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目的初步探讨蛋白酶活化受体PAR-1在正常子宫内膜、子宫内膜增生(包括单纯性增生和复杂性增生)、子宫内膜不典型增生和子宫内膜癌中的表达及意义。方法收集子宫内膜癌组织55例(其中子宫内膜样腺癌50例,浆液性癌5例)、子宫内膜增生组织58例、不典型增生组织22例及正常子宫内膜组织40例,采用免疫组化SP法检测PAR-1表达情况。结果 PAR-1在正常子宫内膜、子宫内膜增生组织中为(-),在不典型增生、高分化和中分化子宫内膜样腺癌组织中的阳性率分别为4.5%(1/22)、4.7%(1/21)和11.1%(2/18),在低分化子宫内膜样腺癌和浆液性癌的阳性率为72.7%(8/11)和100%(5/5),显著高于其余各组(P<0.05)。17例伴盆腔淋巴结转移子宫内膜癌中,PAR-1阳性率为70.6%(12/17);38例无盆腔淋巴结转移子宫内膜癌组中PAR-1阳性率为13.2%(5/38),两组阳性率比较差异显著(P<0.05)。结论 PAR-1在低分化子宫内膜样腺癌和浆液性癌中呈高表达,提示PAR-1与子宫内膜样腺癌的分化程度和肿瘤恶性程度有关,检测PAR-1蛋白表达水平对评价子宫内膜癌的恶性程度及临床预后有一定的指导意义。
Objective To investigate the expression and significance of PAR-1, a proteinase-activated receptor, in normal endometrium, endometrial hyperplasia (including simple hyperplasia and complex hyperplasia), endometrial dysplasia and endometrial carcinoma. Methods 55 cases of endometrial carcinoma (including 50 cases of endometrial adenocarcinoma, 5 cases of serous carcinoma), 58 cases of endometrial hyperplasia, 22 cases of dysplasia and 40 cases of normal endometrium, Immunohistochemical SP method was used to detect the expression of PAR-1. Results The positive rate of PAR-1 in normal endometrium and endometrial hyperplasia tissue was (-), and in atypical hyperplasia, well differentiated and moderately differentiated endometrial adenocarcinoma were 4.5% (1/22 ), 4.7% (1/21), and 11.1% (2/18) respectively. The positive rates in poorly differentiated endometrioid adenocarcinoma and serous carcinoma were 72.7% (8/11) and 100% (5/5) , Significantly higher than the other groups (P <0.05). The positive rate of PAR-1 was 17.6% (12/17) in 17 cases of endometrial carcinoma with pelvic lymph node metastasis. The positive rate of PAR-1 in 38 cases of endometrial carcinoma without pelvic lymph node metastasis was 13.2% (5/38 ), The positive rate of the two groups was significantly different (P <0.05). Conclusions PAR-1 is highly expressed in poorly differentiated endometrioid adenocarcinoma and serous carcinoma, suggesting that PAR-1 is associated with the degree of malignancy of endometrial adenocarcinoma and the expression of PAR-1 protein. Evaluation of the degree of malignancy and clinical prognosis of endometrial cancer have some guiding significance.