Survivin在子宮內膜樣腺癌中的表達

王莉莉 朱振龍 郝彤

[摘要] 目的 研究Survivin在正常子宮內膜、子宮內膜不典型增生和子宮內膜樣腺癌（EA）三種組織中表達的差異。 方法 選取華北石油管理局總醫院2010年1月～2012年6月手術切除子宮并經病理證實的EA存檔標本40例（EA組），經診刮或宮腔鏡檢查病理結果示子宮內膜不典型增生20例（AHE組），同時選取同期因子宮脫垂或子宮肌瘤行子宮切除的正常子宮內膜20例作為對照（CON組）。通過免疫組織化學法檢測三組中Survivin表達情況的差異。應用SPSS 16.0統計軟件進行數據分析。 結果 EA組的Survivin表達陽性率為90%，顯著高于CON組（75%），差異有統計學意義（P < 0.05）。在EA組中，組織分級為G1、G2、G3級的患者Survivin陽性率分別為85.0%、90.9%、100.0%，差異有統計學意義（P < 0.05）;手術-病理分期為Ⅰ期、Ⅱ期、Ⅲ期的患者Survivin陽性率分別為62.1%、85.7%、100.0%，差異有統計學意義（P < 0.05）;肌層浸潤深度<1/2及≥1/2的患者Survivin陽性率分別為88.5%、92.9%，差異無統計學意義（P > 0.05）;存在淋巴結轉移及無淋巴結轉移的患者Survivin陽性率為100.0%、80.6%，差異無統計學意義（P > 0.05）;存在脈管浸潤及無脈管浸潤的患者Survivin陽性率分別為100.0%、84.2%，差異無統計學意義（P > 0.05）。 結論 相較于正常子宮內膜，EA組織中Survivin表達顯著增多。Survivin的陽性表達率與EA組織學分級和手術-病理分期相關，與肌層浸潤、淋巴結轉移及有無脈管浸潤無關。

[關鍵詞] 子宮內膜樣腺癌;Survivin;免疫組織化學;組織分級;手術-病理分期

[中圖分類號] R737.33 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1673-7210（2015）01（a）-0019-04

Expression of Survivin in endometrial carcinoma

WANG Lili1 ? ZHU Zhenlong2▲ ? HAO Tong3

1.Department of Obstetrics and Gynecology， North-China Petroleum Administration Bureau General Hospital， Hebei Province， Renqiu ? 062552， China; 2.Department of Pathology， the First Hospital， Hebei Medical University， Hebei Province， Shijiazhuang ? 050030， China; 3.Department of Pathology， North-China Petroleum Administration Bureau General Hospital， Hebei Province， Renqiu ? 062552， China

[Abstract] Objective To compare the expression of Survivin in normal endometrium， atypical hyperplasia of endometrium and endometrioid adenocarcinoma. Methods Forty cases of endometrioid adenocarcinoma samples resected from operation and confirmed by pathology were selected as EA group， 20 cases of atypical hyperplasia of endometrium （AHE） confirmed by pathologic from endocervical curettage or hysteroscopy were selected as AHE group， 20 cases of normal endometrium from hysterectomy for uterine prolapse or uterine fibroids were selected as control group （CON group） in North-China Petroleum Administration Bureau General Hospital from January 2010 to June 2012. Expression of Survivin in the three groups were detected by immunohistochemistry method. All the data was analyzed by SPSS 16.0. Results The positive expression rate of Survivin in the EA group was 90%， which was higher than that in the CON group （75%）， with statistically significant difference （P < 0.05）. In EA group， the positive expression rates of Survivin in patients with organization classification of G1， G2， G3 were 85.0%， 90.9% and 100.0%， with statistically significant differences （P < 0.05）; which in panties with surgery-pathological staging of Ⅰ， Ⅱ， Ⅲ were 62.1%， 85.7% and 100.0%， with statistically significant difference （P < 0.05）; which in patients with muscularis invasion depth<1/2 or ≥1/2 were ?88.5% and 92.9%， without statistically significant difference （P > 0.05）; which in patients with lymphatic metastasis or non- metastasis were 100.0% and 80.6%， without statistically significant difference （P > 0.05）; which in patients with vascular invasion or non-vscular invasion were 100.0% and 84.2%， without statistically significant difference （P > 0.05）. Conclusion Compared with normal endometrium， endometrioid adenocarcinoma has higher Survivin expression. The positive expression rates of Survivin are correlated with the histological grade and surgery-pathological stage of EA， but has no relationship with myometrial invasion， lymph node metastasis or vascular invasion.