雌激素膜性受体GPR30在子宫内膜癌变过程中的表达及临床意义

目的探讨G蛋白耦联受体30（GPR30）在子宫内膜癌变过程中的表达及其临床意义。方法 20例子宫内膜不典型增生（atypical hyperplasia,AH）组织（AH组）、50例子宫内膜癌（endometrial carcinoma,EC）组织（EC组）,采用免疫组织化学Eli Vision二步法检测2组组织中GPR30的表达情况;另设20例正常子宫内膜组织作为对照组。分析GPR30的表达与EC患者临床病理特征及5年生存率之间的关系。结果对照组、AH组、EC组组织中GPR30的阳性表达率分别为10.0%、45.0%、74.0%,组间比较差异有统计学意义（P〈0.001）,AH组显著高于正常组（P〈0.05）,EC组显著高于AH组（P〈0.05）;GPR30表达与EC患者的年龄、手术-病理分期、肌层浸润深度、肿瘤大小、淋巴结转移情况无关（P〉0.05）,但与组织学类型、组织病理学分级有关（P〈0.05）;EC组5年总体生存率为85.7%,GPR30高表达组5年生存率显著低于低表达组（66.6%vs 96.8%,P〈0.05）;Ⅰ/Ⅱ期GPR30低表达和高表达组5年生存率差异有统计学意义（100.0%vs 83.9%,P〈0.05）,且Ⅲ期GPR30高表达组5年生存率与Ⅰ/Ⅱ期GPR30低表达（20.0%vs 100.0%）和高表达组（20.0%vs 83.9%）相比,差异均有显著统计学意义（P〈0.001）,但与Ⅲ期GPR30低表达组比较（20.0%vs 80.0%）,生存率虽有降低,但差异无统计学意义。结论 GPR30表达可能与子宫内膜癌发生、发展相关,其表达水平对EC患者预后有提示作用。GPR30可能成为治疗子宫内膜癌更为有效的新靶点。

Expression of the Estrogen Membranous Receptor GPR30 during Carcinogenesis of Endometrium and Its Clinical Significance

Objective To explore the expression and clinical significance of G protein-coupled receptor 30（GPR30） during carcinogenesis of endometrium.Methods The expression of GPR30 in 20 cases of atypical hyperplasia（AH group） and 50 cases of endometrial carcinoma（EC group） were detected by immunohistochemical EliVision two-stages method.Another 20 cases of normal endometrial tissues were as a control group.To analyze the relations between GPR30 expression and the clinicalpathologic parameters or 5-year survival rates of EC patients.Results In group of control,AH group and EC group,the positive expression rates of GPR30 were 10.0%,45.0% and 74.0%,respectively.The differences among the three groups was statistically significant（P〈0.001）,AH group was significantly higher than the normal group（P〈0.05）,and significantly lower than the EC group（P〈0.05）.In EC patients,the expression of GPR30 was not associated with age,surgery-pathological stage,depth of myometrial invasion,tumor size and lymph node metastasis（P〈0.05,respectively） but the type of histology,the GPR30 expression level in the special pathological type group was significantly higher than in adenocarcinoma group（P〈0.05）,and the expression of GPR30 with different tumor grade also showed a significant statistical difference（P〈0.05）,the expression rate of GPR30 was significantly higher in G2 and G3 than that in G1;In 50 cases of EC patients,5-year overall survival rate was 85.7%,5-year survival rate of high GPR30 expression group was significantly lower than the low GPR30 expression group（66.6% vs 96.8%,P〈0.05）;The difference of 5-year survival rate between stage Ⅰ/Ⅱ with low GPR30 expression and high GPR30 expression was statistically significant（100.0% vs 83.9%,P〈0.05）,and there showed a statistically significant difference（P〈0.001,respectively） when compared 5-year survival rate of stage Ⅲ,high GPR30 expression with stage Ⅰ/Ⅱ,low GPR30 expression（20.0% vs 100.0%） or stage Ⅰ/Ⅱ,high GPR30 expression group（20.0% vs 83.9%）.In patients with stage Ⅲ,although 5-year survival rate of GPR30 high expression group was significantly lower survival rate than the low group（20.0% vs 80.0%）,but there was no statistical significance.Conclusions GPR30 probably has a relationship with the occurrence and development of endometrial carcinoma.The expression level of GPR30 may suggest good or poor prognosis of patients with endometrial carcinoma.GPR30 could be a more effective novel therapeutic target of endometrial cancer.