中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2013年
8期
509-514
,共6页
王跃%马晓龙%席晨光%林洁%任彩霞%刘从容
王躍%馬曉龍%席晨光%林潔%任綵霞%劉從容
왕약%마효룡%석신광%림길%임채하%류종용
子宫内膜肿瘤%受体,雌激素%病理学,临床
子宮內膜腫瘤%受體,雌激素%病理學,臨床
자궁내막종류%수체,자격소%병이학,림상
Endometrial neoplasms%Receptors,estrogen%Pathology,clinical
目的 通过分析子宫内膜癌中雌激素受体(ER)表达状况与临床病理参数的相关性,对三种不同的ER免疫组织化学评分方式进行对比研究.方法 免疫组织化学EnVision法检测199例子宫内膜癌(其中Ⅰ型癌160例,Ⅱ型癌39例)石蜡标本中ER的表达状况,分别采用美国临床肿瘤学会/美国病理医师学院(ASCO/CAP)、H-Score和Allred score标准进行评判,分析各自与临床病理参数的相关性.结果 三种评分结果均显示,ER表达状况与子宫内膜癌患者术前CA125水平(P=0.015,P=0.007,P=0.023)、组织学分级(均P＜0.01)、孕激素受体(PR)状况(均P＜0.01)以及Ⅰ型癌p53阳性(P=0.042)等参数具有统计学相关性.仅ASCO/CAP(P=0.027)和H-Score(P =0.035)评定结果显示ER的表达状况与Ⅰ型癌患者年龄具有统计学相关性.仅ASCO/CAP与患者的国际妇产科联盟分期(P =0.005)、脉管内瘤栓(P =0.002)、淋巴结转移(P =0.021)、肌层浸润深度(P=0.067)和大网膜受累(P=0.067)呈负相关.结论 与H-Score和Allred score相比,ASCO/CAP标准判定的ER表达状况与临床病理参数的相关性更为密切,该方法简便易行,适合在子宫内膜癌的临床病理诊断中推广应用.
目的 通過分析子宮內膜癌中雌激素受體(ER)錶達狀況與臨床病理參數的相關性,對三種不同的ER免疫組織化學評分方式進行對比研究.方法 免疫組織化學EnVision法檢測199例子宮內膜癌(其中Ⅰ型癌160例,Ⅱ型癌39例)石蠟標本中ER的錶達狀況,分彆採用美國臨床腫瘤學會/美國病理醫師學院(ASCO/CAP)、H-Score和Allred score標準進行評判,分析各自與臨床病理參數的相關性.結果 三種評分結果均顯示,ER錶達狀況與子宮內膜癌患者術前CA125水平(P=0.015,P=0.007,P=0.023)、組織學分級(均P＜0.01)、孕激素受體(PR)狀況(均P＜0.01)以及Ⅰ型癌p53暘性(P=0.042)等參數具有統計學相關性.僅ASCO/CAP(P=0.027)和H-Score(P =0.035)評定結果顯示ER的錶達狀況與Ⅰ型癌患者年齡具有統計學相關性.僅ASCO/CAP與患者的國際婦產科聯盟分期(P =0.005)、脈管內瘤栓(P =0.002)、淋巴結轉移(P =0.021)、肌層浸潤深度(P=0.067)和大網膜受纍(P=0.067)呈負相關.結論 與H-Score和Allred score相比,ASCO/CAP標準判定的ER錶達狀況與臨床病理參數的相關性更為密切,該方法簡便易行,適閤在子宮內膜癌的臨床病理診斷中推廣應用.
목적 통과분석자궁내막암중자격소수체(ER)표체상황여림상병리삼수적상관성,대삼충불동적ER면역조직화학평분방식진행대비연구.방법 면역조직화학EnVision법검측199례자궁내막암(기중Ⅰ형암160례,Ⅱ형암39례)석사표본중ER적표체상황,분별채용미국림상종류학회/미국병리의사학원(ASCO/CAP)、H-Score화Allred score표준진행평판,분석각자여림상병리삼수적상관성.결과 삼충평분결과균현시,ER표체상황여자궁내막암환자술전CA125수평(P=0.015,P=0.007,P=0.023)、조직학분급(균P＜0.01)、잉격소수체(PR)상황(균P＜0.01)이급Ⅰ형암p53양성(P=0.042)등삼수구유통계학상관성.부ASCO/CAP(P=0.027)화H-Score(P =0.035)평정결과현시ER적표체상황여Ⅰ형암환자년령구유통계학상관성.부ASCO/CAP여환자적국제부산과련맹분기(P =0.005)、맥관내류전(P =0.002)、림파결전이(P =0.021)、기층침윤심도(P=0.067)화대망막수루(P=0.067)정부상관.결론 여H-Score화Allred score상비,ASCO/CAP표준판정적ER표체상황여림상병리삼수적상관성경위밀절,해방법간편역행,괄합재자궁내막암적림상병리진단중추엄응용.
Objective To compare the efficiency of three different estrogen receptor (ER) immunostaining scoring systems by analyzing the correlation between ER status and clinicopathologic features for prediction of prognosis of patients with endometrial carcinoma (EC).Methods ER immunostaining (EnVision method) was performed in 160 type Ⅰ EC and 39 type Ⅱ EC paraffin samples and was scored by ASCO/CAP criterion,H-Score and Allred scoring system.Correlation between ER status and clinicopathologic features was statistically analyzed.Results ASCO/CAP criterion,H-Score and Allred (cutoff point:4-8) scoring system showed high concordance in the following aspects.In EC patients,ER status was significantly associated with presurgical CA125 levels (P =0.015,P =0.007,P =0.023),histologic grades (all P ＜ 0.01) and PR status (all P ＜ 0.01).In type Ⅰ EC cohort,ER status was significantly correlated with PR status (P =0.008,P ＜0.01,P ＜0.01) and p53 status (P =0.042,P =0.001,P ＜0.01).As of the predictive value of ER status for type Ⅰ EC patient age,ASCO/CAP (P =0.027) and H-Score criteria (P =0.035) were both superior to Allred score system (P =0.064).Among well-known predictive clinicopathologic parameters,including FIGO stage,lympho-vascular involvement,lymph node metastasis,depth of myometrial invasion and omental involvement,ASCO/CAP scoring offered a better correlation (P =0.005,P =0.002,P =0.021,P =0.067,and P =0.067,respectively) than H-Score (P ＞ 0.05) and Allred scoring system (P ＞ 0.05).Conclusions Compared with H-Score and Allred scoring system,ASCO/CAP criterion is more closely correlated with predictive clinicopathologic parameters.Therefore it may be used as a simple,highly efficient prognostic indicator for EC patients in routine practice.
