| Objective: To study the expressions of androgen receptor and androgen metabolism-related enzymes(AKR1C3,SRD5A1,CYP1A1)in endometrial carcinoma,atypical hyperplasia endometrium,endometrial hyperplasia without atypia and normal endometrium,analyze the clinicopathological characteristics in endometrial carcinoma with the expressions of AR and androgen metabolism-related enzymes,then explore the role of androgen receptor and androgen metabolism-related enzymes played in the development and the biological behavior of endometrial carcinoma.Methods: 50 cases of endometrial cancer,50 cases of atypical hyperplasia endometrium,50 cases of endometrial hyperplasia without atypia and 50 cases of normal endometrium were operated at the department of obstetrics and gynecology of Zhongda hospital affiliated to southeast university From July 2013 to June 2017.The expressions of AR and androgen metabolism-related enzymes was determined by immunochemistry.Five visual fields were randomly counted at high magnification,the expression of AOD was measured by Image J image analysis software,the average AOD of five visual fields in each case was taken as the measurement value of this example.The SPSS 22.0 statistics software was used to analyze the results.Results 1.AR and androgen metabolism-related enyzmes was observed in all endometrial samples.From normal endometrial,endometrial hyperplasia without atypia,atypical hyperplasia to endometrial carcinoma,the immunoreactivity expressions of AR and SRD5A1 had an increasing tendency,with statistical differences about the immunoreactivity expressions and the AOD of AR and SRD5A1 among the four groups(p<0.05).There were no statistical differences about the immunoreactivity expressions and the AOD of AKR1C3 and CYP1A1 among the four groups(P>0.05).2.The expression of AR increased with increasing histological grade,FIGO stage,lymph nodes metastasis and vascular invasion,with statistical differences(P<0.05),there were no statistical differences between AR expression and age,histopathological types and myometrial invasion(P>0.05).The expression of SRD5A1 increased with increasing histological grade,with statistical differences(p<0.001),there were no statistical differences between SRD5A1 expression and age,FIGO stage,histopathological types,myometrial invasion,lymph nodes metastasis and vascular invasion.The expression of AKR1C3 decreased with increasing FIGO stage,with statistical differences(p<0.001),there were no statistical differences between AKR1C3 expression and age,histological grade,histopathological types,myometrial invasion,lymph nodes metastasis and vascular invasion(P>0.05).The expression of CYP1A1 increased with increasing histological grade,what is more,with a lower expression in type II endometrial carcinoma,with statistical differences(p<0.05),there were no statistical differences between CYP1A1 expression and age,FIGO stage,myometrial invasion,lymph nodes metastasis and vascular invasion(p>0.05).3.The expression of AR was correlated with that of ER,PR and AKR1C3 in endometrial carcinoma(r=0.312,P=0.001;r=0.287,P=0.015;r=0.217,p=0.047),and did not have relations to SRD5A1,CYP1A1(r=-0.066,P= 0.31;r=0.137,P=0.25).5.There were statistical differences of the survival curves between positive versus negative immunostaining of AR and AKR1C3 in endometrial carcinoma(X2=6.098,P=0.014;X2=5.579,P=0.018),there was no statistical differences of the Survival curves between positive versus negative immunostaining of SRD5A1 and CYP1A1 in endometrial carcinoma(X2=0.078,P=0.779;X2=2.106,P=0.147).Conclusions: 1.The over-expression of AR may play an important role in the development of endometrial lesion,but it may play a protective role in the progression of endometrial carcinoma.2.Androgen metabolism-related enzymes(AKR1C3,SRD5A1,CYP 1A1)may indirectly promote the development of endometrial carcinoma by regulating local androgen level,high expression of which always related to good prognosis for endometrial carcinoma. |
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