、卵巢癌并称为女性的三大杀手,其中子宫内膜样腺癌是其最常见的组织学类型。其发生发展涉及到细胞凋亡,是一个复杂的过程。凋亡抑制蛋白(IAPs)家族成员XIAP和Livin具有抑制半胱氨酸天冬酶(Caspase),调控细胞凋亡以及细胞分裂、增殖等作用,在恶性肿瘤的发生发展过程中表现非常关键。本实验采取免疫组织化学的实验方法,对正常子宫内膜组织、子宫内膜非典型增生组织以及子宫内膜样腺癌组织中的XIAP和Livin的表达进行检测,进而阐述XIAP和Livin与子宫内膜样腺癌发生发展的关系以及二者之间可能存在的某种关系,为子宫内膜癌的临床诊断及治疗提供理论依据,提高癌症患者的生存率。方法:本实验选取河北医科大学第一医院2013年10月-2016年3月间手术切除,并经病理证实的子宫内膜样腺癌标本40例、子宫内膜非典型增生标本40例(诊刮标本并经病理证实),同时选取同期因子宫脱垂或子宫肌瘤行子宫切除的正常增生期子宫内膜标本40例作为对照,采用免疫组织化学SP法检测XIAP和Livin在三组标本中表达情况,所得数据采用SPSS13.0统计学软件进行统计学处理,计数资料组间的比较以X2检验进行显著性分析,P0.05视为差异有统计学意义。Livin和XIAP表达的相关性采用Spearman等级相关分析。结果:1 HE染色情况将HE染色切片标本置于光学显微镜下,观察结果显示:正常子宫内膜腺体的排列整齐,形态规则,未见核分裂;子宫内膜非典型增生组织可见细胞存在异型性,内膜腺体细胞极性紊乱且排列不规则,可见核分裂;子宫内膜样腺癌组织腺体细胞异型性明显,排列极度紊乱,核分裂多见。其中,高分化腺癌腺管排列紊乱、拥挤,结构类似增生的腺体,细胞轻度异型;中分化腺癌的腺体排列不规则,细胞异型性明显,核分裂像易见;低分化腺癌无腺样结构,核异型性明显,核分裂像多见。2xiap的表达情况子宫内膜样腺癌组的xiap表达阳性率为77.5%(31/40);子宫内膜非典型增生组的xiap表达阳性率为70%(28/40);正常子宫内膜组的xiap表达阳性率仅为20%(8/40)。统计学分析显示,子宫内膜样腺癌组及子宫内膜非典型增生组中xiap表达的阳性率显著高于正常子宫内膜组(p0.05),子宫内膜样腺癌组的xiap表达阳性率较子宫内膜非典型增生组有增高趋势,但差别无统计学意义(p0.05)。3livin蛋白的表达情况子宫内膜样腺癌组的livin表达阳性率为80%(32/40);子宫内膜非典型增生组的livin表达阳性率为75%(30/40);正常子宫内膜组的livin表达阳性率仅为22.5%(9/40)。统计学分析显示,子宫内膜样腺癌组及子宫内膜非典型增生组中livin表达的阳性率显著高于正常子宫内膜组(p0.05),子宫内膜样腺癌组的livin表达阳性率较子宫内膜非典型增生组有增高趋势,但差异无统计学意义(p0.05)。4子宫内膜样腺癌组织中的各临床病理参数与xiap表达的关系在40例子宫内膜样腺癌组织中,xiap的阳性表达与患者年龄、肌层浸润深度、淋巴结的转移与否,差异均无统计学意义(p0.05)。在临床分期中,Ⅰ期的患者xiap的阳性率为55.6%(5/9);Ⅱ期的患者xiap的阳性率为62.5%(5/8);Ⅲ-Ⅳ期的患者xiap的阳性率为91.3%(21/23)。统计学分析显示,xiap的阳性表达率在各临床分期中有统计学差异(p0.05)。病理分级为g1级的患者xiap的阳性率为55.6%(5/9);g2级的xiap的阳性率为57.1%(4/7);g3级的xiap的阳性率为91.7%(22/24)。统计学分析显示,xiap的阳性表达率在不同的病理分级中有统计学差异(p0.05)。5子宫内膜样腺癌组织中各临床病理参数与livin蛋白表达的关系在40例子宫内膜样腺癌组织中,livin的阳性表达与患者年龄、肌层浸润深度、淋巴结的转移与否,差异均无统计学意义(p0.05)。在临床分期中,Ⅰ期的患者livin的阳性率为55.6%(5/9);Ⅱ期的患者livin的阳性率为62.5%(5/8);Ⅲ-Ⅳ期的患者livin的阳性率为95.7%(22/23)。统计学分析显示,livin的阳性表达率在各临床分期中有统计学差异(p0.05)。病理分级为g1级的患者livin的阳性率为55.6%(5/9);g2级的Livin的阳性率为57.1%(4/7);G3级的Livin的阳性率为95.8%(23/24)。统计学分析显示,Livin的阳性表达率在不同的病理分级中有统计学差异(P0.05)。6子宫内膜样腺癌组织中XIAP与Livin的相关性在XIAP阳性的子宫内膜样腺癌组织中,Livin的阳性率为93.5%(29/31),在XIAP阴性的子宫内膜样腺癌组织中,Livin的阳性率为33.3%(3/9);在Livin阳性的子宫内膜样腺癌组织中,XIAP的阳性率为90.6%(29/32);在Livin阴性的子宫内膜样腺癌组织中,XIAP的阳性率为25.0%(2/8)。统计学分析表明,XIAP和Livin在子宫内膜样腺癌中的表达有相关性,二者呈正相关(P0.05)。结论:1与正常子宫内膜比较,子宫内膜样腺癌及子宫内膜非典型增生组织中的XIAP和Livin的表达显著增多。提示XIAP和Livin的过度表达可能与子宫内膜样腺癌的发生有关。2在子宫内膜样腺癌组织中,XIAP和Livin的阳性表达率均与年龄、淋巴结转移及浸润深度无关,而与临床分期、病理分级有关,临床分期和病理分级越高,它们的阳性表达率越高。提示XIAP和Livin的过度表达对判断子宫内膜样腺癌的临床预后有一定的意义。3在子宫内膜样腺癌组织中,Livin的阳性表达与XIAP的阳性表达呈正相关,二者具有协同作用。
[Abstract]:Objective: endometrial carcinoma (Endometrial Carcinoma) is a common malignant tumor in the female reproductive system, and cervical cancer, and ovarian cancer is called the three largest killer of women. Endometrioid adenocarcinoma is the most common histologic type. Its development involves apoptosis and is a complex process. The family of apoptosis suppressor protein (IAPs) family Members XIAP and Livin have inhibition of cysteine asparagus (Caspase), regulate cell apoptosis, cell division and proliferation, and play a key role in the development of malignant tumors. This experiment adopts an immunohistochemical method for normal endometrium, endometrium atypical hyperplasia and uterus. The expression of XIAP and Livin in the adenocarcinoma of the membrane was detected, and the relationship between the development of XIAP and Livin and endometrioid adenocarcinoma and the possible relationship between the two were discussed, and the theoretical basis for the clinical diagnosis and treatment of endometrial cancer was provided to improve the survival rate of the cancer patients. Methods: this experiment selected Hebei medicine. 