摘要
目的 探讨Toll样受体4(TLR4)、微小RNA-433(miR-433)及人第10号染色体缺失的磷酸酶及张力蛋白同源基因(PTEN)在子宫内膜癌组织中的表达情况,并分析其与临床病理特征的关系.方法 回顾性选取2020年3月至2022年4月期间在商洛市中心医院进行手术治疗的子宫内膜癌患者80例作为研究对象.收集患者病灶组织及癌旁组织(距离肿瘤边缘3 mm以上,无肿瘤浸润),分别纳入研究组和对照组.使用免疫组织化学染色检测TLR4、PTEN的表达情况,采用RT-qPCR检测miR-433的表达情况.比较研究组和对照组组织中TLR4、miR-433、PTEN表达情况,并分析研究组TLR4、miR-433、PTEN表达与临床病理特征的关系.观察子宫内膜癌组织中TLR4、miR-433、PTEN的表达与国际妇产科协会(FIGO)分期、肿瘤细胞分化程度和淋巴结转移情况的相关性,分析其对预后的影响.结果 研究组组织中TLR4阳性率、miR-433表达水平和PTEN阳性率分别为27.50％、0.65±0.07、22.50％,均明显低于对照组[75.00％、(1.07±0.10)、81.25％],差异均有统计学意义(P＜0.05).FIGO分期Ⅲ～Ⅳ期、细胞分化程度低、淋巴结转移子宫内膜癌组织中TLR4阳性表达率、miR-433的相对表达量和PTEN的阳性表达率均显著低于FIGO分期Ⅰ～Ⅱ期、细胞分化程度高、淋巴结无转移,差异均有统计学意义(P＜0.05).死亡组FIGO分期Ⅲ～Ⅳ期、细胞中、低分化、存在淋巴结转移的患者比率、TLR4阴性表达率、miR-433低表达的患者比率、PTEN阴性表达率均高于存活组,差异均有统计学意义(P＜0.05);两组年龄、肌层浸润深度比较,差异均无统计学意义(P＞0.05).TLR4阳性表达、miR-433相对表达量高、PTEN阳性表达的子宫内膜癌患者2年累积生存率高于TLR4阴性表达、miR-433表达量低、PTEN阴性表达的患者,差异均有统计学意义(P＜0.05).结论 TLR4、miR-433、PTEN检测方式简单,在子宫内膜癌中的表达降低,且与临床病理特征关系密切,能够作为子宫内膜癌的诊断依据和治疗靶点,为临床提供参考依据.
Abstract
Objective To compare the expression of TLR4,miR-433 and PTEN in endometrial cancer tissues and para-cancerous tis-sues,and explore the relationship with the clinicopathological characteristics of patients.Methods A total of 80 patients with endometrial cancer who underwent surgical treatment in Shangluo Central Hospital from March 2020 to April 2022 were retrospectively selected as the study subjects.The patient s lesion tissue and adjacent tissue(more than 3 mm from the tumor edge,no tumor infiltration)were collected and included in the study group and the control group,respectively.The expression of TLR4 and PTEN was detected by immunohistochemical staining,and the ex-pression of miR-433 was detected by RT-qPCR.The expressions of TLR4,miR-433 and PTEN in the tissues of the study group and the con-trol group were compared,and the relationship between the expressions of TLR4,miR-433 and PTEN in the study group and the clinicopathologi-cal features was analyzed.The correlation between the expression of TLR4,miR-433 and PTEN in endometrial cancer tissues and International Federation of Gynecology and Obstetrics(FIGO)stage,tumor cell differentiation and lymph node metastasis was observed,and its effect on prog-nosis was analyzed.Results The positive rate of TLR4,the expression level of miR-433 and the positive rate of PTEN in the study group were 27.50％,0.65±0.07 and 22.50％,respectively,which were significantly lower than those in the control group[75.00％,(1.07±0.10),81.25％],the differences were statistically significant(P＜0.05).There were significant differences in the degree of tumor cell differentiation,FIGO stage,and lymph node metastasis between the TLR4-negative patients and TLR4-positive patients,as well as the PTEN-negative pa-tients and PTEN-positive patients(P＜0.05).The relative expression of miR-433 was related to the degree of tumor cell differentiation,FI-GO stage,and lymph node metastasis(P＜0.05).The positive expression rate of TLR4,the relative expression of miR-433 and the positive expression rate of PTEN in endometrial carcinoma tissues with FIGO stage Ⅲ-Ⅳ,low degree of cell differentiation and lymph node metastasis were significantly lower than those in FIGO stage Ⅰ-Ⅱ,high degree of cell differentiation and no lymph node metastasis,the differences were statistically significant(P＜0.05).The proportion of patients with FIGO stage Ⅲ～Ⅳ,moderate and low differentiation,lymph node metasta-sis,negative expression rate of TLR4,low expression rate of miR-433 and negative expression rate of PTEN in the death group were higher than those in the survival group,and the differences were statistically significant(P＜0.05);there were no significant differences in age and depth of myometrial invasion between the two groups(P＞0.05).The 2-year cumulative survival rate of endometrial cancer patients with positive expres-sion of TLR4,high relative expression of miR-433 and positive expression of PTEN was higher than that of patients with negative expression of TLR4,low expression of miR-433 and negative expression of PTEN,and the differences were statistically significant(P＜0.05).Conclusion TLR 4,miR-433 and PTEN are simple,with reduced expression in endometrial cancer and closely related to clinical pathological features,which can be used as the diagnostic basis and therapeutic target for endometrial cancer and provide reference for clinical practice.
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