Clinicopathological Study Of Endometrial Carcinoma With Obesity Women

Objectives: Endometrial cancer is one of the most common gynecologic malignant tumors, its incidence has a rising trend in recent years. In this research, mainly combined with the factors of endometrial cancer, we will discussion the correlation between on body mass index, clinical features and immunohistochemical index and its relationship with prognosis,which could provide the basis for improving the prevention and treatment of endometrial cancer.Methods: A total of 328 cases in Shandong cancer hospital from 2003 to 2014 who met the standard were retrospectively analyzed. The complete clinical data, including body mass index(BMI), histologic grade, pathological stage, ovarian metastasis, myometrium invasion,and pathological type, etc were collected by clinography. Further more, the tumor tissues were obtained from surgically resected EC tissues and then the expressions of Ki-67, glucose transporter-4(Glut-4), and p-AKT in 206 EC tissues were detected by immunohistochemistry(IHC). The correlation between clinical pathological features and immunohistochemical index were analyzed using the SPSS software for statistics, the chi-square test(P < 0.05).Results: 1. The age distribution of patients with endometrial cancer was from26-years-old to 81-years-old, the median age was 55-years-old, the incidence peak age was53 ~ 56-years-old; The distribution of body mass index(BMI): the number of < 25, 25 ~ 30,30 were132(40%), 132(40%), 64(20%), respectively.2. FIGO in 2009 standard for clinical pathologic stage and grade, there were214,33,55,24 cases of stage I, II, III, IV, respectively and 118, 109, 54 cases of grade I, II, III,respectively, pathological grade unclear 47 cases. Lesions is limited to the mucosa and infiltrating muscle layer ?1/2 or less 246 cases, infiltrating muscular > 1/2 82 cases. There were 241 cases of Type I endometrial carcinoma and 87 cases of Type II endometrial carcinoma.3. In endometrial carcinoma tissues, IHC showed us that the positive Ki-67, Gult-4, and p-AKT expressions were located in the cell nucleus, membrane, and cytoplasm/membrane,respectively. And its total positive expression rate was 52.43%(108/206), 70.87%(146/206)and 69.90%(144/206), respectively.Conclusions: BMI was associated with pathological stage, histologic grade, ovarian metastasis and pathological type but not myometrium invasion(p<0.05). The expression of Ki-67 was related to histologic grade and myometrium invasion, while Gult-4 and p-AKT expression levels were only associated with BMI. Seven variables, including age, BMI,hypertension, myometrium invasion, pathological type, ovarian metastasis, and Glut4-positive expression were recruited in COX proportional hazard regression model. we find that BMI,hypertension, myometrium invasion, pathological type and the expression of Glut- 4 were associated with poor prognosis, while age and ovarian metastasis were not prognostic factors for patients with EC. Furthermore, linear regression analysis showed that BMI, hypertension,pathological type, and Glut-4 positive expression were correlated with survival time of patients with EC.