覃红,张瑜
QIN Hong,ZHANG Yu

• 1:中南大学湘雅医院妇科
• 2:湘西自治州人民医院&吉首大学第一附属医院妇科

摘要(Abstract)：

目的探讨子宫内膜癌(EC)患者POLQ样蛋白解旋酶(HELQ)的表达及临床意义。方法选取EC患者、子宫内膜不典型增生患者及正常子宫内膜女性分别作为EC组(n=37)、增生组(n=43)及正常组(n=30),取3组研究对象的子宫内膜组织制成石蜡切片,采用苏木精-伊红染色法(HE)、免疫组织化学法(IHC)分别检测3组研究对象子宫内膜组织的病理学特征、HELQ蛋白表达,采用Envision法检测EC组患者子宫内膜组织的增殖抗原指数(Ki67)、雌激素受体(ER)、孕激素受体(PR)的表达;比较HELQ阳性表达和HELQ阴性表达的EC患者肿瘤分化程度、国际妇产科协会(FIGP)分期、肌层浸润深度、淋巴结转移及脉管浸润差异;通过门诊复诊或电话随访EC组患者术后生存情况,采用Cox回归模型和受试者工作特征曲线分析HELQ表达对EC患者术后死亡的影响及预测效能,采用Kaplan-Meier法比较HELQ阳性和阴性的EC患者的生存曲线。结果 EC组患者HELQ阳性率较正常组、增生组低(P<0.05);HELQ阴性组EC患者肌层浸润深度> 1/2肌层、脉管侵袭比率、Ki67阳性率较HELQ阳性组高(P<0.05),PR阳性率较HELQ阳性组低(P<0.05);校正协变量后,HELQ表达不是EC患者死亡预后发生的独立影响因素(P> 0.05);HELQ、HELQ×Ki67、HELQ×PR及HELQ×Ki67×PR预测EC患者死亡的曲线下面积(AUC)分别为0.642、0.711、0.676及0.725,但P> 0.05。结论 HELQ表达可能与EC的发生、发展及死亡有关。
Objective To investigate the expression and clinical significance of Helicase POLQ-like protein(HELQ) in endometrial carcinoma( EC).Methods Thirty-seven patients with EC( EG group), 43 patients with endometrial atypical hyperplasia(hyperplasia group), and 30 women with normal endometrium( control group) were chosen for this study. The endometrial tissues of three groups were made into paraffin sections, and the clinicopathological features and HELQ expression were detected by hematoxylin eosin staining(HE) and immunohistochemistry(IHC). Expression of proliferative antigen index(Ki67), estrogen receptor( ER), and progesterone receptor( PR) were detected by Envision assay in the group of EC. The degree of tumor differentiation, FIGP staging,depth of myometrial invasion, lymph node metastasis and vascular invasion difference in the EC group with HELQ positive expression and HELQ negative expression was compared. The postoperative survival condition of patients in EC group was followed up by outpatient follow-up or telephone. The effect and prediction efficacy of HELQ expression on the death of EC patients was analyzed by Cox regression model and receiver operating characteristic curve. The survival curves of HELQ positive and HELQ negative EC patients was compared by Kaplan-Meier assay.Results The positive rate of HELQ in EC patients was lower than that of control group and hyperplasia group(P< 0. 05). The depth of myometrial invasion, vascular invasion rate and Ki67 positive rate in the HELQ-negative group were higher than those of HELQ-positive group(P< 0. 05); the PR positive rate was lower than those in the HELQ-positive group(P< 0. 05). After adjusting for covariates, HELQ expression was not an independent factor affecting the prognosis of death in EC patients(P< 0. 05). The Area under curve(AUC) of HELQ, HELQ × Ki67, HELQ × PR, and HELQ × Ki67 × PR in predicting EC death prognosis were 0. 642, 0. 711, 0. 676, and 0. 725, respectively(P> 0. 05).Conclusions The expression of HELQ is correlated with occurrence, development, and death of EC.

关键词(KeyWords)： 子宫内膜肿瘤;预后;免疫组织化学;雌激素受体;POLQ样蛋白解旋酶;不典型增生;增殖抗原
endometrial neoplasms;prognosis;immunohistochemistry;estrogen receptors;helicase POLQ-like protein;atypical hyperplasia;proliferative antigen

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金（82073323）

作者(Author): 覃红,张瑜
QIN Hong,ZHANG Yu

DOI: 10.19367/j.cnki.2096-8388.2022.01.012

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