Expression Of Igf-1r, Vegf-c, D2-40 And Their Correlation With Lymphangiogenesis And Lymphatic Node Metastasis In Endometrial Adenocarcinoma

Objectives By detecting the protein expression of insulin-like growth factor-1 receptor (IGF-1R) and vascular endothelial growth factor C(VEGF-C) in normal endometrium , endometrial hyperplasia(simple hyperplasia,complex hyperplasia and atypical hyperplasia) and endometrial adenocarcinoma, to explore the association of IGF-1R and VEGF-C with the development of endometrial adenocarcinoma and clinicopathological characteristics. By detecting the lymphatic vessel density marked by D2-40 of these tissues,to find out their correlation with lymphatic node metastasis in endometrial adenocarcinoma and the significance of lymphangiogenesis in the process of lymphatic metastasis.Methods Immunohistochemical S-P method was used to detect the expression level of IGF-1R,VEGF-C and D2-40 in 14 cases of human normal endometrium,30 cases endometrial hyperplasia and 40 cases endometrial adenocarcinoma tissue.The expression of IGF-1R,VEGF-C and D2-40,and the association with the genesis and clinicopathological characteristics were analysised with SPSS17.0.Results 1.There were expression of IGF-1R in normal endometrium,endometrial hyperplasia and endometrial carcinoma tissues,but there was no significant difference of positive expressionrate in the tissues(P >0.05),however,siginifance difference of overexpression rates was obtained in normal endometrium, endometrial hyperplasia and endometrial adenocarcinoma(P <0.05). 2.The positive rates of VEGF-C protein in normal endometrium, simple hyperplasia,complex hyperplasia and atypical hyperplasia were 35.71%,37.50%,41.67%,50%,and there was no significent difference in these tissues(P >0.05).But siginifance difference of expression rates of VEGF-C was obtained in normal endometrium and endometrial adenocarcinoma(P =0.001<0.05),and the positive rates of VEGF-C protein in atypical hyperplasia and endometrial adenocarcinoma was significantly different(P=0.018<0.05).3.The expression and overexpression were significantly associated with histologic grades(P <0.05), but no associated with surgical stage(P>0.05). In endometrial adenocarcinoma tissues, the lymphatic metastasis was associated with the overexpression of IGF-1R(P<0.05),but no associated with its expression(P>0.05). The expression of VEGF-C in endometrial adenocarcinoma was significantly associated with lymphatic node metastasis(P< 0.05), but no associated with surgical stage and histologic grades (P>0.05).4.In 40 cases endometrial carcinoma,the same positive rates of IGF-1R and VEGF-C was 75%, and three was no significant difference between them(P=0.125>0.05). Significant correlation was found between the overexpression of IGF-IR and expression of VEGF-C in endometrial adenocarcinoma(P=0.035< 0.05,r=0.43).5.The lymphatic vessels density ( LVD ) in endometrial adenocarcinoma was closely positive corrected with the overexpression of IGF-1R and expression of VEGF-C(P< 0.05). Lymphatic vessels density (LDV-pt) in endometrial adenocancinoma tissue was significantly higher than intratumoral lymphatic vessels density (LDV-it) and that in normal tissues(P <0.05).Conclusion1.The overexpression of IGF-1R in normal endometrium, endometrial hyperplasia and endometrial adenocarcinoma was increasing trend, which indicated that IGF-1R was associated with the occurrence of endometrial adenocarcinoma and the development process. In endometrial carcinoma tissues,the overexpression of IGF-1R was associated with histologic grades and the lymphatic metastasis, which indicated that IGF-1R promoted the progress of lymphatic metastasis of endometrial adenocarcinoma.2.The positive expression of VEGF-C significent related to lymph node metastasis,which indicated that the detection of the VEGF-C expression might be helpful to judge the lymphatic metastasis of endometrial adenocarcinoma .3.The IGF-1R overexpression was closely correlated with the VEGF-C expression,which suggested that IGF-1R and VEGF-C might played a positive role to each other in the control of lymphatic metastasis in endometrial adenocarcinoma.The LVD of IGF-1R over expression and VEGF-C positive expression are both significant higher than the expression and negetive expression,the detection of the both two expression and the LVD might be helpful to judge the clinlic stage and to predict the prognosis of endometrial adenocarcinoma.4.The LVD count on D2-40 determination of endometrial adenocarcinoma significantly higher than LVD of normal endometrial group,in endometrial adenocarcinoma tissues, the LVD count of lymph node metastasis positive group was significantly higher than lymphatic metastasis negative group,which suggested that there was clear relationship between the D2-40 labeled LVD coutnting and the progress of endometrial adenocarcinoma,as can be judged lymphatic metastasis of endometrial adenocarcinoma.The peritumoral lymphatic vessel density was siginificantly higher than intratumoral lymphatic vessel density,which indicating the formation of peritumoral lymphangiogenesis in endometrial adenocarcinoma might had played a role in lymph node metastasis.