Expression And Significance Of Cytokeratin (AE1/AE3) And Ki67 In Pelvic Lymph Nodes Of Endometrial Cancer

Objective:The purpose of the study is to find out the expression and the clinical significance of CK(AE1/AE3)and Ki67 in the endometrial carcinoma tissue and lymph nodes in the radical surgery. Methods:We selection 43 patients with endometrial carcinoma who were treated in January 2010 to December 2012,including 29 patients with Stage I(the number of IA was 22 and the number of IB was 7),7 patients with Stage II and 7 patients with Stage IIIC. All of the patients were underwent the radical surgery of endometrial cancer without chemoradiotherapy preoperative, had no history of other malignant tumors and retroperitoneal surgery. Select the paraffin specimens of endometrial carcinoma tissues and 392 lymph nodes,the number of the lymph nodes in Stages I was 242,the number of Stage II was 98.The number of Stage IIIC was 52 including 12 metastasis lymph nodes.Use the immunohistochemical method to detect the clinical significance and the relations with postoperative recurrence of Ki67 and CK(AE1/AE3) in the cancerous tissue and the lymph nodes. Results:1. Positive expression rate of CK(AE1/AE3) in endometrial carcinoma tissue was 100% and the rate of Ki67 was 74.4%. The positive expression rates of Ki67 in the three stage were respectively 65.5%(19/29), 85.7%(6/7) and 100%(7/7).2. The expression rate of CK(AE1/AE3) and Ki67 in metastasis lymph nodes were 100% and 91.7%.The positive expression rates of CK(AE1/AE3) in the non-metastasis lymph nodes in the three stages were 9.1%,15.3% and 22.5%,which had significant difference(P<0.05). The positive expression rate of Ki67 in the non-metastasis lymph nodes was 8.7%,18.4% and 25.0%,which had significant difference(P<0.05).It was showed that the expression of CK(AE1/AE3) or Ki67 in lymph nodes without metastasis was interrelated to the operational stage. Combining CK(AE1/AE3) or Ki67 can detect 24 patients with micrometastases. In the 380 negative lymph nodes from the 43 patiens, the number of CK(AE1/AE3) positive expression was 46 and the number of Ki67 positive expression was 49 and the number of both of the two was 39.3. The expressions of CK(AE1/AE3) in the lymph nodes of the patients with stage I and II endometrial cancer are related with the histological grade,depth of muscular infiltration and lymph-vascular space involvement(P<0.05). The expressions of Ki67 in the lymph nodes of the patients with stage I and II endometrial cancer are related with the histological grade and the depth of muscular infiltration(P<0.05).4. According to the relations of recurrence and different pathological parameters in patients with stage I and II endometrial cancer, we find that the expression of CK(AE1/AE3) and Ki67, the organization classification and the muscular infiltration depth had connected with the tumor recurrence.5.In the multiple regression analysis which was conduceted on many prognostic factors in stage I,II endometrial cancer,we can found that the expression of CK(AE1/AE3) in lymph nodes and lymphatic vessel invasion were the influence of risk factors to the tumor recurrence. Conclusion:1. In lymph nodes without metastasis, the expressions of CK(AE1/AE3) and Ki67 have suggestive value in the prediction of lymph node micrometastasis of endometrial cancer, however, CK(AE1/AE3) has more strong specificity in predicting lymph node micrometastases.2. In stage I,II endometrial cancer,we can found that the expression of CK(AE1/AE3) in lymph nodes is the independent influence risk factor to the tumor recurrence. The expression of Ki67 in lymph nodes is only one of the risk factors of postoperative recurrence in patients with stage I and II endometrial cancer.