摘要
目的 探讨子宫内膜癌癌组织与癌旁组织中第10号染色体同源缺失性磷酸酶-张力蛋白基因(PTEN)、基质金属蛋白酶-7(MMP-7)的表达情况,并分析PTEN、MMP-7表达与其临床病理特征及预后的相关性。方法 回顾性分析60例子宫内膜癌患者的资料,统计癌组织与癌旁组织中PTEN、MMP-7表达情况,并查阅患者术后随访资料,根据患者预后情况分组(术后3年内复发转移情况),比较不同病理特征、预后情况下PTEN、MMP-7的表达情况,并采用COX、列线图分析PTEN、MMP-7表达与其预后的关系。结果 子宫内膜癌患者癌组织中PTEN阳性表达率低于癌旁组织、MMP-7阳性表达率高于癌旁组织(P<0.05)。不同病理类型子宫内膜癌患者癌组织中PTEN、MMP-7阳性表达无显著差异(P>0.05);FIGO分期Ⅱ期、<1/2肌层浸润深度、淋巴结未转移、病理分级G_3的子宫内膜癌患者癌组织中PTEN阳性表达率更高,而FIGO分期Ⅲ期、≥1/2肌层浸润深度、淋巴结转移、病理分级G_2的子宫内膜癌患者癌组织中MMP-7阳性表达率更高(P<0.05)。预后不良组肿瘤FIGO分期Ⅲ期、≥1/2肌层浸润深度、淋巴结转移、病理分级G_3以及MMP-7阳性表达率高于预后良好组,PTEN阳性表达率低于预后良好组(P<0.05);两组其他资料比较无显著差异(P>0.05)。经Cox回归分析发现,子宫内膜癌患者预后不良风险可能与PTEN阴性、MMP-7阳性有关(P<0.05)。PTEN阴性患者术后预后不良风险增加100分,MMP-7阳性患者术后预后不良风险增加62.5分;基于Cox回归分析结果,绘制的列线图模型预测患者术后预后不良风险的C-index为0.745(95%CI:0.666~0.825),提示模型辨别度良好。结论 子宫内膜癌癌组织中PTEN多呈阴性表达、MMP-7多呈阳性表达,且PTEN、MMP-7表达与肿瘤FIGO分期、浸润深度、淋巴结转移、病理分级有关,PTEN阴性、MMP-7阳性可能提示患者预后不良风险增加,应引起重视。
Objective To investigate the expression of phosphatase and tensin homolog deleted on chromosome ten(PTEN)and matrix metalloproteinase-7(MMP-7)on chromosome 10 in endometrial cancer tissues and adjacent tissues,and analyze the correlation between PTEN and MMP-7 expression and their clinical pathological characteristics and prognosis.Methods The data of 60 patients with endometrial cancer were retrospectively analyzed.The expression of PTEN and MMP-7 in cancer tissues and adjacent tissues was statistically analyzed,and the postoperative follow-up data of patients were reviewed.According to the prognosis of patients,the patients were divided into groups(recurrence and metastasis within 3 years after operation),and the expression of PTEN and MMP-7 in different pathological features and prognosis were compared,and the relationship between the expression of PTEN and MMP-7 and its prognosis was analyzed by COX and nomogram.Results The positive expression rate of PTEN in endometrial cancer patients was lower than that in adjacent tissues,and the positive expression rate of MMP-7 was higher than that in adjacent tissues(P<0.05).There was no significant difference in the positive expression of PTEN and MMP-7 in endometrial cancer tissues of patients with different pathological types(P>0.05).The positive expression rate of PTEN was higher in endometrial cancer tissues of patients with FIGO stageⅡ,<1/2 depth of muscle infiltration,no lymph node metastasis,and pathological grade G 3,while the positive expression rate of MMP-7 was higher in endometrial cancer tissues of patients with FIGO stageⅢ,≥1/2 depth of muscle infiltration,lymph node metastasis,and pathological grade G 2(P<0.05).The FIGO stageⅢ,≥1/2 depth of muscle infiltration,lymph node metastasis,G 3 pathological grade,and MMP-7 positive expresion in the poor prog-nosis group were higher than those in the good prognosis group,and PTEN positive expression was higher than those in the good prognosis group(P<0.05).There was no statistical significant difference in other data between the 2 groups(P>0.05).Cox regression analysis found that the risk of poor prognosis in patients with endometrial cancer may be related to PTEN negative and MMP-7 positive(P<0.05).PTEN-negative patients have a 100-point increase in the risk of poor prognosis after surgery,MMP-7 positive patients have a 62.5-point increase in the risk of poor prognosis after surgery;based on the results of Cox regression analysis,the C-index of the nomogram model for predicting the risk of postoperative poor prognosis was 0.745(95%CI:0.666~0.825),suggesting that the model had good discrimination.Conclusion PTEN is mostly negative and MMP-7 is mostly positive in endometrial cancer tissues,and and the expression of PTEN and MMP-7 is related to tumor FIGO staging,infiltration depth,lymph node metastasis,and pathological grading.PTEN negative and MMP-7 positive may indicate an increased risk of poor prognosis in patients,which should be taken seriously.
作者
杨元元
刘俊玲
YANG Yuanyuan;LIU Junling(Zhengzhou First People's Hospital,Zhengzhou,450000)
出处
《实用癌症杂志》
2025年第3期384-389,共6页
The Practical Journal of Cancer
