The Research On The Expression Of ER And PR And Ki-67 And Cellular DNA Contents And Cell Cycles Phase In Cellular Leiomyoma

Objective:To investigate the role of ER and PR and Ki-67 in occurrence and development of cellular leiomyoma,combining DNA contents and cell cycles,further to provide theory basis for clinical diagnosis,differential diagnosis,treatment and prognosis.Methods:The immunohistochemical technique was used to detect the expression of ER, PR and Ki-67 in 32 cellular leiomyoma and among them the expression of ER,PR of 25 corresponding endomembranes and normal muscular layers,and the cellular DNA contents and cell cycle phase analysis of 32 tumour tissues were investigated by flow cytometry.6 usual leiomyoma,4 smooth muscle tumour of uncertain malignant potential and 7 leiomyosarcoma were also studied as cross-check analysis.Results:(1)The immunohistochemical results showed that:The positive expression rates of ER,PR in endomembrane(glandular organ,mesenchyme)and muscular tumour and normal muscular layers tissues of cellular leiomyoma showed the tendency of decreasing progressively, the differences among these groups were significant(P＜0.01);the difference between muscular tumour and normal muscular layers tissues was significant(P＜0.01,P＜0.05);the difference between endomembrane and muscular tumour tissues was no significant(P＞0.05);but comparing the strongly positive expression rate of ER of muscular tumour tissues with glandular organ of endomembrane,the difference was significant(P＜0.05);the difference between glandular organ and mesenchyme of endomembrane was significant(P＜0.05).(2)The positive expression rates of ER,PR in cellular(usual)leiomyoma,usual (cellular)leiomyoma,smooth muscle tumour of uncertain malignant potential,leiomyosarcoma showed the tendency of decreasing progressively,the difference between the former three was no significant(P＞0.05);the difference between cellular leiomyoma and leiomyosarcoma was significant(P＜0.05).The positive expression rates of Ki-67 in usual leiomyoma,cellular leiomyoma,smooth muscle tumour of uncertain malignant potential,leiomyosarcoma had the tendency of increasing gradually,the difference between the former two was no significant(P＞0.05);the difference between cellular leiomyoma and the latter two was significant(P＜0.05).(3)Cellular DNA contents,SPF of usual leiomyoma,cellular leiomyoma,smooth muscle tumour of uncertain malignant potential,leiomyosarcoma had the tendency of increasing gradually.To Cellular DNA contents,the difference between the former three was no significant(P＞0.05);the difference between cellular leiomyoma and leiomyosarcoma was significant(P＜0.05).To SPF,the difference between usual leiomyoma and the latter two was significant(P＜0.05);the difference between cellular leiomyoma and the latter two was no significant(P＞0.05);the difference between usual leiomyoma and cellular leiomyoma was no significant(P＞0.05);PI of cellular leiomyoma,smooth muscle tumour of uncertain malignant potential,leiomyosarcoma had the tendency of increasing gradually,the difference between the former two was no significant(P＞0.05);the difference between cellular leiomyoma and leiomyosarcoma was significant(P＜0.05).(4)The expression rates of ER,PR,Ki-67 in cellular leiomyoma were not related to their quantities,sizes,ages of patients(P＞0.05).(5)Correlated analysis showed:In cellular leiomyoma the expression of ER,PR was positively related to Ki-67(P＜0.05);no significantly to DNA(P＞0.05);In uterine smooth muscle tumour,the expression of ER was negatively related to Ki-67(P＜0.05);the expression of PR was negatively related to cellular DNA contents(P＜0.05).Conclusions:(1)ER,PR discordance in endometrial and ER,PR increasing in tumour tissues,the action of the later which may probably promoto tumour cell proliferation,are related to the formation and development of Cellular leiomyoma.(2)ER,PR,Ki-67 may be an important index to judge the prognosis of cellular leiomyoma,uterine smooth muscle tumours.Combining DNA have signifecances of differential diagnosis to uterine smooth muscle tumours of plesiomorphism but various nature.(3)The positive expression rates of ER,PR,Ki-67 in cellular leiomyoma were not related to clinical pathology parameter.(4)Cellular leiomyoma can produce malignant biological behaviour,so when tumour cells appeared DNA heteroploid and cell proliferation level had the tendency of ascending gradually,we should pay high attention to it and advised to intensify follow-up after operations.