【摘要】 目的 研究子宫内膜样腺癌微囊性、伸长及碎片状(MELF)浸润模式患者的临床病理特征及相关机制。方法 收集河北北方学院附属第一医院225例子宫内膜样腺癌患者的临床资料、病理标本及癌旁标本。根据MELF浸润模式将其分为MELF组、非MELF组。研究子宫内膜样腺癌MELF浸润模式的临床病理特征;根据病理检测结果将标本分为MELF组、非MELF组、空白对照组。Western blot法检测病理标本EMT关键蛋白E-cadherin及凋亡关键蛋白Bcl-2、Bax相对表达水平;实时荧光定量PCR(RT-qPCR)检测E-cadherin m RNA、Bcl-2mRNA、Bax m RNA的相对表达水平。结果MELF组、非MELF组病例数分别为41例(18.22%)、184例(81.78%),其中年龄是否>50岁对患者无明显影响(P> 0.05)。MELF组患者绝经、FIGO分期、肌层浸润深度、淋巴结转移、脉管侵犯、CA199、CA125水平等的占比均明显高于非MELF组,差异均有统计学意义(P<0.05)。Western blot结果显示,MELF组、非MELF组上皮间质转化(EMT)关键蛋白E-cadherin蛋白、促凋亡蛋白Bax表达量较空白对照组明显降低,抑制凋亡蛋白Bcl-2蛋白表达量较空白对照组明显增高;MELF组Ecadherin、Bax蛋白表达量较非MELF组明显降低,Bcl-2蛋白表达量较非MELF组明显增高,差异均有统计学意义(P均<0.05)。RT-qPCR结果显示,MELF组、非MELF组Bcl-2mRNA相对表达量较空白对照组明显增高,E-cadherin、BaxmRNA相对表达量较空白对照组明显降低;MELF组Bcl-2mRNA相对表达量较非MELF组明显增高,E-cadherin、BaxmRNA相对表达量较非MELF组明显降低,差异均有统计学意义(P均<0.05)。结论 MELF浸润模式与患者绝经、FIGO分期、肌层侵犯深度、淋巴结转移、脉管侵犯、CA199、CA125水平等因素有关,其产生机制可能与促进EMT及凋亡有关。更多还原

【Abstract】 Objective To study the clinicopathological characteristics and related mechanisms of endometrioid adenocarcinoma with microcystic, elongated, and fragmented(MELF) infiltration patterns. Methods The clinical data,pathological specimens and paracancerous specimens of 225 patients with endometrioid adenocarcinoma in the hospital were collected. According to the MELF in filtration pattern, the patients were divided into MELF group and nonMELF group. To study the clinicopathological characteristics of MELF infiltration pattern of endometrioid adenocarcinoma; according to the results of pathological examination, the specimens were divided into MELF group, nonMELF group, and blank control group. Western blot was used to detect the relative expression levels of E-cadherin and Bcl-2 and Bax, the key protein of EMT in pathological specimens; the relative expressions of E-cadherin m RNA, Bcl-2mRNA and Bax m RNA were detected by real-time fluorescent quantitative PCR(RT-qPCR) Level. Results The number of cases in the MELF group and the non-MELF group were 41(18. 22%) and 184(81. 78%),respectively. Among them, whether the age was greater than 50 years old had no significant effect on the patients(P>0. 05). The percentages of menopause,FIGO staging,depth of muscle invasion, lymph node metastasis, vascular invasion,CA199 and CA125 levels in MELF group were significantly higher than those in non-MELF group(P<0. 05). Western blot results showed that the expressions of E-cadherin, the key protein of epithelial mesenchymal transformation(EMT), and Bax, the pro-apoptotic protein, were significantly decreased in MELF and non-MELF groups compared with blank control group,and the expression of Bcl-2, the anti-apoptotic protein, was significantly increased compared with the blank control group. The expression levels of E-cadherin and Bax in MELF group were significantly decreased compared with the non-MELF group, while the expression level of Bcl-2 protein was significantly increased compared with the non-MELF group, with statistical significance(allP<0. 05). RT-qPCR results showed that the relative expression of Bcl-2 m RNA in MELF and non-MELF groups were significantly higher than that in the blank control group, while the relative expression of E-cadherin and Bax m RNA was significantly lower than that in the blank control group. The relative expression of Bcl-2 m RNA in MELF group was significantly higher than that in the non-MELF group, and the relative expression of E-cadherin and Bax m RNA was significantly lower than that in the non-MELF group, with statistical significance(all P<0. 05). Conclusion MELF infiltration pattern is related to the patient′s menopause, FIGO stage, depth of muscle invasion, lymph node metastasis, vascular invasion, CA199, CA125 levels and other factors are related, and the mechanism of their production may be related to the promotion of EMT and apoptosis.更多还原