摘要
目的:探讨卵巢上皮性肿瘤组织中尿激酶型纤溶酶原激活物受体蛋白(Urokinase-type Plasminogen Activator Receptor,uPAR)和乳腺癌易感基因1(breast cancer susceptibility gene 1,BRCA-1)的表达,探讨其相关性及临床意义。
方法:42例经病理证实的卵巢上皮性癌标本(浆液性囊腺癌30例,粘液性囊腺癌10例,子宫内膜样腺癌2例),15例交界性卵巢肿瘤,12卵巢上皮性良性肿瘤,采用免疫组化法检测uPAR,BRCA-1的表达,应用SPSS15.0软件应用Kruskal-Wallis H检验法(成组设计多个样本比较秩和检验)、Mann-Whitney U检验法(两样本比较秩和检验)及直线相关分析。
结果:1.卵巢上皮性癌组织中BRCA1的阳性表达率为33.3%(14/42),卵巢交界性肿瘤组织中为60%(9/15),上皮性良性肿瘤组织中为83.3%(10/12)。卵巢上皮性癌组织中BRCA—1蛋白表达阳性率显著低于良性卵巢上皮肿瘤和交界性卵巢肿瘤(P＜0.005)。卵巢癌G_1级BRCA-1阳性率90%(9/10),G_2级阳性率22.2%(4/18),G_3级中阳性率14.3%(2/14),G1与G3、G2与G3之间的阳性表达率存在统计学差异(p＜0.05),说明随着分化程度的降低,BRCA-1的阳性表达率逐渐下降。伴淋巴结转移的患者中BRCA-1阳性率25%(3/12),无淋巴结转移的患者阳性率50%(8/16),结果表明,BRCA-1的表达下调与卵巢癌的淋巴结转移率显著相关(P＜0.05)。
2.卵巢上皮性良性肿瘤中uPAR阳性表达率为25%(3/12);在交界性卵巢肿瘤中,阳性表达率为53.3%8/15);在卵巢上皮性癌中阳性表达率为83.3%(35/42)。卵巢癌中uPAR表达明显高于良性及交界性肿瘤(P＜0.005)。卵巢癌Ⅰ期患者中uPAR阳性率100%(9/9),Ⅱ期阳性率90.9%(10/11),Ⅲ期阳性率91.7%(11/12),Ⅳ期阳性率50%(5/10)。随着临床期别的升高,uPAR的阳性表达率逐渐下降。卵巢癌G_1级uPAR阳性率90%(9/10),G_2级中阳性率88.9%(16/18),G_3级中阳性率71.4%(10/14),表明分化程度降低,uPAR的阳性表达率下调。伴淋巴结转移患者中uPAR阳性率58.3%(7/12)无淋巴结转移的患者中uPAR阳性率81.3%(13/16),结果表明,uPAR的表达下调与卵巢癌的淋巴结转移显著相关(P＜0.05)。
3.卵巢上皮性癌中uPAR和BRCA-1的表达进行Spearman等级相关分析,相关系数为—0.350,P=0.002,具有统计学显著性差异。(P＜0.05)
结论:1.早期、高分化卵巢癌组织中uPAR高表达,提示uPAR至少在卵巢癌的早期发生发展过程中发挥重要的作用。2.BRCA-1表达下调促进卵巢上皮性癌的发生发展,与其侵袭转移密切相关。3.uPAR与BRCA-1的表达呈负相关,提示两种蛋白可能通过不同途径参与卵巢上皮性癌的发生发展。
Objective: It was to observe the expression and sense of UPAR、BRCA-1 in tissue of Epithelial Ovarian Tumour and its correlation.
Methods: BRCA 1 and uPAR protein expressions were detected in 69 epithelial ovarian tumours. Kaplan-Meier method was used to analyze the relationship between their expressions. Spearman's method was used to analyze its correlations.
Results: 1.BRCA1 positive expression rates were 33.3% (14/42)in ovarian cancers, 60 % (9/15)in borderline epithelial ovarian tumour, and 83.3 %(10/12)in benign epithelial ovarian tumour respectivdy. The positive rate of BRCA1 protein in ovarian cancer was lower than that in benign and borderline epithelial ovarian tumours。(P<0.05)。
2.The positive rate of uPAR expression in ovarian cancer is 83.3% (35/42),53.3%(8/15) in borderline epithelial ovarian tumour,and 25% (3/12) in benign epithelial ovarian tumour respectivdy.
3. The expression of BRCA1 was negative correlated wth uPAR in epithelial ovarian cancer (r=-0.350, P<0.05) The positive rate of uPAR protein in ovarian cancer was higher than that in benign and borderline epithelial ovarian tumours。(P<0.005)。
Conclusion: 1. The high expression level and intensity of uPAR at the early stage and good play differential grade ovarian cancer tissue showed that uPAR may, at least,played a important role at the early stage.
2. The low expression of BRCA-1 in ovarian cancer tissue showed that BRCA-1 might play an important roles in the infiltration,metastasis of epithelial ovarian cancer.
3. The expression level and intensity of uPAR was negative correlated to BRCA-1 in the epithelial ovarian cancer tissue,showde that they may played important roles in the infiltration,metastasis of epithelial ovarian cancer in different ways.
引文
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