| Objective:1.Differential expression and clinical significance of p53,Sestrins and p-mTOR in endometrioid adenocarcinoma tissues were detected,and analyze the correlation between them;2.Correlation analysis was performed on the expression of Sestrin family members Sestrin1,Sestrin2 and Sestrin3 in endometrioid adenocarcinoma;3.To further explore the pathogenesis of endometrioid adenocarcinoma,so as to provide new directions for early diagnosis,treatment guidance and prognosis evaluation of patients with endometrioid adenocarcinoma.Methods:According to inclusion and exclusion criteria,100 cases of paraffin tissue blocks of endometrioid endometrial carcinoma surgically removed from the Affiliated Hospital of North Sichuan Medical College during January 1,2011 to December 31,2016 were collected as experimental group.Meanwhile,30 endometrial specimens of proliferative phase of endometrium,40 specimens of endometrial hyperplasia without atypia and 40 specimens of endometrial atypical hyperplasia were randomly selected as controls.Immunohistochemistry staining was used to detect the expressions of p53,Sestrins and p-mTOR in the above tissues.The expression of the above proteins was compared between the experimental group and the control group,and the relationship between the experimental group and clinicopathological features by chi-square test and continuously corrected chi-square test.Spearman rank correlation analysis was used for correlation analysis of p53,Sestrins and p-mTOR.Kaplan-meier survival analysis and log-rank test were used for univariate analysis.All statistical data were analyzed by SPSS 26.0 software,and P<0.05 means the difference is statistically significant.Results:1.The positive expression rates of p53 protein in PE,EH,EAH and EEC tissues were 6.67%(2/30),10.00%(4/40),30.00%(12/40)and 44.00%(44/100),respectively.The positive expression rate of p53 protein in EEC and EAH groups was significantly higher than that in EH and PE groups(P<0.05),but there was no significant difference in the expression of p53 protein in PE and EH groups,EEC and EAH groups(P>0.05).2.The positive expression rates of Sestrins protein in PE,EH,EAH and EEC tissues decreased sequentially.The positive expression rates of Sestrin1 in PE,EH,EAH and EEC tissues were:90.00%(27/30)、85.00%(34/40)、62.50%(25/40)、43.00%(43/100),the positive rate of Sestrin1 protein expression in EEC and EAH groups was significantly lower than that in EH and PE groups(P<0.05),the positive rate of EEC group was lower than that of EAH group(P<0.05),but there was no significant difference between PE and EH groups(P>0.05).The positive expression rates of Sestrin2 in PE,EH,EAH and EEC tissues were:86.67%(26/30),77.50%(31/40),65.00%(26/40),50.00%(50/100),the positive rate of Sestrin2 protein expression in EEC group was significantly lower than that in EH and PE groups(P<0.05),but there was no significant difference between EAH group(P>0.05),there was no significant difference between PE and EH groups(P>0.05).The positive expression rates of Sestrin3 in PE,EH,EAH and EEC tissues were:93.33%(28/30),87.50%(35/40),62.50%(25/40),41.00%(41/100),the positive rate of Sestrin3 protein expression in EEC and EAH groups was significantly lower than that in EH and PE groups(P<0.05),the positive rate of EEC group was lower than EAH group(P<0.05),but there was no significant difference between PE and EH group(P>0.05).3.p-mTOR protein was differently expressed in PE,EH,EAH,EEC tissues:40.00%(12/30)35.00%(14/40)82.50%(33/40)75.00%(75/100).The positive rate of p-mTOR protein expression in EEC and EAH groups was significantly higher than that in EH and PE group(P<0.05),but there was no statistical significance in PE and EH groups,EEC and EAH groups(P>0.05).4.The expression of p53 protein was related to EEC histological grading(P<0.05),was not associated with age,depth of muscularity,FIGO stage or presence of lymph node metastasis(P>0.05).5.The expression of Sestrins protein was correlated with EEC histological grade(P<0.05),Sestrinl was also correlated with age(P<0.05),Sestrin2 was also correlated with the depth of muscularity invasion(P<0.05).6.The expression of p-mTOR protein was correlated with EEC histological grade(P<0.05),was not associated with age,depth of muscularity,FIGO stage or presence of lymph node metastasis(P>0.05).7.p53 protein was negatively correlated with the expression of Sestrinl and Sestrin2 protein in EEC(rP1=-0.322,PP1<0.05,rP2=-0.242,PP2<0.05).There was no significant correlation between p53 protein and Sestrin3 protein expression in EEC(rP3=-0.165,PP3>0.05).There was no significant correlation between p53 protein and p-mTOR protein expression in EEC(rPM=0.047,PPM>0.05).8.There was a positive correlation between Sestrinl and Sestrin2 protein expression in EEC(r12=0.384,P12<0.05);There was a positive correlation between Sestrin2 and Sestrin3 protein expression in EEC(r23=0.386,P23<0.05).There was no significant correlation between Sestrinl and Sestrin3 protein expression in EEC(r13=0.179,P13>0.05).9.p-mTOR protein was negatively correlated with the expression of Sestrinl and Sestrin2 in EEC(rm1=-0.245,Pm1<0.05,rm2=-0.300,Pm2<0.05);There was no significant correlation between p-mTOR protein and Sestrin3 protein expression in EEC(rm3=-0.082,Pm3>0.05).10.A total of 62 patients with 100 cases of intrauterine adenocarcinoma were interviewed.Survival was measured from the month of surgery to 60 months or to the month of death,and the overall survival rate of 62 patients was 90.32%(56/62).Kaplan-meier survival analysis showed that the expression of Sestrin2 protein was significantly correlated with the survival time of endometrioid adenocarcinoma patients(P=0.031),while the expression of p53 protein,Sestrinl protein,Sestrin3 protein and p-mTOR protein was no correlation with the survival rate of endometrioid adenocarcinoma patients(P>0.05).Conclusion:1.p53 protein was differentially expressed in PE,EH,EAH,EEC tissues from low to high,and p-mTOR protein was highly expressed in EAH and EEC tissues,low expression in PE and EH tissues.Both were associated with EEC histological grading,suggesting that increased expression of p53 protein and mTOR protein may be involved in the development of EEC,and p53 protein may also be involved in the occurrence of EEC.2.Sestrins were differentially expressed from high to low in PE,EH,EAH and EEC tissues,all of which were correlated with EEC histological grade.Sestrin1 was also correlated with age,and Sestrin2 was also correlated with the depth of tumor muscular invasion,suggesting that down-regulation of Sestrins expression was involved in the occurrence and development of EEC.3.The expression of p53 protein and p-mTOR protein in EEC tissue is negatively correlated with Sestrinl and Sestrin2.It is speculated that the down-regulation of Sestrinl and Sestrin2 protein expression induces the elevation of mTOR protein,which may be one of the mechanisms by which p53 protein mutation promotes the occurrence and development of EEC.4.The expressions of Sestrin1,Sestrin2 and the expressions of Sestrin2,Sestrin3 in EEC were positively correlated,suggesting that the three had a synergistic effect on the occurrence and development of EEC.5.Sestrin2 protein was significantly correlated with the survival time of EEC patients,suggesting prognosis.p53 protein,p-mTOR protein,Sestrin1 protein and Sestrin3 protein were not significantly correlated with the survival time of EEC patients. |
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