Expressions And Clinical Significance Of ER,PR And ALDH1 In Endometrial Cancer

OBJECTIVE to investigate the expressions and clinical significance of ER,PR and ALDH1 in endometrial cancer.METHODS immunohistochemistry was use to reveal the expressions of ER,PR and ALDH1 in 88 cases ofⅠendometrial cancer tissues ,11 cases ofⅡendometrial cancer tissues,21 cases of atypical tissues hyperplasia(AH),30 cases of complex hyperplasi(aCH)tissues,30 cases of simple hyperplasi(aSH)and 32 cases of normal endometrium tissues,the data was analysised statistically following by PASW Statistics 18.0。RESULTS1. The expression of ER protein(1) The positive expression rates of ER protein:①ER protein were detected in 87.50%(28/32)normal endometriums , 75.31%(61/81)hyperplasia endometriums and 63.64%(63/99)endometrial cancer tissues. endometrial cancer group are significantly lower than normal endometriums group,three groups demonstrated significant difference(P<0.05).②ER protein were detected in 83.33%(25/30)simple hyperplasia,76.67%(23/30)complex hyperplasia and 61.90%(13/21)atypical hyperplasia tissues, the difference between three groups have no significance(P>0.05).③The relationship between the positive expression rates of ER protein and clinicopath-ologic parameters: ER protein which were detected inⅠendometrial cancer(71.59%) are higher thanⅡendometrial cancer(0.00%)(P<0.01); ER protein express decrease following the increase of histological grade(P<0.05). The positive expression rates of ER protein have no significant association with FIGO stage, moymetrial depth ,lymph node metastasis and age(P>0.05)(2)The expression average level of ER protein:①The expression average quantity of ER protein is 5.1750±3.9132 in normal endometriums, 4.3593±3.3730 in hyperplasia endometriums and 2.0101±2.3057 in endometrial cancer tissues respectively. The expression average quantity of ER protein in three group above showed significant difference(P<0.01), endometrial cancer tissues are lower than normal endometriums and hyperplasia endometriums tissues.②The expression average quantity of ER protein is 5.0733±3.2519 in simple hyperplasia, 4.1033±3.0193 in complex hyperplasia and 3.7048±3.9551 in atypical hyperplasia tissues respectively. The expression average quantity of ER protein in three group above showed no significant difference(P>0.05).③The relationship between the expression average quantity of ER protein and clinicopathologic parameters: the expression average quantity of ER protein inⅠendometrial cancer(2.2955±2.3152) are higher thanⅡendometrial cancer ( 0.0000±0.0000 ) (P < 0.01). The expression average quantity of ER protein have no significant association with FIGO stage, histological grade ,moymetrial depth ,lymph node metastasis and age(P>0.05)2. The expression of PR protein(1) The positive expression rates of PR protein:①PR protein were detected in 84.38%(27/32)normal endometriums , 81.48%(66/81)hyperplasia endometriums and 68.69%(68/99)endometrial cancer tissues. Endometrial cancer group are significantly lower than normal endometriums and hyperplasia endometriums group,three groups demonstrated significant difference(P<0.05).②PR protein were detected in 86.67%(26/30)simple hyperplasia, 80.00%(24/30)complex hyperplasia and 76.19%(16/21)atypical hyperplasia tissues, the difference between three groups have no significance(P>0.05).③The relationship between the positive expression rates of PR protein and clinicopathologic parameters: PR protein which were detected inⅠendometrial cancer(75.00%) are higher thanⅡendometrial cancer(18.18%)(P<0.01); The positive expression rates of PR protein also have significant association with FIGO stage(P<0.05), histological grade (P<0.01) and moymetrial depth(P<0.05) ,but have no significant association with lymph node metastasis and age(P>0.05)(2)The expression average level of PR protein:①The expression average quantity of PR protein is 5.7750±4.4061 in normal endometriums, 4.7062±3.5898 in hyperplasia endometriums and 3.1313±3.2534 in endometrial cancer tissues respectively. The expression average quantity of PR protein in three group above showed significant difference(P<0.01), endometrial cancer tissues are lower than normal endometriums and hyperplasia endometriums tissues.