交界性子宫平滑肌瘤临床病理特征及p53\PCNA表达的意义
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[摘要] 目的：分析交界性子宫平滑肌瘤的临床病理特征及预后，检测p53、PCNA在其中的表达并探讨其意义。方法：回顾性分析57例交界性子宫平滑肌瘤患者临床病理特征并追踪；免疫组化S-P法检测其p53、PCNA表达，同时检测随机抽取10例正常子宫肌壁、20例子宫肌瘤、20例子宫肉瘤的p53、PCNA表达作为对照，分析二者在四组间表达的差异及意义。结果：交界性子宫平滑肌瘤临床表现无特异，病理上镜下可见核分裂象0～10个/5HPF，细胞一定异型性。预后好，可复发，多次复发后可恶变。肉瘤组p53阳性率、PCNA强阳性率高于肌瘤组和交界瘤组(P<0.05)。交界性子宫肌瘤 p53阳性组、PCNA强阳性组复发率高于阴性组及非强阳性组(P<0.05)。结论：交界性子宫平滑肌瘤预后良好，未育者可考虑保留子宫，但多次复发后可恶变。术后无需化疗，应加强随访。p53阳性表达和PCNA强阳性表达与交界性子宫肌瘤的不良预后存在密切关系，可预测交界性子宫平滑肌瘤复发和恶变，为临床诊断、鉴别、判断预后及治疗提供指导。
[关键词] 交界性子宫肌瘤；平滑肌瘤；子宫肉瘤；免疫组化；p53；PCNA
[中图分类号] R737.33 [文献标识码]A [文章编号]1673-7210(2011)03(c)-016-04
A study on the clinico-pathological characteristics and expression of p53, PCNA in uterine borderline leiomyoma
LI Kai, LIU Fengying
Department of Gynaecology and Obstetrics, the Second Xiangya Hospital of Central South University, Hu′nan Province, Changsha 410011, China
[Abstract] Objective: To analyse clinico-pathological features and prognosis of uterine borderline leiomyoma, and to studythe expression and signification of protein p53 and PCNA in uterine borderline leiomyoma. Methods: The clinico-pathological characteristics of 57cases with uterine bordline leiomyomas were analyzed retrospectively. S-P immunostaining was used to examine the expression of p53 and PCNA, while 10 cases normal myometrium tissue, 20 cases usual leiomyoma, and 20 cases leiomyosarcoma were sampled randomly as the control group. The difference of protein p53 and PCNA expression among the four groups were assessed. Results: The symptoms of borderline leiomyoma were not obvious. In microscope, the mitotic figure was 0-10/5HPF, cell atypia was lighte. Borderline leiomyoma had good prognosis, but it could recur after operation. The expression of p53 and the strong positive expression of PCNA in leiomyosarcoma was significantly higher than those in usual leiomyoma and borderline leiomyoma (P<0.05). In borderline leiomyoma, the patients with p53(+) and the patients with PCNA(+++) had higher recrudescence rates, compared with patients with p53(-) and PCNA(-,+,++) (P<0 ......
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