王莉莉 朱振龙 郝彤

[摘要] 目的 研究Survivin在正常子宫内膜、子宫内膜不典型增生和子宫内膜样腺癌（EA）三种组织中表达的差异。 方法 选取华北石油管理局总医院2010年1月～2012年6月手术切除子宫并经病理证实的EA存档标本40例（EA组），经诊刮或宫腔镜检查病理结果示子宫内膜不典型增生20例（AHE组），同时选取同期因子宫脱垂或子宫肌瘤行子宫切除的正常子宫内膜20例作为对照（CON组）。通过免疫组织化学法检测三组中Survivin表达情况的差异。应用SPSS 16.0统计软件进行数据分析。 结果 EA组的Survivin表达阳性率为90%，显著高于CON组（75%），差异有统计学意义（P < 0.05）。在EA组中，组织分级为G1、G2、G3级的患者Survivin阳性率分别为85.0%、90.9%、100.0%，差异有统计学意义（P < 0.05）;手术-病理分期为Ⅰ期、Ⅱ期、Ⅲ期的患者Survivin阳性率分别为62.1%、85.7%、100.0%，差异有统计学意义（P < 0.05）;肌层浸润深度<1/2及≥1/2的患者Survivin阳性率分别为88.5%、92.9%，差异无统计学意义（P > 0.05）;存在淋巴结转移及无淋巴结转移的患者Survivin阳性率为100.0%、80.6%，差异无统计学意义（P > 0.05）;存在脉管浸润及无脉管浸润的患者Survivin阳性率分别为100.0%、84.2%，差异无统计学意义（P > 0.05）。 结论 相较于正常子宫内膜，EA组织中Survivin表达显著增多。Survivin的阳性表达率与EA组织学分级和手术-病理分期相关，与肌层浸润、淋巴结转移及有无脉管浸润无关。

[关键词] 子宫内膜样腺癌;Survivin;免疫组织化学;组织分级;手术-病理分期

[中图分类号] R737.33          [文献标识码] A          [文章编号] 1673-7210（2015）01（a）-0019-04

Expression of Survivin in endometrial carcinoma

WANG Lili1   ZHU Zhenlong2▲   HAO Tong3

1.Department of Obstetrics and Gynecology， North-China Petroleum Administration Bureau General Hospital， Hebei Province， Renqiu   062552， China; 2.Department of Pathology， the First Hospital， Hebei Medical University， Hebei Province， Shijiazhuang   050030， China; 3.Department of Pathology， North-China Petroleum Administration Bureau General Hospital， Hebei Province， Renqiu   062552， China

[Abstract] Objective To compare the expression of Survivin in normal endometrium， atypical hyperplasia of endometrium and endometrioid adenocarcinoma. Methods Forty cases of endometrioid adenocarcinoma samples resected from operation and confirmed by pathology were selected as EA group， 20 cases of atypical hyperplasia of endometrium （AHE） confirmed by pathologic from endocervical curettage or hysteroscopy were selected as AHE group， 20 cases of normal endometrium from hysterectomy for uterine prolapse or uterine fibroids were selected as control group （CON group） in North-China Petroleum Administration Bureau General Hospital from January 2010 to June 2012. Expression of Survivin in the three groups were detected by immunohistochemistry method. All the data was analyzed by SPSS 16.0. Results The positive expression rate of Survivin in the EA group was 90%， which was higher than that in the CON group （75%）， with statistically significant difference （P < 0.05）. In EA group， the positive expression rates of Survivin in patients with organization classification of G1， G2， G3 were 85.0%， 90.9% and 100.0%， with statistically significant differences （P < 0.05）; which in panties with surgery-pathological staging of Ⅰ， Ⅱ， Ⅲ were 62.1%， 85.7% and 100.0%， with statistically significant difference （P < 0.05）; which in patients with muscularis invasion depth<1/2 or ≥1/2 were  88.5% and 92.9%， without statistically significant difference （P > 0.05）; which in patients with lymphatic metastasis or non- metastasis were 100.0% and 80.6%， without statistically significant difference （P > 0.05）; which in patients with vascular invasion or non-vscular invasion were 100.0% and 84.2%， without statistically significant difference （P > 0.05）. Conclusion Compared with normal endometrium， endometrioid adenocarcinoma has higher Survivin expression. The positive expression rates of Survivin are correlated with the histological grade and surgery-pathological stage of EA， but has no relationship with myometrial invasion， lymph node metastasis or vascular invasion.