②The expression average quantity of PR protein is 5.2533±3.4621 in simple hyperplasia, 4.4967±3.3173 in complex hyperplasia and 4.2238±4.1773 in atypical hyperplasia tissues respectively. The expression average quantity of PR protein in three group above showed no significant difference(P>0.05).③The relationship between the expression average quantity of PR protein and clinicopathologic parameters: the expression average quantity of PR protein inⅠendometrial cancer(3.4432±3.2655) are higher thanⅡendometrial cancer ( 0.6364±1.8040 ) (P < 0.01). The expression average quantity of PR protein also showed significant association with FIGO stage(P<0.05), but have no significant association with histological grade ,moymetrial depth ,lymph node metastasis and age(P>0.05)3. The expression of acetaldehyde dehydrogenase 1(ALDH1)(1) The positive expression rates of ALDH1:①ALDH were detected in 0.00%(0/32)normal endometriums , 14.81%(12/81)hyperplasia endometriums and 52.53%(52/99)endometrial cancer tissues. Endometrial cancer group are significantly higher than normal endometriums and hyperplasia endometriums group,three groups demonstrated significant difference(P<0.01).②ALDH1 were detected in 3.33%(1/30)simple hyperplasia, 6.67%(2/30)complex hyperplasia and 42.86%(9/21)atypical hyperplasia tissues, the difference between three groups have significance(P <0.01).③The relationship between the positive expression rates of ALDH1 and clinicopathologic parameters: The positive expression rates of ALDH1 only have significant association with histological grade (P<0.05).(2)The expression average level of ALDH1 :①The expression average level of ALDH1 is 0.0000±0.0000 in normal endometriums, 0.9049±2.4224 in hyperplasia endometriums and 3.5152±4.1637 in endometrial cancer tissues respectively. The expression average quantity of ALDH1 in three group above showed significant difference(P<0.01), endometrial cancer tissues are higher than normal endometriums and hyperplasia endometriums tissues.②The expression average quantity of ALDH1 is 0.1067±0.4571 in simple hyperplasia, 0.4833±2.2225 in complex hyperplasia and 2.6476±3.4052 in atypical hyperplasia tissues respectively. The expression average quantity of ALDH1 in three group above showed significant difference(P<0.01).③The relationship between the expression average quantity of ALDH1 and clinicopathologic parameters: the expression average quantity of ALDH1 also have significant association with moymetrial depth (P<0.05) only. It have no significant association with pathologic type ,FIGO stage, histological grade ,lymph node metastasis and age(P>0.05).4. The relationship between ER,PR,ALDH1 and prognosis99 cases of endometrial cancer 1,3,5 year's disease free survival (DFS) was 91%,87%,84% respectively,the total 1,3,5 year's survival of all patients was 94%,88%,84%。Log-Rank test revealed that pathologic types ,FIGO stage , metastases of lymphnode and the expressions of PR and ALDH1 were related with the prognosis(P<0.05); The multivariate analysis of Cox proportion hazards regression model showed that pathologic types, FIGO stage and the expressions of ALDH1 were related with the prognosis significantly.CONCLUSIONS1. Expression decline of ER and PR may have relation with the tumorigenesis and progression of endometrial cancer.2. ALDH1 significantly high expression in atypical hyperplasia tissues and endometrial cancer tissues,suggested that ALDH1 may be a related factor responsible for in tumorigenesis of endometrial cancer.3.IN endometrial cancer tissues the expression average level of ER and PR have obvious correlationship;But the expression average level of ALDH1 have no relation with their's.4.PR and ALDH1 have close relation with the prognosis.Expecially PR(-) and ALDH1(+)are significantly associated with poor clinical outcome .