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目的探讨抑癌基因PTEN及错配修复基因hMLH1在子宫内膜癌中的表达及其与子宫内膜癌的临床病理学特征的关系。方法采用免疫组化SP法,检测36例散发性子宫内膜癌、22例子宫内膜不典型增生、23例正常子宫内膜组织中PTEN及hMLH1的表达。结果hMLH1基因在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌中的表达分别为83%(19/23)、64%(14/22)、11%(4/36),hMLH1基因在子宫内膜不典型增生及正常子宫内膜中的表达与其在子宫内膜癌中的表达差异有显著性(P<0.01);hMLH1基因表达与子宫内膜癌的淋巴结转移、肌层侵润、手术分期、病理类型无统计学差异(P>0.05),与子宫内膜癌病理分化程度有关(P<0.01);PTEN基因在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌中的表达分别100%(23/23)、73%(16/22)、56%(20/36),PTEN基因在子宫内膜不典型增生、子宫内膜癌中的表达与其在正常子宫内膜中的表达差异有显著性(P<0.01);PTEN基因表达与子宫内膜癌的分化程度、淋巴结转移、手术分期、病理类型、肌层是否侵润无统计学相关(P>0.05);PTEN与hMLH1两种基因蛋白在子宫内膜癌变过程中的表达有相关性(相关系数r=0.28;P<0.05)。结论hMLH1及PTEN均是子宫内膜的保护性基因,在子宫内膜的癌变过程中表达逐渐减少,可能与早期子宫内膜癌癌变的启动有关,且二者有显著的相关性;免疫组化法测定PTEN的表达有可能成为筛选子宫内膜癌变的早期指标;测定hMLH1的表达有可能成为预测子宫内膜癌预后的指标。
Objective To investigate the expression of tumor suppressor gene PTEN and mismatch repair gene hMLH1 in endometrial carcinoma and its relationship with the clinicopathological features of endometrial carcinoma. Methods Immunohistochemical SP method was used to detect the expression of PTEN and hMLH1 in 36 cases of sporadic endometrial carcinoma, 22 cases of endometrial dysplasia and 23 cases of normal endometrium. Results The expression of hMLH1 gene in normal endometrium, endometrial dysplasia and endometrial carcinoma were 83% (19/23), 64% (14/22), 11% (4/36), hMLH1 The expression of hMLH1 gene in endometrial dysplasia and normal endometrium was significantly different from that in endometrial carcinoma (P <0.01). The expression of hMLH1 gene correlated with lymph node metastasis, (P> 0.05), which was related to the degree of pathological differentiation of endometrial carcinoma (P <0.01). PTEN gene expression in normal endometrium, endometrial dysplasia, endometrial The expressions of PTEN gene in endometrial dysplasia and endometrial carcinoma were 100% (23/23), 73% (16/22), 56% (20/36), respectively. (P <0.01). There was no significant correlation between the expression of PTEN gene and the differentiation of endometrial carcinoma, lymph node metastasis, stage of operation, pathological type and invasion of muscular layer (P> 0.05) PTEN was associated with the expression of hMLH1 protein in endometrial carcinogenesis (r = 0.28; P <0.05). Conclusions Both hMLH1 and PTEN are protective genes of endometrium, which may be related to the initiation of carcinogenesis in early stage of endometrial cancer. The expression of hMLH1 and PTEN may be related to the carcinogenesis of endometrial cancer. Immunohistochemistry Determination of PTEN expression may be an early indicator of screening for endometrial cancer; determination of hMLH1 expression may be predictive of prognosis of endometrial cancer indicators.