本文關鍵詞： 子宮內膜腺癌 ER PR Ki-67 ING4 免疫組織化學　出處：《石河子大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:檢測ING4、ER、PR、Ki-67在不同子宮內膜組織中的表達,分析其與子宮內膜腺癌臨床特征及預后的關系,探討在子宮內膜腺癌發(fā)生、發(fā)展過程中的意義,為子宮內膜腺癌的早期診斷、臨床治療方案的選擇提供理論依據(jù)。方法:回顧性分析2008年1月-2013年1月在石河子大學醫(yī)學院第一附屬醫(yī)院婦科行手術治療并有病理診斷的子宮內膜腺癌患者的組織蠟塊,根據(jù)術后病理診斷進行分組,其中對照組為非瘤子宮內膜組織,共20例,病例組為非典型增生子宮內膜組織39例及子宮內膜腺癌組織76例。分別分析ING4、ER、PR、Ki-67的表達水平與子宮內膜腺癌臨床特征之間的關系,對其生存率進行回訪,并分析各蛋白在子宮內膜腺癌中表達的相關關系。采用SPSS 21.0進行統(tǒng)計分析。結果:1.子宮內膜腺癌組織ER表達陽性率為48.7%(37/76),低于不典型增生型子宮內膜組織76.3%(29/38)和非瘤子宮內膜組織95.0%(19/20),在不同組織學分級、病理分型、臨床分期的子宮內膜腺癌患者組織中ER的表達差異有統(tǒng)計學意義(P0.05)。ER陽性者的生存率明顯高于ER表達陰性的患者,差異有統(tǒng)計學意義(P0.05)。2.PR在子宮內膜腺癌組織中陽性率為53.9%(41/76),低于不典型增生型子宮內膜組織71.1%(27/38)和非瘤子宮內膜組織90.0%(18/20),在不同組織學分級、病理分型、臨床分期、腫瘤大小、腫瘤肌層浸潤深度的子宮內膜腺癌患者組織中PR的表達差異有統(tǒng)計學意義(P0.05)。PR陽性者的生存率明顯高于PR陰性者,差異有統(tǒng)計學意義(P0.05)。3.Ki-67在子宮內膜腺癌組織中陽性表達率為69.7%(53/76),高于不典型增生型子宮內膜組織34.2%(13/38)和非瘤子宮內膜組織10.0%(2/20),在不同組織學分級、臨床分期的子宮內膜腺癌患者組織中Ki-67的表達差異有統(tǒng)計學意義(P0.05)。Ki-67陽性者的生存率與Ki-67陰性者無明顯差異,差異沒有統(tǒng)計學意義(P0.05)。4.子宮內膜腺癌組織ING4表達陽性率為55.3%(42/76),低于不典型增生型子宮內膜組織89.5%(34/38)和非瘤子宮內膜組織100%(20/20),ING4蛋白在不同組織學分級、病理分型、臨床分期的子宮內膜腺癌組織中的表達差異有統(tǒng)計學意義(P0.05)。ING4陽性者的生存率與ING4陰性者無明顯差異,差異沒有統(tǒng)計學意義(P0.05)。5.子宮內膜腺癌組織中ER與PR的表達呈正相關(r=0.425,P=0.000),ER與ING4的表達呈正相關(r=0.241,P=0.036)。結論:1.ER、PR及ING4在子宮內膜腺癌組織中呈低表達;而Ki-67在子宮內膜腺癌組織中高表達,表明四者的表達均參與了子宮內膜腺癌的發(fā)生、發(fā)展過程。2.ER、PR、Ki-67及ING4在子宮內膜腺癌的表達在一定程度上反映出腫瘤的進展及惡性程度,對腫瘤的臨床診斷及治療方案的選擇可以起到一定程度的指導作用。3.ER、PR與子宮內膜腺癌的生存率呈顯著相關。
[Abstract]:Objective: to detect the expression of PRKI-67 in different endometrial tissues, analyze its relationship with the clinical features and prognosis of endometrial adenocarcinoma, and explore its significance in the occurrence and development of endometrial adenocarcinoma, which is the early diagnosis of endometrial adenocarcinoma. Methods: from January 2008 to January 2013, the tissue wax masses of patients with endometrial adenocarcinoma who underwent surgical treatment and pathological diagnosis in the first affiliated Hospital of Shihezi University Medical College were retrospectively analyzed. According to the postoperative pathological diagnosis, 20 cases were divided into two groups: the control group (n = 20) was nontumorous endometrial tissue. There were 39 cases of atypical hyperplasia endometrium and 76 cases of endometrial adenocarcinoma. The relationship between the expression of PRKi-67 and clinical characteristics of endometrial adenocarcinoma was analyzed, and the survival rate was reviewed. The positive rate of ER expression in endometrial adenocarcinoma was 48.7 / 37 / 76, which was lower than that in atypical hyperplasia endometrial tissue (76.33 / 29 / 38) and non-neoplastic endometrial tissue (P < 0.01). The endometrial tissue, 95.0 / 20, is graded in different histology. The difference of ER expression in patients with endometrial adenocarcinoma was statistically significant. The survival rate of patients with positive P0.05 or ER was significantly higher than that of patients with negative expression of ER. The difference was statistically significant in the positive rate of P0.05, PR in endometrial adenocarcinoma tissues was 53.9%, which was lower than that in atypical hyperplasia endometrial tissues (71.1% 27 / 38) and non-tumorous endometrial tissues (90.018% 20%), and in different histological grades, pathological types, clinical stages, tumor size. There was significant difference in the expression of PR in endometrial adenocarcinoma with the depth of myometrial invasion. The survival rate of patients with positive P0.05 or PR was significantly higher than that of patients with negative PR. The positive expression rate of Ki-67 in endometrial adenocarcinoma was 69.7%, which was higher than that in atypical hyperplasia endometrial tissue (34.2x 13 / 38) and non-neoplastic endometrial tissue (10.0% / 20%), and was graded in different histological grades. There was no significant difference in the expression of Ki-67 between the patients with positive P0.05 and Ki-67 and those with negative Ki-67. The positive rate of ING4 expression in endometrial adenocarcinoma was 55.3%, which was lower than that in atypical hyperplasia endometrial tissue (89.55 / 34 / 38) and non-neoplastic endometrial tissue (100% 20 / 20% 20 / 20% ING4) in different histological grade and pathological type. The positive rate of ING4 expression in endometrial adenocarcinoma was 55.3%, which was significantly lower than that in atypical hyperplasia endometrial tissue (89.55 / 34 / 38) and non-neoplastic endometrial tissue (100% 20% 20% ING4). There was no significant difference in the survival rate between the patients with positive P0.05N. ING4 and those with negative ING4 in clinical staging of endometrial adenocarcinoma. There was no significant difference in the expression of ER and PR in endometrial adenocarcinoma tissues. There was a positive correlation between ER and PR expression in endometrial adenocarcinoma tissues. There was a positive correlation between ER and ING4 expression in endometrial adenocarcinoma tissues. Conclusion: 1. The expression of PR and ING4 in endometrial adenocarcinoma tissues is low, while Ki-67 is highly expressed in endometrial adenocarcinoma tissues. The expression of PRKI-67 and ING4 in endometrial adenocarcinoma reflects to some extent the progression and malignancy of endometrial adenocarcinoma. The selection of clinical diagnosis and treatment of tumor may play a guiding role to some extent. 3. ERP has a significant correlation with the survival rate of endometrial adenocarcinoma.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.33

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