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目的：探讨子宫内膜癌的发生及发展与癌基因ｃ－ｅｒｂＢ２表达的关系。方法：应用差别聚合酶链反应（ＤＰＣＲ）和免疫组化法测定了２５例正常子宫内膜、３１例增生性子宫内膜和７２例子宫内膜癌组织中癌基因ｃ－ｅｒｂＢ２的扩增与表达。结果：正常子宫内膜仅有２例（２／２５，８．０％）低倍扩增，而子宫内膜增生及内膜癌组织中分别有１５和４５例（１５／３１，４８．４％；４５／７２，６２．５％）扩增，且扩增倍数从２～１２不等。免疫组化与ＤＰＣＲ法测定结果在阴性标本有很好的相关性。在子宫内膜增生中，不典型增生与复合增生的扩增率明显高于单纯性增生者。子宫内膜癌中，ｃ－ｅｒｂＢ２的高倍扩增率（≥５倍）与肿瘤的病理分级和癌细胞对血管或淋巴管侵入密切相关。结论：子宫内膜增生的癌变可能与ｃ－ｅｒｂＢ２的激活有关。高度激活的ｃ－ｅｒｂＢ２与内膜癌的发展、分化以及转移倾向密切相关，有可能作为临床预后的指标之一。
Objective: To investigate the relationship between the occurrence and development of endometrial carcinoma and the expression of oncogene c-erbB2. Methods: The amplification of c-erbB2 gene in 25 cases of normal endometrium, 31 cases of proliferative endometrium and 72 cases of endometrial carcinoma was determined by differential polymerase chain reaction (DPCR) and immunohistochemistry expression. Results: There were only 2 cases (2 / 25,8.0%) of normal endometrium with low magnification, while 15 and 45 cases of endometrial hyperplasia and endometrial carcinoma (15 / 31,48.4 %; 45/72, 62.5%) amplification, and amplification multiples of 2 to 12 range. Immunohistochemistry and DPCR assay results in the negative specimens have a good correlation. In endometrial hyperplasia, atypical hyperplasia and complex hyperplasia rate was significantly higher than simple hyperplasia. Endometrial cancer, c-erbB2 high-fold amplification (≥ 5 times) and tumor pathological grade and cancer cells on the invasion of blood vessels or lymphatic closely related. Conclusion: The carcinogenesis of endometrial hyperplasia may be related to the activation of c-erbB2. Highly activated c-erbB2 is closely related to the development, differentiation and metastasis of endometrial carcinoma, which may be one of the indicators of clinical prognosis.