探讨子宫内膜腺癌(adenocarcinoma endometrium)中水通道蛋白(aquaporin protein, AQP)1的表达及其与微血管密度(microvessel density，MVD)之间的关系，明确水通道蛋白1在子宫内膜病变发展中的作用。

选择2007年6月至2009年6月在烟台山医院妇科确诊的55例子宫内膜腺癌患者的子宫内膜腺癌标本，纳入AC组，包括50例接受手术切除患者的子宫内膜腺癌标本及5例接受诊刮确诊为子宫内膜腺癌(患者放弃手术治疗)标本(均为Ⅲ期以上患者)。同时，选择同期因手术和诊断性刮宫标本(病理学诊断为不典型增生的子宫内膜组织)31例，纳入EIN组；选择同期因子宫肌瘤行子宫全切或次全切除术患者的正常子宫内膜标本15例，纳入对照组。AC组、EIN组和对照组患者的年龄分布等比较，差异无显著意义(P>0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，研究征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。采用免疫组织化学EnVision法检测水通道蛋白1表达及其与微血管密度。

水通道蛋白1主要表达于各组织的毛细血管和小血管的内皮细胞。随着子宫内膜病变的进展，水通道蛋白1的表达与血管密度均逐渐增高，AC组分别与EIN组和对照组水通道蛋白1的表达量比较，差异均有显著意义(P<0.001，P<0.001)。AC组标本中，当子宫内膜腺癌组织标本病理学分级为G2/G3、肌层浸润深度>1/2、临床分期为Ⅱ，Ⅲ/Ⅳ期及有淋巴结转移时，水通道蛋白1呈高表达，与病理学分级为G1、肌层浸润深度≤1/2、临床分期<Ⅱ期及无淋巴结转移标本的水通道蛋白1表达水平比较，差异有显著意义(P<0.5)。AC组标本中，水通道蛋白1的表达与血管密度呈正相关(r=0.652，P<0.001)。在AC组、EIN组和对照组组织标本中，水通道蛋白1总表达水平与CD₃₄特异性标记染色的微血管密度同样呈显著正相关(r=0.689，P<0.001)。

水通道蛋白1在子宫内膜腺癌的发生发展过程中与血管生成密切相关。

To investigate the correlation of aquaporin protein 1 (AQP1) expression and microvessel density (MVD) in adenocarcinoma endometrium, and discuss the roles of aquaporin protein 1 and microvessel density in the process of adenocarcinoma endometrium.

From June 2007 to June 2009, 55 cases who diagnosed as adenocarcinoma endometrium in Yantai Mountain Hospital of Yantai City were included into this study (AC group), including 50 patients underwent surgical resection and 5 patients underwent curettage diagnosis (they gave up surgery) specimens (stage Ⅲ or Ⅳ). Meanwhile, another 31 cases with atypical hyperplasia endometrial tissues were included into EIN group. Another 15 cases that underwent hysterectomy or subtotal hysterectomy were included into control group. Age distribution of patients among AC group, EIN group and control group had no significant difference (P>0.05). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Yantai Mountain Hospital of Yantai City. Informed consent was obtained from all participants. Expression of aquaporin protein 1 and microvessel density in adenocarcinoma endometrium were detected by immunohistochemistry.

Aquaporin protein 1 expressed mainly in the capillaries of the organizations and small vascular endothelial cells. With the development of endometrial lesions, aquaporin protein 1 expression and vascular density gradually increased. Aquaporin protein 1 expression among three groups had significant differences (P<0.001). In AC group, when histopathologic grade was G2/G3, depth of myometrial invasion > 1/2, clinical stage was Ⅱ, Ⅲ/Ⅳ with lymph node metastasis, aquaporin protein 1 had the high expression. In AC group, aquaporin protein 1 expression and vascular density was positively correlated (r=0.689, P< 0.001).

Aquaporin protein 1 in the development of adenocarcinoma endometrium is closely related with angiogenesis.