자궁내막암 환자에서 스테로이드 호르몬 수용체와 bcl-2, 돌연변이 p53의 발현과 임상병리학적 예후인자와의 연관관계

Abstract

Objectives : To observe the degree of expression and the interrelationship of bcl-2, p53 mutation and estrogen/progesterone receptors in endometrial cancer and to evaluate the usefulness of the above mentioned factors as prognostic factors in endometrial cancer by comparing them to the clinicopathological factors. Patients and methods : In 33 endometrial cancer specimens, the expression of bcl-2 and p53 mutation was demonstrated using the immunohistochemical staining, and using the enzyme immunoassay, the estrogen/progesterone receptor's expression was demonstrated. The results were compared to the clinicopathological prognostic factors and analyzed using the SPSS program. Results : P53 mutation was observed in 27.3%(9/33), well correlated with poorly differentiated and more advanced endometrial cancer and showed statistically significant poorer survival(p=0.0029). Bcl-2 overexpression was noted in 36.4%(12/33) of the endometrial cancer specimens studied and correlated with deep myometrial invasion(p=0.049) but it was not related with survival rate. P53 mutation showed negative correlation with expression of progesterone receptors but no statistically significant correlation with bcl-2 overexpression and expression of steroid hormone receptors. Conclusions : P53 mutation was demonstrated in progesterone receptor negative, histologically poorly differentiated, more advanced stage endometrial cancer and related with poorer survival rate, therefore showing the possibility of its usage as a prognostic factor. Although bcl-2 showed positive relationship with deep myometrial invasion, it seemed that bcl-2 might have a weak role in carcinogenesis in endometrium and might not be controlled by hormonal stimuli. In order to make any conclusive remarks in using the genetic factors as prognostic factors in endometrial cancer, further studies involving a larger number of cases are warranted.