子宫内膜癌变hMSH6与p53表达的意义

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目的子宫内膜癌因其逐年上升的发病率和年轻化趋势而备受关注,深入研究其癌变机制,对于子宫内膜癌的防治具有重要意义。本研究分析子宫内膜样腺癌、子宫内膜不典型增生和子宫内膜增生不伴非典型性内膜中hMSH6和p56的表达,探讨hMSH6和p53在子宫内膜癌变过程中的表达相关性及临床意义。方法用免疫组化法检测滨州医学院附属医院病理科2010-08-01-2013-03-01刮宫及手术切除的65例子宫内膜癌,15例子宫内膜不典型增生及20例子宫内膜增生不伴非典型性组织中p53和hMSH6的表达情况,统计学分析其表达水平与临床病理因素之间的相关性。结果子宫内膜样腺癌组织hMSH6蛋白表达率为27.6%(18/65),明显低于子宫内膜不典型增生组织75.0%(15/20),及子宫内膜增生不伴非典型性组织73.3%(11/15)。子宫内膜样腺癌组织p53蛋白表达率55.3%(36/65),明显高于子宫内膜不典型增生组织13.3%(2/15),及子宫内膜增生不伴非典型性5.0%(1/20),其中子宫内膜样腺癌组hMSH6及p53的表达与子宫内膜不典型增生组及子宫内膜增生不伴非典型性组织相比差异有统计学意义(χ~2=10.99,P=0.002;χ~2=10.99,P=0.004),而子宫内膜增生不伴非典型性组织与子宫内膜不典型增生组相比差异无统计学意义,P>0.05;hMSH6及p53蛋白的表达均与手术病理分期和组织学分级有关,均P<0.001。结论 hMSH6基因表达缺失及p53蛋白的表达与子宫内膜癌的发生有关,通过检测两者的表达水平可对子宫内膜癌的早期预防,早期诊断提供重要依据。 Purpose Endometrial cancer has drawn much attention because of its increasing incidence and rejuvenation trend. It is of great significance to study its mechanism of carcinogenesis in order to prevent and treat endometrial cancer. This study analyzed the expression of hMSH6 and p56 in endometrial adenocarcinoma, endometrial dysplasia and endometrial hyperplasia with atypical atypia, and the correlation between hMSH6 and p53 expression in endometrial carcinogenesis And clinical significance. Methods The immunohistochemical method was used to detect the pathological changes of 65 cases of endometrial carcinoma and 15 cases of endometrial dysplasia and 20 cases of uterine endometrial cancer undergoing curettage and surgical resection in Binzhou Medical College Affiliated Hospital. Membranous hyperplasia was not associated with the expression of p53 and hMSH6 in atypical tissues, and the correlation between the expression levels and clinicopathological factors was statistically analyzed. Results The expression of hMSH6 protein in endometrioid adenocarcinoma was 27.6% (18/65), significantly lower than that in endometrial dysplasia (75.0%, 15/20), with no atypical endometrial hyperplasia 73.3% (11/15). The expression of p53 protein in endometrioid adenocarcinoma was 55.3% (36/65), significantly higher than that in endometrial dysplasia (13.3%, 2/15) and in endometrial hyperplasia (5.0%) 1/20). The expression of hMSH6 and p53 in endometrial adenocarcinoma group was significantly different from that in atypical hyperplasia group and endometrial hyperplasia group (χ ~ 2 = 10.99 , P = 0.002; χ ~ 2 = 10.99, P = 0.004), while there was no significant difference between endometrial hyperplasia and atypical hyperplasia in endometrial dysplasia group, P> 0.05; hMSH6 and p53 Protein expression was related to pathological stage and histological grade, both P <0.001. Conclusions The loss of hMSH6 gene expression and the expression of p53 protein are related to the occurrence of endometrial carcinoma. The detection of the expression of hMSH6 gene may provide an important basis for the early prevention and early diagnosis of endometrial carcinoma.
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