Clinicopathological Research Of ASRGL1 And MELF Morphology In Uterine Endometrioid Adenocarcinoma

Purpose To investigate the expression of ASRGL1 in endometrioid endometrial carcinoma(EEC)and its clinicopathological significance.To study the pathological significance of microcystic elongated and fragmented(MELF)invasion pattern in EEC and its correlation with ASRGL1 expression level.Methods(1)The relationship between ASRGL1 m RNA expression and pathological features,prognosis and immune cell infiltration in uterine corpus endometrial cancer(UCEC)was analyzed by bioinformatics database.The co-expressed genes were searched for GO gene enrichment analysis and KEGG pathway enrichment analysis.(2)The expression of ASRGL1 in 100 cases of EEC and 70 cases of normal endometrium was detected by immunohistochemistry.The correlation between ASRGL1 expression and MELF invasion pattern and its clinicopathological significance were analyzed.Results(1)Bioinformatics analysis showed that ASRGL1 expression was related to EEC stage,differentiation degree,depth of myometrial invasion,tumor,lymph node metastasis and distant metastasis(all P﹤0.05),and was related to overall survival(P=1.6e-05)and recurrence-free survival(P=0.0077).GO gene enrichment analysis and KEGG pathway enrichment analysis showed that ASRGL1 was mainly involved in ciliary motility and a variety of basic metabolic pathways(FDR ﹤ 0.05).The expression of ASRGL1 was correlated with the infiltration of activated CD4+ T cells,immature dendritic cells,and macrophages(all P﹤0.05).(2)The results of immunohistochemistry showed that the expression of ASRGL1 protein in EEC was significantly lower than that in normal endometrial tissues(P=0.014).The expression of ASRGL1 protein was negatively correlated with the grade,stage and vascular invasion of EEC patients,and positively correlated with the status of ER and PR(all P <0.05).It was not correlated with the patient’s age,depth of myometrial invasion,lymph node metastasis,distant metastasis,Ki-67 proliferation index and p53expression(all P >0.05).The expression of ASRGL1 protein in 6 cases with direct spread and metastasis was consistent with that in the primary tumor.(3)The incidence of MELF pattern was 23.0%(23/100).The MELF pattern was positively correlated with age,stage,depth of myometrial invasion,vascular invasion and lymph node metastasis,and negatively correlated with EEC grade(all P <0.05).However,it was not correlated with distant metastasis,Ki-67 proliferation index,ER,PR status and p53 expression(all P >0.05).(4)The expression of ASRGL1 protein in low-grade EEC tumors was not related to MELF invasion(r=0.185,P=0.288).The low expression of ASRGL1 in the invasion frontier of MELF was negatively correlated with lymph node metastasis(r=-0.626,P=0.015).Conclusion The low expression of ASRGL1 protein in EEC is associated with poor differentiation,which can be used as a potential molecular marker for evaluating the differentiation of EEC and is worthy of further study.MELF invasion in low-grade EEC is associated with a variety of poor prognostic factors,which should be clearly described in the pathological diagnosis.