Study Of Factors Affecting Prognosis Of Endometrial Carcinoma Results

Objective: To analyze relative factors affecting prognosis of endometrial cancer through 1)comparing the expression of progesterone receptor(PR), estrogen receptor(ER), Ki-67, p53, and C-erb B-2 in cancerous endometrial tissue with those in non-cancerous endometrial tissues; 2)following up prognosis of the disease, the status of the grades of cellular differentiation, the pathological and histological types, clinical stages, clinical features, CA125 and ages of subjects involved in the study.Methods: To comprehensively analyze the impacts of endometrial cancer prognosis we selected surgically treated patients with endometrial cancer and with abnormal uterine bleeding(n = 96 for each case) admitted in the Hexi College affiliated Zhangye People’s Hospital between January2010 to October 2014. The expression of ER, PR, C-erb B-2, p53 and Ki-67 was compared in the two groups. Prognosis of diseases was followed up. Statistical analysis of the concentrations of preoperative serum CA125, intraoperative and postoperative pathological examinations of muscular infiltration depth, metastasis of lymph node and uterine appendages, vascular tumors bolt, histological classification, grades of cellular differentiation, pathological types and surgical pathologic stages and ages of patients with endometrial cancer was performed.Results: 1) There were significant variations in the expression of ER, PR, C-erb B-2, p53 and Ki-67 between the group of patients with endometrial carcinoma and those with abnormal uterine bleeding(p <0.05). 2). Univariate analysis showed that factors affecting overall survival and disease-free survival were significantly associated with total 11 items including age, surgicalpathologic sages, clinical stages, histological types, cellular differentiation, myometrial invasion,metastasis of uterine appendages and lymph nodes, vascular invasion, and the expression of PR,ER and p53(all p <0.05); Concentrations of CA125 were significantly associated with disease-free survival(p <0.05), but not with overall survival(p> 0.05); The expression of Ki-67 and C-erb B-2 was irrelevant to either overall survival or disease-free survival(p> 0.05); We also found that prognosis of patients with ≥60 years of age, the late phase of surgical pathology, type II endometrial cancer, specific pathological types,metastasis of uterine appendages, depth of muscular invasion > 1/2, vascular invasion and lymph node metastasis was poor; Disease-free survival in patients with higher concentrations of CA125( ≥35.0U / m L) was slightly lower compared with those with lower concentrations of CA125. Poor prognosis was also found in patients with negative expression of PR and ER and those with p53 overexpression. Multivariate analysis showed that independent factors affecting overall survival were age, PR expression and surgical staging; while independent factors influencing disease-free survival were myometrial invasion, surgical pathological stage and expression of PR.Conclusion:1) Expression of genes encoding ER, PR, C-erb B-2, p53 and Ki-67 significantly increased in tissues derived from endometrial carcinoma; 2) expression of Ki-67 and C-erb B-2was not associated with either disease-free survival or overall survival; 3) The independent risk factors affecting overall survival include the late phase of surgical pathology, age ≥6O years old and negative expression of PR; while independent risk factors affecting disease-free survival were the late phase of surgical pathology, depth of myometrial invasion ≥1 / 2 and PR-negative expression; and 4) Combination of detecting expression of ER, PR and p53 might predictprognosis of endometrial carcinoma, wherein the levels of expression of PR is closely associated with the prognosis of endometrial cancer.