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目的探讨抑癌基因磷酸酶与张力蛋白同源物(PTEN)、巨噬细胞移动抑制因子(MIF)在高分化子宫内膜样腺癌及癌前病变中表达的意义。方法 126例高分化子宫内膜样腺癌及癌前病变、10例正常的增生期子宫内膜,应用RT-PCR方法测定中PTEN mRNA,应用免疫组织化学检测PTEN、MIF蛋白的表达情况。结果高分化宫内膜样腺癌组、子宫内膜不典型增生组PTEN mRNA表达率明显低于增生期子宫内膜组,差异有统计学意义(t值分别为23.39、24.06,均P<0.01);高分化宫内膜样腺癌PTEN mRNA表达率低于子宫内膜不典型增生组,但差异无统计学意义(t=1.70,P>0.05)。在增生期子宫内膜组、子宫内膜轻/中度不典型增生组、子宫内膜重度不典型增生组及高分化宫内膜样腺癌组,PTEN蛋白表达率逐渐降低,MIF蛋白表达率依次升高,两者表达呈显著负相关(rs=-0.172 7,P<0.05)。PTEN蛋白在病变组表达率与增生期子宫内膜组比较差异均有统计学意义(χ~2值分别为7.07、12.07、17.07,P<0.01),但在病变组之间比较差异无统计学意义(χ~2值分别为0.73、1.85和0.21,均P>0.05);MIF蛋白在子宫内膜重度不典型增生组和高分化宫内膜样腺癌组阳性率显著高于子宫内膜轻/中度不典型增生组和增生期子宫内膜组,差异有统计学意义(χ~2值分别为4.01、6.35、5.91、7.90,P<0.05),但在子宫内膜重度不典型增生组和高分化宫内膜样腺癌组比较差异无统计学意义(χ~2值分别为1.29、0.08,均P>0.05)。结论 PTEN与MIF蛋白异常表达共同参与子宫内膜癌的发生、发展,是子宫内膜样腺癌发生的早期事件。联合检测PTEN与MIF蛋白表达情况对子宫内膜样腺癌的发生、发展具有一定的预测作用,但对子宫内膜重度不典型增生和宫内膜样腺癌鉴别诊断帮助不大。
Objective To investigate the expression of tumor suppressor gene phosphatase and tensin homology (PTEN) and macrophage migration inhibitory factor (MIF) in highly differentiated endometrial adenocarcinoma and precancerous lesions. Methods 126 cases of well-differentiated endometrioid adenocarcinoma and precancerous lesions, 10 cases of normal proliferative endometrium, PTEN mRNA was detected by RT-PCR. The expression of PTEN and MIF protein was detected by immunohistochemistry. Results The expression of PTEN mRNA in well-differentiated endometrial adenocarcinoma group and endometrial dysplasia group was significantly lower than that in proliferative endometrium group (t = 23.39,24.06, P <0.01, respectively) ). The expression of PTEN mRNA in well differentiated endometrial adenocarcinoma was lower than that in atypical hyperplasia group (t = 1.70, P> 0.05). In proliferative endometrium group, endometrial dysplasia group, endometrial dysplasia group and well-differentiated endometrial adenocarcinoma group, PTEN protein expression rate gradually decreased, MIF protein expression rate Followed by a rise, the expression of the two was significantly negatively correlated (rs = -0.172 7, P <0.05). PTEN protein expression in the diseased group was significantly different from that in the proliferative endometrium group (χ ~ 2 = 7.07,12.07,17.07, P <0.01), but no significant difference was found between the two groups (Χ ~ 2 = 0.73, 1.85 and 0.21, respectively, P> 0.05). The positive rate of MIF protein in endometrial dysplasia group and well-differentiated endometrioid adenocarcinoma group was significantly higher than that in endometrial carcinoma / Moderate dysplasia group and proliferative endometrium group, the difference was statistically significant (χ ~ 2 values were 4.01,6.35,5.91,7.90, P <0.05), but in the endometrial dysplasia group There was no significant difference between the two groups (χ ~ 2 = 1.29,0.08, P> 0.05). Conclusion The abnormal expression of PTEN and MIF protein participate in the occurrence and development of endometrial carcinoma, which is an early event of endometrial adenocarcinoma. Joint detection of PTEN and MIF protein expression of endometrial adenocarcinoma of the occurrence and development of a certain degree of predictive effect, but endometrial dysplasia and endometrial adenocarcinoma differential diagnosis is not helpful.