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目的探讨PTEN基因、Ki-ras基因在子宫内膜腺癌中的表达及意义。方法采用免疫组织化学S-P法测定20例正常增生期子宫内膜、20例不典型增生子宫内膜及45例子宫内膜腺癌组织中的PTEN、p21ras蛋白表达。结果PTEN在正常子宫内膜、不典型增生和内膜腺癌中的阳性表达率逐渐降低,分别为95.0%、40.0%、31.1%。正常子宫内膜组织中的PTEN阳性表达率显著高于不典型增生和内膜腺癌(P<0.01)。p21ras蛋白在正常子宫内膜、不典型增生和子宫内膜腺癌中的阳性表达率分别为0、50.0%、64.4%,子宫内膜不典型增生和子宫内膜腺癌组均显著高于正常子宫内膜组(P<0.01)。PTEN与p21ras蛋白表达呈负相关(r=-0.303,P<0.05),且均与细胞分化程度显著相关(P<0.05)。结论1)PTEN、ki-ras基因在子宫内膜腺癌发生发展中起重要作用,PTEN是其发生的早期分子事件;2)PTEN、p21ras的蛋白表达与病理分级有关;3)在子宫内膜腺癌中PTEN与p21ras可能参与同一蛋白通路发挥生理作用。
Objective To investigate the expression and significance of PTEN and Ki-ras in endometrial adenocarcinoma. Methods The expressions of PTEN and p21ras in 20 cases of normal proliferative endometrium, 20 cases of atypical hyperplasia endometrium and 45 cases of endometrial adenocarcinoma were detected by immunohistochemical S-P method. Results The positive rates of PTEN in normal endometrium, atypical hyperplasia and endometrial adenocarcinoma decreased gradually to 95.0%, 40.0% and 31.1% respectively. The positive expression rate of PTEN in normal endometrium was significantly higher than that in atypical hyperplasia and endometrial adenocarcinoma (P <0.01). The positive rate of p21ras protein in normal endometrium, atypical hyperplasia and endometrial adenocarcinoma was 0, 50.0% and 64.4%, respectively. The expression of p21ras in endometrial dysplasia and endometrial adenocarcinoma was significantly higher than that in normal Endometrium group (P <0.01). The expression of PTEN was negatively correlated with the expression of p21ras protein (r = -0.303, P <0.05), and both were significantly correlated with cell differentiation (P <0.05). Conclusions1) The PTEN and ki-ras genes play an important role in the development of endometrial adenocarcinoma. PTEN is an early molecular event. 2) The protein expression of PTEN and p21ras is related to the pathological grade. 3) In adenocarcinoma PTEN and p21ras may participate in the same protein pathway play a physiological role.