Expression And Clinical Significance Of MUC1 In Endometrial Adenocarcinoma

Expression and Clinical Significance of MUC1 in Endometrial AdenocarcinomaObjective: Endometrial cancer, also known as uterine body cancer ,is a group of epithelial malignant tumor which derives from endometrial tissue ,most of which stem from endometrial glands. Endometrial cancer accounts for 7% of women systemic malignant tumor,20% ~ 30% of female reproductive system and one of the three malignant tumors.In recent years, since women use estrogen replacement therapy and longer average life span and other reasons, the incidence of endometrial cancer has tended day by day , however , 5-year survival rate gradually decreases. The exact pathogeny of endometrial cancer is still not quite sure, most patients are relevant with estrogen long-term stimulation and lack of progesterone antagonist .The key of endometrial cancer therapeutic effect is early diagnosis and early treatment. However,there's no specific early screening method of endometrial cancer . Understanding the expression of endometrial cancer markers not only can guide early clinical diagnosis and pathological diagnosis, but also help to individualize treatment and prognosis .Mucin 1 (MUC1) ,a tumor marker,is highly expressed in breast cancer,ovarian cancer,Pancreatic cance,stomach cancer,colon cancer and esophageal cancer . Many studies show that MUC1 contributes to invasiveness and metastasis of tumor.The change of MUC1 expression and construction in malignant tumor leads to appear new antigen tables. when contacted with the body's immune system , MUC1 can induce an antineoplastic cytotoxic T lymphocyte immune response .Therefore, MUC1 is an ideal target molecule to anti-tumor immune. Now many vaccines based on the immune to MUC1 have developed, some already enter clinical trials stage.At present there is less report about MUC1 expression in endometrial adenocarcinoma. This research probes MUC1 expression in the normal endometrial,endometrial hyperplasia and endometrial adenosquamous carcinoma and its relationship with clinicopathological features (age,clinical stage,histological grade,and lymph node metastasis) in order to discuss the role in the occurrence and development of endometrial adenosquamous carcinoma and to provide a new theoretical basis of diagnosis and treatment of endometrial carcinoma .Method: All of the cases are selected from the inpatient and outpatient cured in maternity of the second clinical hospital of Jilin university from November 2009 to September 2010. 34 patients are endometrial adenocarcinoma:phase I ,22 cases; phase II ,6 cases;phase III ,6 cases ;phaseⅣ, 0 case.18 cases are endometrial hyperplasia disease (endometrial simple type ,6 cases;endometrial hyperplasia of the factors , 6 cases;endometrial hyperplasia of atypical,6 cases). 12 patients as a control group are normal endometrium (6 cases are endometrial hyperplasia, 6 cases are secretory endometrium ).All the specimens are diagnosed in pathology department of the second clinical hospital of Jilin university, not accepting preoperative chemotherapy,taking drug therapy and sex hormones .they are primary cancer . Immunohistochemistry is used to detect the expression of MUC1 in various tissues.we analysis the relationship between MUC1 expression with endometrial adenocarcinoma clinical pathology parameters(surgical pathology stage, histopathological grade, age, lymph node metastasis) and discuss the role MUC1 playing in the occurrence and development of endometrial adenocarcinoma .All datas are treated by statistical analysis .The statistically significant level is P< 0.05.Conclusions:(1) The respectively positive expression of MUC1 in normal endometrium,endometrial hyperplasia disease and endometrial adenocarcinoma is 33.3% (4/12),33.3% (6/18),76.5% (24/34).The respective average gray value is: 148.93士25.66,147.16士18.23,29.39士22.31. The expression cf MUC1 in endometrial adenocarcinoma is significantly higher than normal endometrial and endometrial hyperplasia disease (P < 0.05); The expression cf MUC1 in endometrial hyperplasia was not statistically significant compared to normal endometrial tissue (P > 0.05).(2) The respectively positive expression of MUC1 in high,medium and low differentiated endometrial cancer is 54.5%(6/11),76.5%(13/17),83.3%(5/6). The respective average gray value is 134.24士25.18,121.71士36.95,120.90士23.59 . The expression cf MUC1 in each endometrial hyperplasia has no significant difference (P > 0.05).(3) The respectively positive expression of MUC1 in endometrial adenocarcinoma GIGO stageI,II,III is 55.6%(12/22),100%(6/6),100%(6/6). The respective average gray value is 135.76士24.01,119.70士11.95,115.70士14.33 . The expression of MUC1 in stage III is obviously higher than stage I (P < 0.05). The expression of MUC1 in stage II has no significant difference compared to stage I and stage III (P > 0.05).(4) The respectively positive expression of MUC1 in the group age 50 years old,and﹥50years old is 77.3% (11/15),68.4% (13/19). The respective average gray value is127.96士23.23,130.72士22.03. The expression of MUC1 in all the age groups is not significant difference (P > 0.05). (5) The respectively positive expression of MUC1 in the group lymph node metastasis and not lymph node metastasis is17.6%(6/34),82.4%(28/34). The respective average gray value is 115.70士14.33,132.32士22.80. The expression of MUC1 in each group has no significant difference (P > 0.05).Conclusions:(1) The expression of MUC1 in endometrial adenocarcinoma obviously higher than normal endometrium and endometrial hyperplasia, therefore ,MUC1 may play a role in the process of endometrial adenocarcinoma.(2) MUC1 may participate in the malignant evolution,invasion and metastasis of endometrial adenocarcinoma.(3) The expression of MUC1 in endometrial adenocarcinoma is irrelevant with histology differentiation,lymph node metastasis and the patient's age .