Expressions Of EGFR, WT-1, CD10 And OTR In Endometrial Stromal Sarcomas

Objetive: To study the expressions of EGFR, WT-1, CD10 and OTR in endometrial stromal sarcomas, so as to explore their applications in the diagnosis and differential diagnosis of ESS.Methods: Using the SP staining method of immunohistochemical technique, the expressions of epidermal growth factor receptor (EFGR), the Wilms tumor gene product (WT-1) , CD10 and oxytocin receptors (OTR) were studied in 40 endometrial stromal sarcomas (ESSs) including 35 cases of low-grade and 5 cases of undifferentiated endometrial sarcomas, and in 15 cases of highly cellular leiomyomas(HCLs) , 10 cases of uterine leiomyosarcomas(ULSs) . The differences of expressing EFGR ,WT-1,CD10 and OTR in each kinds of tumor were analyzed with counting the immunstaining positive rates and image analytical technique.Results:1. The expression products of EFGR,CD10 and OTR was located in the cytoplasm and /or tumor cell membrane. The expression products of WT-1 were shown mainly in the nuclei. In endometrial stomal sarcomas, highly cellular leiomyomas and uterine leiomyosarcomas, the immunstaining positive rates of EGFR were 67.5%(27/40),80.0%(12/15) and 70.0%(7/10) respectively; WT-1 were 52.5%(21/40),46.7%(7/15)and 50.0%(5/10) respectively; CD10 were 82.5%(33/40), 13.3% (2/15) and 0 (0/10) respectively; and OTR were 7.25%(3/40),100%(15/15) and 100% (10/10) respectively .2. EGFR was showed in 27 of 40 cases of endometrial stomal sarcomas, and 23 cases were moderate and strong positive. 12 of 15 highly cellular leiomyomas showed positive for EGFR, 10 cases were moderate and strong positive. Among 10 uterine leiomyosarcomas, 7 cases were revealed moderate to strong EGFR positive. Image analysis showed that the area integral optical densities (AIODs) of EGFR were 0.0123±0.0035,0.0127±0.0030 and 0.0125±0.0022 respectively in endometrial stoma sarcomas, highly cellular leiomyomas and uterine leiomyosarcomas. The difference of AIOD for EGFR has no statistical significant in these kinds of tumors.3. WT-1 was expressed in 21 cases of 35 low-grade ESSs, and 16 cases were moderate and strong positive. 5 cases of UESs were WT-1 negative. 7 cases of 15 HCLs were WT-1 positive, and 6 cases were moderate and strong positive. 5 cases of 10 ULSs were WT-1 positive, and 4 cases were moderate and strong positive. Image analysis showed that the AIODs of WT-1 were 0.0046±0.0013 , 0.0054±0.0017 and 0.0053±0.0016 respectively in ESSs, HCLs and ULSs. The difference of AIOD for WT-1 has no statistical significant between ESSs and HCLs, ULSs.4. CD10 was detected in 33 cases of 40 ESSs, and 28 cases were moderate and strong positive. Only 1 case of 5 UESs expressed CD10 weakly. 2 of 15 HCLs expressed CD10 weakly. None of 10 cases of ULSs expressed CD10. The AIODs of CD10 were 0.0120±0.0025 in ESSs, 0.0005±0.0001 in HCLs and 0 in ULSs respectively. The AIOD of CD10 in ESSs was higher than that in HCLs and ULSs (P<0.01).5. OTR was not expressed in 40 cases ESSs, except 3 cases that showed partly positive in regions of smoooth muscle differentiation. All 15 cases of HCLs showed cytoplasmic expression of OTR with 14 cases being moderate to strong intensity. All 10 ULSs expressed OTR, there were strong intensity in 6 cases and moderate staining in the remaining 4 cases. Image analysis showed that the AIODs of OTR were 0.0006±0.0003,0.0125±0.0019 and 0.0128±0.0017 respectively in ESSs, HCLs and ULSs. The AIOD in ESSs was lower than that in HCLs and ULSs; the difference has statistical significance, (p < 0.01).Conclusions:1. EGFR was expressed highly in ESSs, HCLs and LMSs. Therefore, it hints that EGFR could not be an immunstaining marker in the differential diagnosis of ESS, HCL and ULS.2. WT-1 was highly expressed in ESSs, HCLs and ULSs, but was not expressed in UESs, which indicated that may be related to tumor cells differentiation. It hints that WT-1 could not be an immunstaining marker in the differential diagnosis of ESS, HCL and ULS.3. CD10 was highly expressed in ESSs, but was not or seldom expressed in HCLs and ULSs. It indicates that CD10 could be a specific tumor marker in the differential diagnosis between ESS and HCL or ULS4. OTR was not expressed in ESSs, but highly expressed in HCLs and ULSs. It hints that OTR could be one of specific tumor markers in the differential diagnosis between ESS and HCL or ULS too.