国际肿瘤学杂志

国际肿瘤学杂志 ›› 2017, Vol. 44 ›› Issue (5): 351-355.doi: 10.3760/cma.j.issn.1673422X.2017.05.007

• 论著 • 上一篇    下一篇

HE4、OPN及uPA检测对子宫内膜癌患者诊断的临床意义

李美艳   

  1. 056008 河北省邯郸市中心医院妇一科
  • 出版日期:2017-05-08 发布日期:2017-04-19
  • 通讯作者: 李美艳，Email: lmy200602744@163.com E-mail:lmy200602744@163.com

Clinical significance of detection of HE4, OPN and uPA in the diagnosis of endometrial carcinoma

Li Meiyan   

  1. First Department of Gynaecology, Handan Central Hospital of Hebei Province, Handan 056008, China
  • Online:2017-05-08 Published:2017-04-19
  • Contact: Li Meiyan E-mail:lmy200602744@163.com

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摘要： 目的探讨人附睾分泌蛋白4(HE4)、骨桥蛋白(OPN)和尿激酶型纤溶酶原激活物(uPA)在子宫内膜癌(EC)组织中的表达情况及其关系，并分析其在EC患者检测和诊断中的临床意义。方法免疫组织化学SP法检测30例正常子宫内膜、50例癌前病变内膜和171例EC组织中HE4、OPN和uPA蛋白的表达，分析HE4、OPN和uPA与EC临床病理特征的关系及三者表达的相关性。结果HE4、OPN和uPA在正常组、癌前病变组和EC组阳性表达率分别为13.3%、32.0%、70.8%；10.0%、24.0%、63.7%；6.7%、22.0%、51.5%，差异均有统计学意义(χ2=46.36，P<0.05；χ2=44.14，P<0.05；χ2=28.10，P<0.05)。HE4、OPN和uPA的表达均与病理分期(χ2=4.644，P=0.031；χ2=5.780，P=0.016；χ2=28.920，P=0.000)、组织学分级(χ2=4.888，P=0.027；χ2=7.885，P=0.005；χ2=4.564，P=0.033)、肌层浸润深度(χ2=5.099，P=0.024；χ2=5.139，P=0.023；χ2=12.297，P=0.000)、淋巴结转移(χ2=5.421，P=0.020；χ2=4.093，P=0.043；χ2=5.362，P=0.021)有关。另外，HE4的表达与组织学类型相关(χ2=4.437，P=0.035)。HE4与uPA表达呈正相关（r=0.341，P=0.007）；OPN与uPA表达呈正相关（r=0.360，P=0.002）；HE4与OPN表达呈正相关（r=0.454，P=0.000）。结论HE4、OPN和uPA在EC中的表达高于正常子宫内膜和癌前病变内膜，三者在EC的发生、发展中具有明显的正向协同效应，是EC临床诊断预测的有效指标。

关键词: 子宫内膜肿瘤, 骨桥蛋白质, 人附睾分泌蛋白4, 尿激酶型纤溶酶原激活物

Abstract: ObjectiveTo investigate the expressions and relationships of human epididymal secretory protein 4 (HE4), osteopontin (OPN) and urokinasetype plasminogen activator (uPA) in endometrial carcinoma (EC) and analyze their clinical significance of detection and diagnosis in EC patients. MethodsThe expressions of HE4, OPN and uPA proteins in 30 cases of normal endometrium, 50 cases of precancerous lesion endometrium and 171 cases of EC were detected by immunohistochemistry SP method. The relationships between HE4, OPN, uPA and clinicopathological features of EC, and the correlation of them were analyzed. ResultsThe positive expression rates of HE4, OPN and uPA in the normal endometrium group, precancerous lesion endometrium group and EC group were 13.3%, 32.0%, 70.8%；10.0%, 24.0%, 63.7%；6.7%, 22.0%, 51.5%. The differences were statistically significant (χ2=46.36, P<0.05； χ2=44.14, P<0.05； χ2=28.10, P<0.05). The expressions of HE4, OPN and uPA were correlated with pathological stage (χ2=4.644, P=0.031； χ2=5.780, P=0.016； χ2=28.920, P=0.000), histological grade (χ2=4.888, P=0.027； χ2=7.885, P=0.005； χ2=4.564, P=0.033), myometrial invasion depth (χ2=5.099, P=0.024； χ2=5.139, P=0.023； χ2=12.297, P=0.000) and lymph node metastasis (χ2=5.421, P=0.020； χ2=4.093, P=0.043； χ2=5.362, P=0.021). In addition, the expression of HE4 was correlated with the histological type (χ2=4.437, P＝0.035). HE4 expression was positively correlated with uPA expression (r=0.341, P=0.007). OPN expression was positively correlated with uPA expression (r=0.360, P=0.002). HE4 was positively correlated with OPN expression (r=0.454, P=0.000). ConclusionThe expression rates of HE4, OPN and uPA in the EC group were higher than that in normal endometrium and precancerous lesions. They have obvious positive synergistic effect in the occurrence and development of EC. HE4, OPN and uPA are the effective indicators for clinical diagnosis of EC.

Key words: Endometrial neoplasms, Osteopontin, Human epididymis secretory protein 4, Urokinasetype plasminogen activator