Study On The Relationship Between MMR And P53 Gene Expression And Clinicopathological Features After Staged Surgery For Endometrial Cancer

Objective To explore the manifestation of MMR and p53 in uterine endometrial cancer and to characterise their relationship with the clinicopathological features and prognosis of endometrial cancer.Research Methodology The clinicopathological data of a total of 92 patients operated in the Department of Obstetrics and Gynecology of Inner Mongolia Baogang Hospital from January 2017 to December 2021 and diagnosed with endometrial cancer by postoperative pathology were collected,and the patients included in the study were followed up by telephone until December 31,2022.The analysis of the expression of MMR(including MLH1,PMS2,MSH2,MSH6)and p53 in endometrial cancer tissues was performed by immunohistochemistry to analyse 1.the relationship between MMR and p53 and clinicopathological features;2.the relationship between MMR and each of these proteins and p53;and 3.the factors affecting the survival outcome of EC patients.Results1.MMR immunohistochemistry was obtained in all 92 cases included in the study,and the findings suggest that MMR exposure is correlated with pelvic lymph node migration(P = 0.040)and FIGO stage(P = 0.044),and the occurrence of pelvic lymph node metastasis and FIGO stage III-IV was rare in EC patients in the MMR-deficient group compared with the MMR-intact group,and MMR expression status was not associated with age,BMI muscle level infiltration depth,grading,histological type and the size of the tumour were not related(P > 0.05).2.In endometrial cancer tissues from MMR,the deletion rates of MLH1,PMS2,MSH2 and MSH6 presentation were 17.4%,16.3%,7.6% and 3.3%,respectively.The expression of the four proteins was not related to age,BMI,pelvic lymph node metastasis,depth of muscular infiltration,stage,grade,histological type and tumour size(P > 0.05).3.All 92 cases underwent p53 immunohistochemistry,and the results showed that: p53 expression status was associated with histological type(P = 0.022)and grade(P = 0.010),and the incidence of non-endometrioid carcinoma was higher in p53 mutant than in p53 wild type;the incidence of high-grade endometrial carcinoma was higher in p53 mutant than in p53 wild type;while p53 expression status was not associated with age,BMI p53 expression status was not associated with age,BMI,pelvic lymph node metastasis,depth of muscle infiltration,FIGO stage and tumour size(p > 0.05).4.The p53 expression status was not associated with MMR,MLH1,MSH2,MSH6 and PMS2(P > 0.05).5.An analysis of univariate Cox regression reveals that p53(HR: 1.97,95% CI:1.22-3.17),metastases to pelvic lymph nodes(HR: 1.84,95% CI: 1.03-3.27)and FIGO stage(HR: 1.75,95% CI: 1.02-2.98)are risk factors for recurrence or death from endometrial cancer.Multi-factor Cox regression modelling of factors together at P<0.05 in univariate analysis showed that p53(HR: 2.06,95% CI: 1.27-3.32)and pelvic lymph node metastasis(HR: 1.98,95% CI: 1.10-3.54)were independent risk factors for survival outcome in endometrial cancer.Conciusion1.MMR expression status is associated with pelvic lymph node metastases and FIGO staging,with EC patients with MMR-deficient phenotypes often showing lower staging and fewer pelvic lymph node metastases compared to MMR-intact phenotypes.2.The expression status of p53 correlates with the histological type and grade.EC patients with p53 mutations often present with non-endometrioid carcinoma and low differentiation compared to p53 wild type.3.p53 and pelvic lymph node metastasis are independent risk factors affecting the survival outcome of patients with endometrial cancer,and the prognosis of EC patients can be assessed clinically by testing the expression status of the p53 gene.