Epithelial-Mesenchymal Transition Related Factors Expressions In Early Stage Cervical Cancer And Its Correlation With Clinicopathologic Features And Prognosis

Objective:To investigate the prognostic value of epithelial-mesenchymal transition (EMT) related proteins (E-cadherin and Vimentin) in early squamous cervical carcinoma and its correlation with clinicopathologic features.Method:50samples of cervical squamous carcinoma from patients who received radical resection of cervical carcinoma at the Second Xiangya Hospital of Central South University from Janury2007to Janury2009were collected. The expressions of E-cadherin and Vimentin were detected by immunohistochemistry, to analyze the prognostic value of EMT markers and its relationship with clinicopathologic features in early stage cervical cancer. Enumeration data were analyzed using chi-square test. The correlation between EMT markers was analyzed using the Spearman correlation coefficient. The survival curve was drawn by Kaplan-Meier method, and the survival rate was analyzed using the Log-rank test. Multivariate analysis was done by Cox proportional hazard model.Results:The expression of E-cadherin was closely associated with pathologic differentiation degree and lympho vascular space invasion (LVSI)(P<0.05), while Vimentin was related to pathologic differentiation degree and lymph node metastasis (P<0.05). A negative correlation between the expression of E-cadherin and Vimentin was detected(r=-0.347, P=0.014).The results of univariate survival analysis show that lymph node metastasis, depth of myometrial invasion and E-cadherin significantly associated with overall survival (P＜0.001, P=0.037, P=0.028). Patients with Vimentin expression demonstrated a trend of unfavorable prognosis, which had a5-year survival rate of72.2%compared with87.4%in those patients with negative Vimentin expression (P=0.136). Cox proportional hazards regression showed that lymph node metastasis and E-cadherin were independent prognostic factors of5-year overall survival (P=0.037, P=0.014).Conclusion:1. The gain of E-cadherin and the loss of Vimentin known as "EMT" play a crucial role in tumor cell invasiveness and metastasis.2. There is a negative correlation between the expression of E-cadherin and Vimentin.3. E-cadherin and lymph node metastasis were independent prognostic factors for5-year overall survival. Patients with high expression of Vimentin demonstrated a trend of unfavorable prognosis, but the difference is statistically insignificant.