Expression And Significance Of ?-catenin, YAP-1, TBX5 And Survivin In Endometrail Carcinoma

Objective: Endometrial carcinoma is one of the most common malignancy of female reproductive system. Its incidence is increasing rapidly worldwide, although great improvements have been achieved in the field of molecular genectis and lots of researches about endometrial carcinoma have been done, the total survival rate of the patients with endometrial carcinoma did not improve much. The replase rate remained 10%-20%. The basic reason for this fact is that we did not know well about the exact mechanism of the pathogenesis of endometial carcinoma. This study try to find epidemiological characteristica of emdometial carcinoma through analysing the cases with endometrail carcinoma in the last ten years of Tianjin General Hospital and also we try to find some useful molecules involved in the pathogenesis of endometial carcinoma, including type ?and type ? by immunohistchemistery method. we expect to grasp the epidemiological features of the endometrial carcinoma and find the possible mechanisms involved in the occurence of the endomentrial carcinoma, and hope to provide some theoretical foudations for the prevention, diagnosis and therapy of endometrail carcinoma.Section 1 Epidemiological analysis of different types of endometrial carcinomaMethod: In this study, we select 817 cases of endometrail carcinoma diagnosed from 2005 to 2014 as the subjects. All cases were form the department of pathology of Tianjin General Hospital and were rediagnosed by pathology doctors again to confirm the diggnosis. Among which,770 cases were type? endometrail carcinoma, and 77 cases were type? endometrail carcinoma. The qualitative data was analyses by chi square test, Kruskal-Wallis test and T test by SPSS17.0 software.Results: 1 The age constitution of endometrail carcinomaThe youngest patient was 27 years old, and the oldest was 89 years old. The average age was 59.22±10.46. The peak age range of endometrail carcinoma was from 51 to 60, the corresponding constitute ratio was 44.6%.2 The age constitution of type? and ? endometrail carcinomaIn the type ? endometrail carcinoma, the youngest patient was 27 years old,and the oldest one was 89 years old. The average age was 58.61±10.273. The peak age range of type? endometrail carcinoma was form 51 to 60, the corresponding constitute ratio was 46.4%. In the type? endometrial carcinoma, the youngest patient was 35 years old, and the oldest one was 87 years old. The average age was 65.13±10.439. The peak age range of type? endometrial carcinoma was form 51 to 60, the corresponding constitute ratio was 49.4%.3 The variation trend of age in endometrail carcinoma type? and ?There was no significant difference in the variation trend of age between endometrail carcinoma type? and ?(P>0.05).Section Two Expression and significance of ?-catenin, YAP-1, TBX5 and Survivin in Endometrial carcinomaMethod: In this study, we select 100 cases of Endometrail biopsies with different lesions diagnosed between 2009 and 2015. Among them, 15 cases were proliferation period endometrium,15 cases were simple endometrial hyperlasia, 20 cases were complex endometrail hyperplasia, 30 cases were endometrioid adenocarcinoma, and 20 cases were endometrial serous adenocarcinoma. All cases were form the department of pathology of Tianjin General Hospital and were rediagnosed by pathological doctors again to confirm the diagnosisThe two-step PV-6000 immunohistochemical staining method was used to detect the expression of ?-catenin ? YAP1 ? TBX5 and Survivin in different endometrail diseases. All data were analysed by statistic software SPSS,version 17.0. The qualitative data was analysed by chi square test.The method of pearson contingency was used to analysis the correlation.P<0.05 was defined as statistical significant.Results: 1 The exprssion of ?-catenin?YAP1?TBX5 ? Survivn in different endometrail lesions1.1 The ?-catenin was expressed in the membrane of proliferation period endometrium, but it was expressed in nucleus of simple endometrial hyperlasia, complex endometrial hyperplasia, endometrioid adenocarcinoma. The positive rate of ?-catenin increasing in such a sequence. The differences are statistically significant(P<0.05). The?-catenin was not expressed in type ? endometrial carcinoma. The differences of positive rate between endometrioid adenocarcinoma and endometrial serous adenocarcinoma are statistically significant(P<0.01).1.2 The YAP1 was expressed in nucleus, the positive rates of YAP1 rise gradually in the order of proliferation period endometrium, simple endometrail hyperlasia, complex endometrail hyperplasia and endometrioid adenocarcinoma,the differences are statistical significance(P<0.05). The positive rates of YAP1 in endometrail serous adenocarcinoma is 5%. The different positive rate between endometrioid adenocarcinoma and endometrial serous adenocarcinoma are statistically significant(P<0.01). 