HMLH1Methylation Correlation Between Clinical Pathological Characteristics Of Endometrial Carcinoma And Meta Analysis

Background: Endometrial cancer is important in the three malignanttumors of female genital tract, but the incidence of it is the highest ingynecological malignant tumor in the European and American countries.In our country, women’s health has been seriously threaten by it.According to statistics, its incidence has been increasing in the recenttwenty years.The five-year survival rate of the EC is about eighty-sixpercent. Its prognosis will be poorer if it is in the event of metastasis orrecurrence. Ninety percent is sporadic, ten percent has geneticbackground. So far, its exact pathogenesis remains unclear. With thedevelopment of molecular biology technology and it is widely used,people gradually understand molecular genetic features of EC.Oncogene and tumor suppressor genes and DNA mismatch repair genesaffect the occurrence and development of EC. In addition, its formationis also involved a series of molecular biology gene changes. One canimagine that it is a multi-step process and continuous. The current studyhas found that gene methylation is related to development of EC,including p16, p53, PTEN, Rb, APC (B–catenin), hMLH1, hMLH2, ER, PR, K–ras. Whether the hMLH1promoter methylation is relationwith clinical pathological characteristics of EC, the related reports arenot only few but also their views are different.Objective: Explore the association between hMLH1promotermethylation and clinical pathological characteristics of endometrialcancer by using the method of meta-analysis.Methods: We use a computer to retrieve research literature abouthMLH1promoter methylation in endometrial cancer in CNKI, WanFang medical network, Wei Pu database, Chinese biomedical literatureservice system, PUBMED and MEDLINE database from1998to2013.Through early screening related literature. we obtain34inChinese literature,1041articles in English literature. Reading theabstract and the full text, rule out these articles that does not meet theinclusion criteria and are repetition of the published literature. In thelast, we obtain5articles, including2in Chinese literature and3articlesin English literature. Depending on the screening program all the data isdivided into five groups: FIGO staging, histological type,differentiation degree, with or without lymph node metastasis,myometrium invasion group. Extract the data and use RevMan5.2statistical software to analysis. Use meta analysis forest to get the forestfigure and funnel figure about the relationship between hMLH1promoter methylation and FIGO staging, histological type, differentiation degree, with or without lymph node metastasis,myometrium group.Results: According to including and excluding standards,5referencesare obtain, including2in Chinese literature and3articles in Englishliterature.(1) Compare hMLH1promoter methylation relationship withI-II stage and III-IV stage in FIGO staging of EC: the OR value of2.0, P is0.02, I2is15%. The incidence of hMLH1promotermethylation in stage I-II is higher than phase III-IV in EC;(2)Compare hMLH1promoter methylation relationship with endometrioidcarcinoma and non-endometrioid carcinoma in EC histology: the ORvalue of3.11, P is0.02, I2is0%. Namely incidence of it inendometrioid carcinoma is higher than the non-endometrial carcinoma;（3）Compare hMLH1promoter methylation relationship with the high,medium and low differentiation in EC:①Compare hMLH1promotermethylation in high or medium and low in the degree of differentiationin EC: the OR value of1.42, P is0.38, I2is0%. It does not admit thedifferentiation of incidence in high or medium and low EC.②Compare hMLH1promoter methylation in high and low or medium inthe degree of differentiation of EC: the OR value of0.81, P is0.53, I2is0%. It does not admit the differentiation of incidence in high and low ormedium EC.(4) Compare hMLH1promoter methylation in EC withand without lymph node metastasis: the OR value of0.41, P is0.06, I2 is0%. The incidence in EC without lymph node metastasis is higherthan with it;(5) Compare hMLH1promoter methylation relationshipwith myometrium invasion in EC: the OR value of0.84, P is0.77, I2is0%. It does not prove that the incidence in myometrium invasion EC isdifferent.Conclusion: The incidence of hMLH1methylation in I-II,endometrioid carcinoma and no lymph node metastasis in EC patients ishigh,and it can’t yet think that it relates to the degree of differentiationand myometrium invasion.