Expression Of ALCAM In Endometrioid Adenocarcinoma And Its Correlation With ER,PR,P53 And Ki-67

Background and ObjectiveEndometrial carcinoma(EC)is one of the common malignant tumors of female reproductive tract.It is clinically divided into hormone-dependent typeⅠand non-hormone-dependent type II,and endometrioid adenocarcinoma(EEC),belonging to the type I,is the most common one among them.In recent years,the incidence and fatality rate of EEC have been increasing year by year in the world,and there is a significant trend of younger age.However,its specific pathogenesis has not been very clear up to now.Activated leukocyte cell adhesion molecule(ALCAM),also known as CD166,is a member of the immunoglobulin superfamily(Ig SF)of cell adhesion molecules.It is widely distributed in various organs and tissues of human bodies,and exerts its biochemical functions.It also plays a role in the occurrence and development of tumors.Studies have found that ALCAM is abnormally expressed in tumors such as melanoma,colorectal cancer,primary breast cancer and endometrial cancer and other malignant tumors,suggesting that it may affect the progression and prognosis of the disease.The molecular markers related to endometrial carcinoma that have been discovered are estrogen receptor(ER),progestogen receptor(PR),P53 and Ki-67 proteins.And we can determine the development and prognosis of EEC and guide individualized treatment by measuring their expression.However,studies on the correlation between ALCAM and them have not been reported yet.This study aims to detect the expression of ALCAM in endometrioid adenocarcinoma tissues.We tend to analyze the relationship between its expression level,clinical pathological characteristics and disease prognosis,and further explore the correlation between ALCAM and ER,PR,P53 and Ki-67,in order to better guide the clinical diagnosis and treatment of endometrioid adenocarcinoma and improve the prognosis of the disease.Methods1.Retrospectively collected 112 cases of endometrioid adenocarcinoma patients who were admitted to the Department of Gynecology,the First Affiliated Hospital of Shantou University Medical College,including medical records,follow-up data and corresponding paraffin tissue specimens.These patients were divided into different groups according to age,menopausal state,FIGO stage,histological grade,depth of myometrial invasion,and vascular space involvement.2.The expression of ALCAM of these 112 samples of endometrioid adenocarcinoma was detected by immunohistochemistry.Then we analyzed the relationship between ALCAM and clinical pathological characteristics,evaluated its value as a marker of prognosis,and further explored the correlation between ALCAM and ER,PR,P53 and Ki-67.Results1.112 patients were followed up in the experiment and none were lost to follow-up.Immunohistochemical study showed that ALCAM was expressed on the endometrial luminal and glandular epithelial cells of EEC but not on the endometrial stromal cells.There were 15 cases(15/112,13.39%)in the ALCAM no-expression group,41 cases(41/112,36.61%)in the ALCAM low expression group,42 cases(42/112,37.5%)in the ALCAM medium expression group,and 14cases(14/112,12.5%)in the ALCAM high expression group.Comparison of clinicopathological features of each group showed that the expression of ALCAM was correlated with histological grade,FIGO stage and depth of muscular invasion,with statistical significance(all P < 0.05).However,there were no statistically significant differences between the two groups about the expression of ALCAM on age,menopausal state,and vascular space involvement(all P>0.05).2.Univariate analysis showed that FIGO stage,histological grade,depth of myometrial invasion,vascular space invasion and ALCAM expression were all related to the overall survival rate of EEC,with statistically significant differences(P < 0.05).In multivariate analysis,histological grade,depth of myometrial invasion and vascular space involvement were independent factors affecting overall survival rate of EEC,while the ALCAM expression was not statistically significant(P>0.05).3.Pearson correlation analysis showed that there was no correlation between ALCAM and ER and PR(r=0.064,P=0.528;r=0.152,P=0.134).ALCAM was negatively correlated with P53expression(r=-0.203,P=0.046).Correlation analysis was not performed because there were constants in the results of Ki-67.Conclusions1.The expression of ALCAM in endometrioid adenocarcinoma is related to the histological grade and the depth of myometrial invasion.2.The decreased expression of ALCAM in endometrioid adenocarcinoma cells may promote the invasion and progression of tumors,which may indicate a poor prognosis.3.Combined detection of the expression of ALCAM,PR,and P53 can comprehensively evaluate the prognosis of patients with endometrioid adenocarcinoma,which also has the significance for guiding the individualized adjuvant therapy of patients.