目的:研究子宫内膜癌原发灶和转移灶组织中KAI1蛋白的表达并探讨其临床意义.方法:应用免疫组化S-P法检测KAI1蛋白在子宫内膜癌76例原发肿瘤和44例转移肿瘤中的表达,并分析其与临床病理特征的关系.结果:子宫内膜癌原发灶组织中KAI1的阳性表达随着手术-病理分期(P=0.0089)、组织学分级(P=0.0103)增高及深肌层浸润(P=0.0356)而降低,并与盆腔淋巴结转移(P=0.0091)、宫旁或附件受累(P=0.0073)呈显著相关,与年龄(P=1.0000)、宫颈是否受累(P=0.0911)以及病理类型(P=0.7927)均无相关性.KAI1在子宫内膜癌的肌层浸润癌灶组织和淋巴结转移癌灶组织中的阳性表达差异有统计学意义(P=0.01).KAI1表达阴性组和阳性组的生存率差异具有统计学意义(P=0.0043),多因素分析显示KAI1表达不是子宫内膜癌的独立预后因素.结论:KAI1蛋白在子宫内膜癌的发展进程中表达缺失,它可能作为临床预测子宫内膜癌患者发生淋巴结转移和评估预后的综合指标之一.
To study the expression difference of KAI1 protein in primary site and metastatic site of endometrial carcinoma and its clinical significance. Methods:SP immunohistochemistry was used to detect the expression of KAI1 protein in 76 primary tissue sampies and 44 metastatic tissue samples. Results:The positive rate of KAI1 protein decreased as the surgical-pathological stages( P = 0.0089 ) and histological grades( P = 0.0103 ) increased and deep myometrial infiltration (P = 0.0356). The expression in the primary site was positively related to lymph nodes metastasis and invasion to parametrium and adnexa (P = 0. 0091, 0. 0073). The positive rate had no relation with age ( P = 1. 0000 ), cervix invasion ( P = 0. 0911 ) and pathological types( P = 0.7927 ). There was significant difference between expressions of KAI1 in muscle infiltration tissues and lymph nodes metastasis tissue( P = 0.01 ). The survival rate was significantly different between KAI1 negative and positive groups (P =0. 0043). Multiple factor analysis showed KAI1 expression was not an undependent prognosis factor. Conclusion:The loss of KAI 1 protein in the development of endometrial cancer may be a potential target to predict the probability of lymph node metastasis and evalute the prognosis.