40 cases of endometrioid adenocarcinoma, 40 specimens of endometrium hyperplasia confirmed by pathology, and 40 cases of endometrium adenocarcinoma confirmed by pathology in October 2013 -2016 years, and 40 specimens of endometrium in normal hyperplastic period of hysterectomy or hysteromyoma were selected as control. The immunohistochemical SP method was used to detect the expression of XIAP and Livin in the three groups. The data were statistically treated with SPSS13.0 statistics software, and the comparison between the count data groups was statistically analyzed by X2 test. P0.05 was considered as a difference in the correlation between.Livin and XIAP expression using Spearman grade correlation score. Results: the results of 1 HE staining showed that the specimens of HE stained slices were placed under the optical microscope. The results showed that the normal endometrium glands were arranged orderly, the morphology was regular and no mitosis was found; the atypical hyperplasia tissues of the endometrium showed that the cells were heterotypic, the endometrial glands were very disorderly and irregular in permutation, and the endometrium was visible in the uterus. The glandular cells of the adenocarcinoma of the membrane were characterized by an obvious dysplasia, extremely disorderly arrangement and more mitosis. Among them, the adenocarcinoma of the highly differentiated adenocarcinoma was arranged in disorder, crowded, the structure resembles hyperplasia gland, the cell was mild heteromorphic, the adenocarcinoma in the middle differentiated adenocarcinoma was irregular, the cell heteromorphosis was obvious, and the mitosis was easy to see; the low differentiated adenocarcinoma without adenoid structure and nuclear heteromorphosis The positive rate of XIAP expression in endometrioid adenocarcinoma group was 77.5% (31/40), and the positive rate of XIAP expression in the endometrium atypical hyperplasia group was 70% (28/40), and the positive rate of the normal endometrium group was only 20% (8/40). Statistical analysis showed that endometrioid adenocarcinoma group and endometrium were found in endometrioid adenocarcinoma group and endometrium. The positive rate of XIAP expression in the atypical hyperplasia group was significantly higher than that in the normal endometrium group (P0.05). The positive rate of XIAP expression in endometrioid adenocarcinoma group was higher than that of the endometrium atypical hyperplasia group, but the difference was not statistically significant (P0.05) the expression of.3livin protein in the endometrioid adenocarcinoma group was 80% (32/4). 0) the positive rate of Livin expression in the endometrium atypical hyperplasia group was 75% (30/40), and the positive rate of Livin expression in the normal endometrium group was only 22.5% (9/40). The statistical analysis showed that the positive rate of Livin expression in endometrioid adenocarcinoma group and endometrium atypical hyperplasia group was significantly higher than that of normal endometrium group (P0.05), endometrioid adenocarcinoma. The positive rate of Livin expression in the group was higher than that of the endometrium atypical hyperplasia group, but the difference was not statistically significant (P0.05) the relationship between the clinicopathological