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目的探讨芳香化酶蛋白、雌激素受体(ER)、孕激素受体(PR)及细胞增殖相关核抗原Ki67在子宫内膜病变组织中的阳性表达率及其在子宫内膜病变的诊断和治疗中的价值。方法采用免疫组化链霉菌抗生物素蛋白-过氧化物酶链接(SP)法,检测148例子宫内膜病变患者(观察组,其中子宫内膜增殖症30例,轻、中、重度子宫内膜非典型增生各10例,子宫内膜腺癌88例)及30例因患宫颈原位癌行子宫全切除术患者的正常子宫内膜组织(对照组,其中增殖期及分泌期子宫内膜各15例)中芳香化酶蛋白、ER、PR及Ki67的阳性表达率。结果(1)观察组子宫内膜增殖症、子宫内膜非典型增生组织芳香化酶蛋白、ER、PR、Ki67的阳性表达率与对照组增殖期内膜比较,差异无统计学意义(P>0·05);(2)观察组子宫内膜腺癌组织芳香化酶蛋白阳性表达率为64%(56/88),与子宫内膜非典型增生(23%,7/30)、子宫内膜增殖症(13%,4/30)及对照组(0/15)比较,差异均有统计学意义(P<0·01);(3)芳香化酶蛋白的阳性表达率与子宫内膜腺癌的临床分期(Ⅰ期61%、Ⅱ期77%、Ⅲ期70%、Ⅳ期67%)、肿瘤细胞分化级别(高分化64%,中分化74%,低分化58%)、有无淋巴转移(转移59%,无转移67%)无明显相关性(P>0·05)。(4)子宫内膜腺癌组织中ER、PR、Ki67的阳性表达率分别为22%(19/88)、19%(17/88)、41%(36/88),与对照组分别比较,差异均有统计学意义(P<0·01)。结论子宫内膜良性病变组织与正常内膜组织中,芳香化酶蛋白表达无明显差异;子宫内膜腺癌组织中芳香化酶蛋白的过度表达,可作为诊断子宫内膜腺癌的指标之一。
Objective To investigate the positive expression rates of aromatase, estrogen receptor (ER), progesterone receptor (PR) and cell proliferation associated nuclear antigen (Ki67) in endometrial lesions and their clinical significance in endometrial lesions The value of treatment. Methods Immunohistochemical streptavidin - peroxidase linked (SP) method was used to detect 148 cases of endometrial lesions (observation group, including 30 cases of endometrial hyperplasia, mild, moderate and severe intrauterine 10 cases of atypical hyperplasia, 88 cases of endometrial adenocarcinoma, and 30 cases of normal endometrial tissue underwent hysterectomy with carcinoma of the cervix (control group, in which proliferative and secretory endometrium Each of 15 cases) in the aromatase protein, ER, PR and Ki67 positive expression rate. Results (1) The positive rate of expression of aromatase, ER, PR and Ki67 in endometrial hyperplasia and endometrial atypical hyperplasia in observation group was not significantly different from that in control group (P> 0.05). (2) The positive rate of aromatase expression in the endometrial adenocarcinoma tissue in the observation group was 64% (56/88), which was significantly higher than that in the endometrial atypical hyperplasia (23%, 7/30) (13%, 4/30) and control group (0/15), the difference was statistically significant (P <0.01); (3) The positive rate of aromatase protein expression in the endometrium The clinical stage of adenocarcinoma (stage Ⅰ 61%, stage Ⅱ 77%, stage Ⅲ 70%, stage Ⅳ 67%), differentiation of tumor cells (well differentiated 64%, moderately differentiated 74%, poorly differentiated 58%), with or without There was no significant correlation between lymph node metastasis (59% metastasis, 67% without metastasis) (P> 0.05). (4) The positive rates of ER, PR and Ki67 in endometrial adenocarcinoma were 22% (19/88), 19% (17/88) and 41% (36/88) respectively, which were significantly higher than those in control group , The differences were statistically significant (P <0.01). Conclusions There is no significant difference in the expression of aromatase between benign endometrial lesions and normal endometrial tissues. Overexpression of aromatase in endometrial adenocarcinoma may be one of the diagnostic criteria for endometrial adenocarcinoma .