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雄激素受体在子宫内膜癌中的表达及其与肿瘤复发、预后的关系
作者:李凡  赵孝芳 
单位:安康市人民医院 妇产科, 陕西 安康 725000
关键词:雄激素受体 子宫内膜癌 复发 预后 
分类号:R737.33
出版年·卷·期(页码):2019·47·第七期(773-778)
摘要:

目的:探讨子宫内膜癌组织中雄激素受体(AR)的表达情况及其与肿瘤复发、预后的关系。方法:收集陕西省安康市人民医院收治的并经病理学确诊的283例子宫内膜癌患者的肿瘤组织标本,应用免疫组化方法检测组织中AR、雌激素受体(ER)及孕酮受体(PR)的表达情况。应用简单Kappa系数及McNemar检验分析AR表达与ER及PR表达的相关性,应用Log-Rank检验比较AR表达阳性患者与表达阴性患者之间的疾病复发时间,应用COX模型探索子宫内膜癌预后的影响因素。结果:患者AR的表达阳性率为57.70%,相关性分析显示AR与ER、PR在子宫内膜癌组织中的表达有相关性(分别Kappa系数=0.296 0,P<0.000 1;Kappa系数=0.319 7,P<0.000 1)。AR表达阴性患者无复发生存时间短于AR表达阳性患者(P<0.000 1);COX模型显示子宫内膜癌的病理分型及AR表达情况是疾病复发的重要影响因素(HR=2.04,95%CI:1.28~3.24;HR=2.48,95%CI:1.51~4.09)。结论:AR在子宫内膜癌的发生、发展中起着重要的作用,并且与预后有密切的关系。通过干预AR的表达可能延缓或控制子宫内膜癌病情的发展。

Objective:To investigate the expression of androgen receptor (AR) in endometrial cancer tissue and itsrelationship with the risk of tumor recurrence andprognosis.Methods:Two hundred and eighty-threesamples of endometrial cancer which had confirmed by pathology were collectedfrom Shanxi Ankang People's Hospital. Immunohistochemical stains were performed to detected express of androgen receptor (AR), estrogen receptor(ER), and progesterone receptor(PR). Simple Kappa coefficient and McNemar test were used to explore the correlation between AR and ER, PR expressions.The Log-Rank test was used to compare the recurrence time between patients with AR expression positive and negative. COX model was used to explore the prognostic factors of endometrial carcinoma. Results:The positive rate of AR expression was 57.70% in these patients. The correlation analysis showed that the expression of AR was closely related to expression ofER and PR in endometrial cancer tissue (Kappa=0.296 0, P<0.000 1; Kappa=0.319 7, P<0.000 1;reapectively). The non- recurrent survival time of AR negative patients was lower than those of AR positive patients (P<0.000 1). COX model showed that the pathological classification of endometrial carcinoma and the expression of AR were important factorsof recurrence(HR=2.04, 95%CI:1.28-3.24; HR=2.48, 95%CI:1.51-4.09). Conclusion:AR plays an important role in the occurrence and development of endometrial carcinoma and is closely related to the prognosis. This suggests that interfering with the expression of AR may be a feasible way to delay or control the development of endometrial cancer.

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