1.3 The TBX5 was expressed in nucleus, the positive rates of TBX5 rise gradually in the order of proliferation period endometrail, simple endometrail hyperlasia, complex endometrail hyperplasia and endometrioid adenocarcinoma tissue, and the differences are statistically significant(P<0.05). The positive rates of TBX5 rate between endometrioid adenocarcinoma and endometrial serous adenocarcinoma are statistically significant(P<0.01). 1.4 The Survivin was expressed in nucleus, the positive expression rates of Survivin rise gradually in the order of proliferation period endometrial, simple endometrial hyperlasia, complex endometrial hyperplasia and endometrioid adenocarcinoma, and the differences are statistically significant(P<0.05). The positive rates of Survivin in endometrail serous adenocarcinoma is 65%. The different positive rate between endometrioid adenocarcinoma and endometrial serous adenocarcinoma are not statistically significant(P>0.05). 2 The exprssion of ?-catenin?YAP1?TBX5 and Survivin in different hisological grade of type ? endometrioid carcinoma and the relationship between ?-catenin?YAP1?TBX5,Survivn and with the clinopathological parameters 2.1 The positive rates of ?-catenin in well, moderate and poor-differentiated endometrioid adenocacinoma are gradually decreased, and the differences are statistically significant(P<0.05). There is no significant differences between the expression of ?-catenin and the other clinopathological parameters,such as age, TNM stage, muscular infiltration depth and lymphatic metastasis(P>0.05). There is on nucleus expression of ?-catenin in type ? endometrail carcinoma.2.2 The positive rate of YAP1 in well, moderate and poor-differentiated endometrioid adenocacinoma is not statistically significant(P>0.05). There is no significant differences between the expression of YAP1 and the other clinopathological parameters in type?and type?endomertial carcinoma, such as age, TNM stage, muscular infiltration depth and lymphatic metastasis(P>0.05). 2.3 The positive rate of TBX5 in well, moderate and poor-differentiated endometrioid adenocacinoma is not statistically significant(P>0.05). There is no significant differences between the expression of TBX5 and the other clinopathological parameters in type?and type?endomertial carcinoma, such as age, TNM stage, muscular infiltration depth and lymphatic metastasis(P>0.05). 2.4 The positive rate of Survivin in well, moderate and poor-differentiated endometrioid adenocacinoma is not statistically significant(P>0.05). There is no significant differences between the expression of Survivin and the other clinopathological parameters in type?and type ?endomertial carcinoma, such as age, TNM stage, muscular infiltration depth and lymphatic metastasis(P>0.05). 3 The correlation analysis showed that the expression of?-catenin and YAP1, ?-catenin and Survivin?YAP1 and Survivn are positive correlated in type? endometrail carcinoma(P<0.05). There is no correlation between TBX5 and other indexs(P>0.05).There is no correlation about all indexs in type? endometrail carcinoma.Conclusions: 1. The average age of type ? endometrail carcinoma is older than that of type?. The average age of type? was58.61±10.273, and 58.61±10.273 for type ?. The peak age range of type? endometrail carcinoma was form 51 to 60, and above 66 for type ?. 2. There is no significant difference in the age trends of endometrail carcinoma through the Kruskal-Wallis test(P>0.05), and it is the same results whether in the type?and ? endometrial carcinoma(P>0.05).3. ?-catenin takes part in the initiation and progression of endometrioid adenocarcinoma, but did not take part in the pathogenesis of type ?endometrial carcinoma. 4. YAP1 and TBX5 take part in the initiation and progression of endometrioid adenocarcinoma, but did not take part in the pathogenesis of type ?endometrial carcinoma. 5. Survivin take part in the initiation and progression in both the type I and type? endometrail carcinoma. 6. The correlation analysis showed that Wnt/?-catenin signaling pathway take part in the initiation and progression of type?endometrail carcinoma., and?-catenin can cooperate with YAP1 in this progress. Wnt/?-catenin signaling pathway do not take part in the initiation and progression of the type ? endometrail carcinoma. 7. The expression of YAP1?TBX5?Survivin did not show correlation with the clinopathological parameters of the endometrial carcinoma. The expression of ?-catenin diseased from the well different to poor different endometrioid andenocarcinoma. 8. The expression of ?-catenin ? YAP1 and TBX5 in type I and type ? endometrial carcinoma is statistically different, this suggest that all these marker are potentially useful biomarkers in differential diagnosis.