Application Research Of E-cad And Fascin In The Diagnosis Of Endometrial Carcinoma With MELF Infiltration

Background and objectiveEndometrial carcinoma is one of the most common malignant tumors in female reproductive system,accounting for 20%-30%.In recent years,the incidence of endometrial cancer increased significantly,and the trend of younger,a serious threat to the health of women in China.Endometrioid carcinoma was divided into type I and type II on the basis of different origins,clinical pathological features and genetic characteristics.Endometrioid carcinoma is the most common type of endometrial carcinoma.In recent years,pathology circles found in endometrial carcinoma is a rare special mode of invasion;MELF(microcystic elongated and fragmented)research has confirmed the infiltration occurred only in endometrioid adenocarcinoma of the histological type.It has been reported that it occurs only in low grade endometrial carcinoma with myometrial invasion.It can occur in any clinical stage.At present,it is generally accepted that endometrial carcinoma with this special infiltration method has a higher lymph node metastasis rate and poor prognosis.Therefore,the correct diagnosis of endometrial carcinoma with MELF infiltration is very important,it is important to guide the clinical treatment and prognosis of patients.The diagnosis of this disease is mainly based on HE staining under the microscope to observe,MELF infiltration is only located in the uterine muscle,and endometrial adenocarcinoma can exist in the presence of a continuous or focal in the muscle.And the occurrence of more hidden,only by HE naked eye is easy to miss diagnosis.In addition,it is easy to confuse with the vascular and other tissues of the muscle,and only HE may have the possibility of misdiagnosis.Therefore,it is necessary to use immunohistochemistry to assist in the diagnosis.At present,the diagnosis of endometrial carcinoma with immunohistochemical indicators: CK,CK7,ER,PR,Vimentin,P16,KI-67,etc.According to the immunohistochemical method of MELF diagnosis in the literature,CK7 can be used to assist in the diagnosis of MELF infiltration.Therefore,the use of CK7 in the diagnosis of endometrial carcinoma with highly suspected MELF infiltration.However,the effect is not satisfactory,so it is urgent to find a new target for MELF diagnosis.In addition,we found that actin binding protein(Fascin)can be expressed in normal cells and tumor cells in the basic research of MELF.There is a close relationship between the upregulation of expression and invasion of tumor cells.Epithelial cadherin(E-cadherin)is a kind of cell adhesion protein,which plays an important role in mediating cell adhesion and cell signal transduction.The expression of E-cad is the most important mechanism of tumor invasion and metastasis,and may be related to the invasion of MELF.In this study,the expression of E-cad and Fascin in 23 cases of endometrial carcinoma with suspected MELF infiltration were detected by immunohistochemical method,and the role of the two methods in the diagnosis of MELF infiltration was analyzed.MethodsA total of 140 cases of endometrioid carcinoma diagnosed by hysterectomy in the First Affiliated Hospital of Zhengzhou University from 2011-2015 were collected in.According to the criteria of MELF infiltration in literature,23 cases with suspected MELF infiltration were found.The age ranged from 45-70 years,with an average age of 58.3 years.The expression of E-cad and Fascin protein was detected by immunohistochemical method,and the results were compared.Objective to investigate the possibility of adjuvant diagnosis of endometrioid carcinoma with MELF infiltration.The application of SPSS 17.0 for data analysis,qualitative data were compared by the χ2test,α=0.05 level test.Results1.The results of CK7 infiltration in 23 cases of suspected MELF: among them,there were diffuse strong positive in all the 8 cases,and the positive intensity of the endometrial adenocarcinoma was different.Diagnosis of MELF infiltration combined with tissue morphology.In this study,the incidence rate was 5.71%(8/140).2.The results of E-cad infiltration in 23 cases of suspected MELF: among them,there were 15 cases of discontinuous weak positive,and the surrounding endometrial carcinoma glands were more homogeneous and complete basement membrane staining.Diagnosis of MELF infiltration combined with tissue morphology.3.The results of Fascin invasion of MELF in 23 cases were positive: the positive and small interstitial vessels were positive in all the cases,and the negative or positive foci were found in the surrounding endometrial carcinoma in the 11 cases.4.E-cad,Fascin and the combination of the two in the diagnosis of MELF infiltration statistical results: E-cad and CK7 in the detection of MELF infiltration rate was statistically significant(P<0.05).There was no significant difference in the detection rate of Fascin and CK7 in MELF(P>0.05).There was no significant difference in the rate of MELF infiltration between E-cad and Fascin and CK7(P>0.05).5.The accuracy of the results of the comparison of the three methods: E-cad and Fascin for the diagnosis of MELF infiltration rate of coincidence(78.26%)higher than the use of E-cad(69.57%)and Fascin(60.87%)in the diagnosis of coincidence rate.In this experiment,the coincidence rate of MELF with Fascin alone(60.87%)was lower than that of E-cad(69.57%)alone.There was no significant difference between the three groups(P>0.05),E-cad,Fascin and the combination of the two groups in the diagnostic accuracy of MELF infiltration.Conclusions1.E-cad and Fascin can be used as adjuvant diagnosis of endometrioid carcinoma with MELF infiltration,but the diagnosis of the need to combine the histological morphology,the combination of the two effect is better.