| HE4蛋白与OPN蛋白对子宫内膜癌患者预后的影响 |
| 投稿时间：2016-08-25 修订日期：2016-09-05 点此下载全文 |
| 引用本文：李美艳,韩新彦,马利辉,呼君瑜,宋春丽,张易欣,朱明明,刘平.HE4蛋白与OPN蛋白对子宫内膜癌患者预后的影响[J].医学研究杂志,2017,46(4):146-153 |
| DOI：
10.11969/j.issn.1673-548X.2017.04.038 |
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| 中文摘要:目的 探讨正常子宫内膜组、癌前病变组和子宫内膜癌（endometrial carcinoma，EC）组中人附睾分泌蛋白4（HE4）和骨桥蛋白（OPN）的表达和相关性，及其对EC手术预后的影响。方法 采用免疫组化（SP）法，检测分析2009年1月~2015年6月期间就诊于邯郸市中心医院的正常组、癌前病变组及癌组中HE4、OPN的表达情况，采用Kaplan-Meier生存分析法和Log-rank检验来评价各因素与EC患者生存时间的关系，并用COX风险模型进行多因素分析。结果 正常组、癌前病变组和癌组的子宫内膜组织中，HE4蛋白的阳性表达率逐渐升高分别为13.33%、32.00%、70.76%，OPN蛋白的阳性表达率也逐渐升高分别为10.00%、24.00%、63.74%，且组间比较差异有统计学意义（P < 0.05）。HE4蛋白及OPN蛋白的阳性表达率在手术-病理分期、组织学分级、肌层浸润深度及有无淋巴结转移组中比较，差异均有统计学意义（P < 0.05）。Spearman相关分析显示，EC中HE4蛋白的表达与OPN蛋白的表达呈正相关（r=0.397，P < 0.05）。Kaplan-Meier分析显示手术-病理分期、肌层浸润深度、淋巴结转移、HE4阳性表达及OPN阳性表达5个因素与预后相关（P < 0.05），年龄、组织学分级、组织学类型与预后不相关（P > 0.05）。COX多因素逐步分析显示，手术-病理分期、组织学分级、肌层浸润深度、HE4阳性表达、OPN阳性表达是影响预后的显著因素，但组织学分级影响最不明显（P=0.049）。结论 HE4和OPN蛋白在EC中高表达且正相关，手术-病理分期晚、组织学分级高、肌层浸润深、HE4表达阳性、OPN表达阳性者预后差，HE4和OPN有望成为评价EC预后的重要标记。 |
| 中文关键词:子宫内膜癌 HE4蛋白 OPN蛋白 预后 COX回归模型 |
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| Effect of HE4 Protein and OPN Protein on the Prognosis of Patients with Endometrial Carcinoma |
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| Abstract:Objective To investigate the expression of human epididymis secretory protein 4 (HE4) and osteopontin(OPN) in normal endometrium group, precancerous lesion group and endometrial cancer group, and to analyze the correlation between the two proteins as well as the effect on the prognosis of EC operation. Methods Immunohistochemical SP method was used to detect the expression of HE4 and OPN in normal group, precancerous lesion group and cancer group of Handan Central Hospital from January 2009 to June 2015, and the correlation of factors and overall survival time was evaluated by Kaplan-Meier method and Log-rank test. COX model was used for multivariate analysis. Results In normal group, precancerous lesion group and cancer group, the positive expression of HE4 protein gradually increased respectively 13.33%, 32.00%, 70.76%, and the positive expression of OPN protein also gradually increased respectively 10.00%, 24.00%, 63.74%, with statistically significant difference between the three groups (P < 0.05). The positive expression rate of HE4 and OPN protein in surgery pathological stage, histological grade, myometrial invasion and lymph node metastasis group, and the differences were statistically significant (P < 0.05). Spearman correlation analysis showed that the expression of HE4 protein was positively correlated with the expression of OPN protein in endometrial carcinoma (r=0.397, P < 0.05). Kaplan-Meier analysis showed that the five factors of surgical pathologic staging, myometrial invasion, lymph node metastasis, HE4 positive status and OPN positive status were associated with prognosis (P < 0.05), while the age, histological grade, histological type were not associated with prognosis (P > 0.05). COX multivariate stepwise analysis showed that the significant factors influencing the prognosis were surgery pathological stage, histological grade, myometrial invasion, HE4 positive status and OPN positive status, but the histological grade was the least (P=0.049). Conclusion HE4 and OPN protein is highly expressed in the EC and both were positively correlated. The endometrial carcinoma patients with late surgery pathological stage, high histological grade, deep myometrial invasion, HE4 expression positive, OPN expression positive have poor prognosis. HE4 and OPN are expected to be an important marker for evaluating the prognosis of EC. |
| keywords:Endometrial carcinoma HE4 protein OPN protein Prognosis COX regression model |
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