| Purpose: Through investigating the expression of MTA-1protein and p73protein in the normal endometrium,atypical hyperplasia endometrium and endo-metrioid adenocarcinoma, discuss the role in the occurrence and development ofendometrioid adenocarcinoma,analysis the relationship between the MTA-1and p73expression and endometrioid adenocarcinoma of surgical pathological staging,muscular invasion depth, histologic differentiation degree,infiltration depth, presenceof lymph node metastasis. The experience would discusses the function andmechanism of the two kinds of protein in normal endometrium to endometrioidadenocarcinoma, look for the new markers for evaluating biological characters andjudging prognosis of endometrioid adenocarcinoma.Method:We use Immunohistochemistry SP method to examine the expression ofMTA-1and p73protein in the normal endometrium (25specimens),atypicalhyperplasia endometrium(30specimens), and endometrioid adenocarcinoma(66specimens), all specimens are from the Jilin University China-Japan FriendshipHospital in2011January to2013January during the obstetrics and gynecologyoutpatient and hospitalization in patients with endometrium tissue paraffinblock.Preoperative were not taken for treatment.We group them as follows:(1)Thenormal control group:Due to a cervical lesions of hysterectomy,The postoperativepathology confirmed as normal endometrium of patients with,a total of25cases, ageof38-61years, mean age45.8years;(2) atypical hyperplasia endometrium:In the clinicof concurrent cervical cone excision or due to cervical lesions of hysterectomy,postoperative pathology confirmed that atypical hyperplasia endometrium,a total of30cases, age of36-64, mean age45.8years.(3) endometrioid adenocarcinoma:66cases, at the age of29-68, mean age48.1years.According to clinical stage (inreference to the2009FIGO staging): I patients in26cases, II patients in19cases, IIIpatients in21cases.According to the pathological grading: well-differentiation in28cases,23cases of differentiation, less-differentiation in15cases. According to thelymph node metastasis: associated with lymph node metastasis in21cases, no lymph node metastasis in45cases. The average age of three groups had no significantdifferences (P <0.05), with statistical significance.All specimens were fixed by10%formaldehyde solution, paraffin embedding, made of4microns sections.In normalcervical tissue and typical hyperplasia endometrium as positive control,using0.01mol/L PBS instead of as a negative control.The experimental results of the judging standard of MTA-1protein in epithelialcells of the nucleus expression, dyed brown for the positive expression.P73positivecells mainly located in the endometrial glands,dyed brown for the positiveexpression,According to the method,commonly used in the world,we grade theexpression of MTA-1and P73protein by the percentage of positive cells and stainingintensity of slices,which is in400x optical microscope count five horizons, eachvision for100-200cells, positive cell number/total number of cells is protein positiveexpression rate. First, we grade the consequence according to the percentage ofpositive cells of observation:0point,no positive fine cytoportion;1point,positive cells≤10%,2points, positive cells from10％to50%,3points, positive cells from50%to80%,four points,4point;more than80%. Then by cells show color intensity:0point,cells show no color,1point,the cells are yellow,2points, cells are tan-yellow,3points,cells are brown or oven particles. Product of two scoring3or higher is dividedinto positive, product <3points for negative, the result judge reference Salvesenmethod[1].All slice both determinated by pathologists blinded.All dates are managed bySPSS17.0sofeware process.The correlation analysis of the counting material are usedX2inspection,P＜0.05said difference was statistically significant.Result:(1) The MTA-1protein positive expression rate in the25cases of thenormal endometrium is8%;in30cases of atypical hyperplasia endometrium is33.33%;in66cases of endometrioid adenocarcinoma is77.27%. MTA-1proteinpositive expression rate of normal endometrium'atypical hyperplasia endometrium'endometrioid adenocarcinoma was increased.The MTA-1positive expression ratein atypical hyperplasia endometrium group was significantly higher than that innormal ormal endometrium, with significant between the two groups difference (P <0.05).That in the endometrioid adenocarcinoma group was significantly higher thanthat of atypical hyperplasia endometrium, two groups had significant difference (P <0.05).