【摘要】 目的探讨抑癌基因p53、PTEN与子宫内膜癌临床病理特点及预后的相关性。方法回顾性分析99例子宫内膜癌患者的临床病理资料,按照影响预后的高危因素分组。采用免疫组化法检测其组织中p53、PTEN的表达,分析其与临床病理特征、生存率的相关性。结果 p53蛋白过度表达在子宫内膜癌手术病理分期中差异有统计学意义(P=0.028),同时与Ⅰ型、G1+G2级、Ⅰ+Ⅱ期、无淋巴结转移差异有统计学意义。单因素分析Logrank检验显示组织学分型及分级、手术病理分期、淋巴结转移与生存率相关,p53蛋白过度表达阳性者生存率低。Cox’s比例风险回归模型进行多因素分析,病理分期和p53蛋白过度表达是内膜癌独立预后影响因素。PTEN表达缺失在分期越晚、分级越高的病例中更多,同时PTEN表达缺失与p53蛋白过度表达无关。PTEN表达缺失与组织学分级、期别、淋巴结转移有无等与子宫内膜癌生存率无相关性(P>0.05)。结论 p53过度表达是子宫内膜癌独立的预后影响因素,对Ⅰ型子宫内膜癌、G1+G2级、Ⅰ+Ⅱ期、无淋巴结转移的病例,p53过度表达阳性者生存率低。PTEN在分化越差和分期越晚的病例中表达缺失越多;PTEN表达缺失和子宫内膜癌患者的生存率无相关性。更多还原

【Abstract】 Objective To study the relationship between p53 and PTEN and clinicopathological characteristics and prognosis of endometrial carcinoma. Methods The clinical and pathological data of 99 patients with endometrial carcinoma were retrospectively analyzed, and the risk factors were classified according to the prognostic factors. The expression of p53 and PTEN in tissues was detected by immunohistochemistry,and the correlation between the expression of p53,PTEN and clinicopathological features and survival rate was analyzed. Results There was significant difference in the overexpression of p53 protein in surgical-pathologic staging( P = 0. 028). The overexpression of p53 protein was associated with the survival rate on type I endometrial carcinoma,G1 + G2 grade,Ⅰ + Ⅱ stage,and no metastatic patients. Univariate analysis Log-rank test results showed that histological type and grade,surgical-pathologic stage,lymph node metastasis were associated with survival rate,p53 protein positive overexpression has low survival rate. Pathological staging and p53 protein overexpression were independent prognostic factors of en-dometrial cancer by Cox’ s proportional hazard regression model. The expression of PTEN was absent in the later stage and higher grade,and the expression of PTEN was not correlated with histological grade and stage,pathological type and lymph node metastasis. While the loss of PTEN expression was not associated with overexpression of p53 protein( P > 0. 05). Conclusion p53protein overexpression was an independent prognostic factor of endometrial carcinoma. The typeⅠendometrial carcinoma,G1 + G2 grade,Ⅰ + Ⅱ stage,no lymph node metastasis with p53 protein overexpression had lower survival rate. PTEN expression was absent in the worse differentiation and clinical staging,and it was not related to the survival rate in the patients.更多还原