摘要
目的探究胰岛素样生长因子ⅡmRNA结合蛋白3(IMP3)、P16蛋白、人附睾蛋白4(HE4)、P53蛋白在卵巢浆液性肿瘤中表达及其临床意义。方法采用免疫组织化学法对2010年11月至2017年11月该院卵巢浆液性囊腺瘤204例(良性组),卵巢交界性浆液性肿瘤42例(交界性组),卵巢浆液性癌64例(恶性组)组织进行IMP3、P16蛋白、HE4及P53蛋白检测并分析临床病理意义。结果 IMP3、P16蛋白、HE4在良性组中的阳性表达率(15.20%、24.02%和25.00%)明显低于交界性组(54.76%、71.43%和71.43%)和恶性组(73.44%、85.94%和75.00%),差异均有统计学意义(P<0.05);P53蛋白在良性组(4.90%)和交界性组(4.76%)阳性表达率明显低于恶性组(42.19%),差异均有统计学意义(P<0.05);IMP3、HE4和P53蛋白阳性表达率在不同分化程度卵巢浆液性癌间比较,差异均具有统计学意义(P<0.05);HE4阳性表达率在盆腔淋巴结有无转移者间比较,差异具有统计学意义(P<0.05);四项指标联合检测卵巢浆液性囊腺癌灵敏度(92.19%)和特异度(96.88%),显著高于IMP3(分别为42.19%和60.94%)和P16蛋白单项检测(分别为40.62%和45.31%),差异均有统计学意义(P<0.05)。IMP3、P16蛋白、HE4和P53蛋白联合检测的受试者工作特征曲线(ROC曲线)下面积0.869显著高于各指标单独检测的曲线下面积(P<0.05);在四项指标的单独检测中,HE4的ROC曲线下面积0.816最大(P<0.05)。结论 IMP3、P16蛋白、HE4和P53蛋白联合检测能够提升临床卵巢浆液性癌的诊断率,有望成为卵巢浆液性癌检测良好指标。
Objective To observe of expression of IMP3,P16 protein,HE4 and P53 protein in serous ovarian tumors and its clinical significance.Methods 204 cares with serous cystadenomas(benign group)and 42 cares with serous borderline tumors(borderline group)and 64 cares with serous adenocarcinomas(malignant group)in a hospital from November 2010 to November 2017,which were immunohistochemical stained IMP3,P16 protein,HE4 and P53 protein,the clinical pathological significance were analyzed.Results The expression rates of IMP3,P16 protein,HE4 in benign group(15.20%,24.02% and 25.00%)was significantly lower than that in borderline group(54.76%,71.43% and 71.43%)and malignant group(73.44%,85.94%and 75.00%).The datas all had statistically significant difference(P<0.05).The expression rates of P53 protein in benign group(4.90%)and borderline group(4.76%)was significantly lower than that in malignant group(42.19%).The datas all had statistically significant difference(P<0.05).The expression rates of IMP3,HE4 and P53 protein were significantly different in different differentiation degrees serous adenocarcinomas(P<0.05).The expression rates of HE4 was significantly different in lymph node metastasis(P<0.05).The sensitivity(92.19%)and specificity(96.88%)of combined detection of four indicators of ovarian serous cystadenocarcinoma,significantly higher those the IMP3(42.19% and 60.94%)and P16 protein(40.62% and 45.31%)single examination,The dates had statistical significance(P<0.05).The area under the receiver operating characteristic curve(ROC curve)measured by IMP3,P16 protein,HE4 and P53 protein was significantly higher than the area under the curve of each index(P<0.05).In the separate detection of the four indexes,the area under the ROC curve of P53 protein was 0.816(P<0.05).Conclusion IMP3,P16 protein,HE4 and P53 protein the four joint detection can improve the diagnostic yield of serous adenocarcinomas,it is likely to be a good indicator to detect serous adenocarcinomas.
引文
[1]岳娟,刘菲,姚丽,等.DUSP10和BZW1在卵巢浆液性肿瘤中的表达及临床意义[J].现代肿瘤医学,2016,24(10):1625-1630.
[2]郭艳萍,周巾,栾媛媛,等.NAC1、FOXQ1在不同级别卵巢浆液性癌组织中表达及其临床意义[J].临床和实验医学杂志,2017,16(10):965-970.
[3]AYHAN A,KURMAN R J,YEMELYANOVA A,et al.Defining the cut point between low-grade and high-grade ovarian serous carcinomas:a clinicopathologic and molecular genetic analysis[J].Am J Surg Pathol,2009,33(8):1220-1224.
[4]高晓,吴宏培,张冠军.63例卵巢浆液性癌的MDACC分级及临床病理意义[J].医学临床研究,2016,33(3):507-509.
[5]印永祥,王曦辉,赵华,等.CD44及IMP3在上皮性卵巢癌中的表达[J].中国妇幼保健,2017,32(10):2212-2214.
[6]赵立武,申彦,师宜荃,等.P16、P53和CyclinD1蛋白在卵巢浆液性肿瘤中的表达及意义[J].解剖学研究,2012,34(4):251-255.
[7]林洁,杜娟,张春妤,等.卵巢浆液性癌两级组织学分级系统的评估及p53蛋白过表达的意义[J].中华病理学杂志,2010,39(10):655-660.
[8]张湛,许相丰,魏刚.MRI在宫颈癌分期及淋巴结转移评估中的价值探讨[J].天津医药,2016,44(8):1022-1025.
[9]SCHUMMER M,NG W V,BUMGARNER R E,et al.Comparative hybridization of an array of 21,500ovarian cDNAs for the discovery of genes overexpressed in ovarian carcinomas[J].Gene,1999,238(2):375-385.
[10]唐灿,邹琼,粟占三,等.卵巢浆液性肿瘤中IGF-2R的表达及其意义[J].临床与实验病理学杂志,2016,32(9):1041-1043.
[11]王小娟,成洲,王晓萍,等.IMP3恶性肿瘤的诊断及预后标志物[J].医学综述,2017(23):4633-4637.
[12]ELBALAT A,SAONGER N,KARN T,et al.IMP3expression in borderline tumors of the ovary[J].Anticancer Res,2017,37(2):583-588.
[13]王祎杰,王晓英.新抗癌基因p16的分析检测研究进展[J].分析科学学报,2017,33(4):562-566.
[14]LEE Y H,HEO J H,KIM T H,et al.Significance of cell cycle regulatory proteins as malignant and prognostic biomarkers in ovarian epithelial tumors[J].Int J Gynecol Pathol,2011,30(3):205-217.
[15]赫慧.毕芳芳,杨清.MSLN,HE4和Ki67在高级别浆液性卵巢癌组织中的表达及意义[J].现代肿瘤医学,2017,25(20):3290-3294.
[16]WEI S U,LI H,ZHANG B.The diagnostic value of serum HE4and CA-125and ROMA index in ovarian cancer[J].Biomedical Rep,2016,5(1):41-44.
[17]张仁峰,公蕾.p53基因与肿瘤治疗研究进展[J].现代免疫学,2016,20(2):150-153.