(2)66cases of endometrioid adenocarcinoma, the expression rate of MTA-1 protein positive rates were associated with surgical pathological staging,muscularinvasion depth, histologic differentiation degree,infiltration depth, presence of lymphnode metastasis.In endometrioid adenocarcinoma,26patients with stage I,19patientswith stage II and21patients with stage III,the MTA-1protein positive expressionrates were61.54%（16/26）、84.21%（16/19）、90.48%（19/21）.All groups havesignificant difference(P <0.05).According to histologic differentiation degree can bedivided into groups of high differentiation, differentiation and low differentiationgroup.MTA-1protein positive expression rates were:60.71%（17/28）、86.96%（20/23）、93.33%（14/15）, the three groups have significant difference (P <0.05).They are divided into accompanied by lymph node metastasis group and withoutlymph node metastasis group,and the MTA-1protein positive expression rates were68.89%（31/45）、95.23%（20/21）,between the two groups have significant difference(P <0.05). According to muscular invasion depth can be divided into groups of＜1/2group and≥1/2group，the MTA-1protein positive expression rates were:67.58%（25/37）、89.66%（26/29）.Between the two groups had significant difference(P <0.05).(3) The p73protein positive expression rate in the25cases of the normalendometrium is12%;in30cases of atypical hyperplasia endometrium is36.67%;in66cases of endometrioid adenocarcinoma is72.73%. P73protein positive expressionrate of normal endometrium'atypical hyperplasia endometrium'endometrioidadenocarcinoma was increased.The p73positive expression rate in atypicalhyperplasia endometrium group was significantly higher than that in normal ormalendometrium, with significant between the two groups difference (P <0.05).That inthe endometrioid adenocarcinoma group was significantly higher than that of atypicalhyperplasia endometrium, two groups had significant difference (P <0.05).(4)66cases of endometrioid adenocarcinoma, the expression rate of p73protein positiverates were associated with surgical pathological staging,muscular invasion depth,histologic differentiation degree,infiltration depth, presence of lymph nodemetastasis.In endometrioid adenocarcinoma,26patients with stage I,19patients withstage II and21patients with stage III,the p73protein positive expression rates were53.85%（14/26）、84.21%（16/19）、85.71%（18/21）.All groups have significantdifference(P <0.05).According to histologic differentiation degree can be dividedinto groups of high differentiation, differentiation and low differentiation group.P73 protein positive expression rates were:64.29%（18/28）、73.91%（17/23）、86.67%（13/15）, the three groups have no significant difference (P＞0.05).They aredivided into accompanied by lymph node metastasis group and without lymph nodemetastasis group,and the p73protein positive expression rates were90.48%（19/21）、64.44%（29/45）.Between the two groups have significant difference (P <0.05).According to muscular invasion depth can be divided into groups of＜1/2group and≥1/2group，the P73protein positive expression rates were:67.57%（25/37）、79.31%（23/29）.Between the two groups had no significant difference (P＞0.05).(5) Theexperimental results show in endometrioid adenocarcinoma with MTA-1protein andp73protein positive expression were positively correlated (rs=0.317, P <0.05).Conclusion:1, The expression of MTA-1is lower in normal endometrium tissues, and higherin endometrial atypical hyperplasia and endometrial cancer high expression.Explainthe MTA-1positive and the surgical pathological staging,muscular invasion depth,histologic differentiation degree,infiltration depth, presence of lymph node metastasisrelevant.2, The expression of p73is lower in normal endometrium tissues, and higher inendometrial atypical hyperplasia and endometrial cancer high expression. It isAssociated with surgical pathological staging, lymph node metastasis, and has nothingto do with the muscular infiltration depth and histological differentiation degree.3, The experimental results show in endometrioid adenocarcinoma with MTA-1protein and p73protein positive expression were positively correlated.4, MTA1and p73for endometrial adenocarcinoma in early diagnosis, treatment,prognosis and judge the biological behavior of malignant tumors has importantclinical reference value. |
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