parameters and the expression of XIAP in the endometrioid adenocarcinoma of.4 was in 40 endometrioid adenocarcinoma tissues. The positive expression of XIAP was associated with the patient's age, the depth of myometrium infiltration, and the metastasis of lymph nodes. The positive rate of XIAP in stage I was 55.6% (5/9), and the positive rate of XIAP in stage II patients was 62.5% (5/8), and the positive rate of XIAP in stage III - IV patients was 91.3% (21/23). Statistical analysis showed that the positive rate of XIAP was statistically different (P0.05) in the clinical stages (P0.05). The positive rate of XIAP at grade G1 was 55.6% (5/9), the positive rate of XIAP at G2 level was 57.1% (4/7), and the positive rate of XIAP in G3 grade was 91.7% (22/24). Statistical analysis showed that the positive rate of XIAP was statistically different in different pathological grades (P0.05) all the clinicopathological parameters and the protein table in the endometrioid adenocarcinoma tissue of the.5 subuterine. In 40 cases of endometrioid adenocarcinoma, the positive expression of Livin was not statistically significant (P0.05). In clinical stage, the positive rate of Livin in stage I was 55.6% (5/9); the positive rate of Livin in stage II patients was 62.5% (5/8), and liv in stage III - IV patients liv. The positive rate of in was 95.7% (22/23). Statistical analysis showed that the positive rate of Livin was statistically different in each clinical stage (P0.05). The positive rate of Livin in G1 grade patients was 55.6% (5/9); the positive rate of Livin at G2 grade was 57.1% (4/7), and G3 class Livin was 95.8%. The expression rate was statistically different in different pathological grades (P0.05) the correlation between XIAP and Livin in.6 endometrioid adenocarcinoma was in XIAP positive endometrioid adenocarcinoma tissue, the positive rate of Livin was 93.5% (29/31). In XIAP negative endometrioid adenocarcinoma tissue, the positive rate of Livin was 33.3% (3/9), and in Livin positive uterus. In endometrioid adenocarcinoma, the positive rate of XIAP was 90.6% (29/32); in Livin negative endometrioid adenocarcinoma tissue, the positive rate of XIAP was 25% (2/8). Statistical analysis showed that the expression of XIAP and Livin in endometrioid adenocarcinoma was correlated, and the two was positively correlated (P0.05). Conclusion: 1 compared with normal endometrium, endometrioid glands are compared. The expression of XIAP and Livin in the atypical hyperplasia of carcinoma and endometrium increased significantly. It was suggested that the overexpression of XIAP and Livin may be associated with the occurrence of endometrioid adenocarcinoma in endometrioid adenocarcinoma. The positive expression of XIAP and Livin is not related to age, lymph node metastasis and depth of infiltration, but with clinical stage and pathology. The higher the clinical stage and pathological grade, the higher the positive expression rate of XIAP and Livin. It is suggested that the overexpression of XIAP and Livin has a certain significance in judging the clinical prognosis of endometrioid adenocarcinoma. In endometrioid adenocarcinoma tissue, the positive expression of Livin is positively correlated with the positive expression of XIAP, and the two have synergistic effect.
【学位授予单位】:河北医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R737.33

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