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目的探讨抑癌基因PTEN、增殖细胞核抗原Ki-67、β-连环素(β-Cat)及基质金属蛋白酶-7(MMP-7)在Ⅰ型子宫内膜癌发生、发展中的作用。方法采用免疫组化SP法检测20份正常子宫内膜、69份单纯性增生、65份复杂性增生、57份非典型增生和82份Ⅰ型子宫内膜癌组织中PTEN、Ki-67与β-Cat、MMP-7表达并分析其与临床病理参数的关系。结果正常子宫内膜、单纯性增生、复杂性增生、非典型增生和Ⅰ型子宫内膜癌组织中PTEN蛋白阳性表达率依次降低,而Ki-67、β-Cat、MMP-7阳性表达率依次升高,子宫内膜癌和非典型增生组织中PTEN、MMP-7阳性表达率明显低于复杂性增生组织(P均<0.05),内膜癌组织中Ki-67的阳性表达率明显高于非典型增生、复杂性增生组织(P均<0.05),β-Cat的异常表达率显著高于正常子宫内膜(P<0.05)。PTEN、Ki-67、β-Cat阳性率与临床分期和组织学分级有关,MMP-7阳性率仅与肌层浸润程度有关。内膜癌中PTEN蛋白表达与Ki-67、β-Cat呈负相关(P均<0.05),β-Cat蛋白表达与MMP-7呈正相关(P<0.05)。结论 PTEN、Ki-67和β-Cat、MMP-7蛋白均参与了子宫内膜癌的发生、发展,有可能成为子宫内膜组织早期癌变的有用标记物。
Objective To investigate the role of tumor suppressor gene PTEN, proliferating cell nuclear antigen Ki-67, β-catenin and matrix metalloproteinase-7 in the development of type Ⅰ endometrial carcinoma. Methods Immunohistochemical SP method was used to detect the expression of PTEN, Ki-67 and β in 20 normal endometrium, 69 simple hyperplasia, 65 complex hyperplasia, 57 atypical hyperplasia and 82 type Ⅰ endometrial carcinoma -Cat, MMP-7 expression and analysis of its relationship with clinicopathological parameters. Results The positive expression rates of PTEN protein in normal endometrium, simple hyperplasia, complex hyperplasia, atypical hyperplasia and type Ⅰ endometrial carcinoma were decreased in turn, while the positive rates of Ki-67, β-Cat and MMP-7 were in turn The positive rates of PTEN and MMP-7 in endometrial carcinoma and atypical hyperplasia tissues were significantly lower than those in complex hyperplasia tissues (all P <0.05). The positive expression rate of Ki-67 in endometrial carcinoma was significantly higher than that in endometrial carcinoma Atypical hyperplasia and complex hyperplasia tissue (all P <0.05), the abnormal expression rate of β-Cat was significantly higher than that of normal endometrium (P <0.05). The positive rates of PTEN, Ki-67 and β-Cat were related to clinical stage and histological grade. The positive rate of MMP-7 was only related to the degree of myometrial invasion. The expression of PTEN protein in endometrial carcinoma was negatively correlated with Ki-67 and β-Cat (all P <0.05). The expression of β-Cat protein was positively correlated with MMP-7 (P <0.05). Conclusion The expressions of PTEN, Ki-67, β-Cat and MMP-7 are all involved in the development and progression of endometrial carcinoma and may be useful markers for the early carcinogenesis of endometrial tissue.