| Objective Endometrioid adenocarcinoma is the most common pathological types of endometrial cancer(accounting for more than 80%),whose incidence gradually rise in recent years,and patients showed a trend of getting younger.more than 80% of endometrioid adenocarcinoma patients have no children or have desires to give birth to children.Early stage patients who were treated by comprehensive therapy,which is mainly composed of surgery,could be able to obtain good survival,but young patients lose fertility and ovarian endocrine function to maintain women's physiological characteristics,which in turn leads to metabolic disorders and related complications,seriously affecting the patient's life quality.How to improve the efficacy and retain the patients' endocrine and reproductive function has become the focus of clinical workers and researchers.In recent years,researchers have made some achievements on endometrioid adenocarcinoma treatment to retain reproductive function.esearchers proposed the progesterone therapy method.which has been proved certain curative effect by many years clinical practice.However the efficacy of progesterone therapy is closely related with the PR expression in tumor tissue.The studies showed PR positive patients had a good result with progesterone treatment but PR negative patients did not.And the loss of PR is related to the increased degree of malignancy and invasion and the hormone independent tumor transformation.There is no effective therapy to retain reproductive function for PR negative early endometrioid adenocarcinoma patients recently.CD146 is a kind of cell adhesion molecules and belong to immunoglobulin superfamily.Recent researchs have showed that the function of CD146 is not only involved in cell-cell,cell and interstitial cell adhesion process,but also participated in many events.The studies also found that CD146 expressed in various malignant tumors,playing an important role in the occurrence and development of tumor.CD146 antibody AA98 which prepared by team of professor Xiyun Yan worked in Chinese Academy of Sciences Institute of Biophysics has also been confirmed the function of anti growth and angiogenesis of melanoma,breast cancer,pancreatic cancer,osteosarcoma and mesothelioma.Recent literatures reported that CD146 was highly expressed in endometrioid adenocarcinoma,which is a new biological marker for endometrioid adenocarcinoma.But there is no report on the expression of CD146 in PR negative endometrioid adenocarcinoma.The immunohistochemistry results of postoperative specimens can guide the diagnosis and treatment of tumors,but the multiple immunohistochemical research in Formalin fixed paraffin embedded tissue is restricted,while in the traditional double immunofluorescence staining,organic dyes must be excitated at different wavelengths,and then overlays the images by image processing software,at last get the final images of double immunofluorescence staining.quantum dots(quantum dots,QDs)aroused extensive attention again which attracted scientists' attention early in 1970 s with its unique optoelectronic properties,initially was applied in immunofluorescence,and achieved satisfactory results.Because of its narrow and balanced emission band,not affected by the excitation spectrum,we can excite all colors QDs simultaneously by using a single excitation source,making it possible to make variety of markers for subcellular molecules.People began to pay attention to The application of QDs double-tagging immunofluorescence in medical detection.Based on the above situation,we intended to collect the clinical specimens of endometrioid adenocarcinoma in the First Affiliated Hospital of Yangtze University.and test the co-expression of PR and CD146 in endometrioid adenocarcinoma by QDs double-tagging immunofluorescence,and explore the clinical significance of CD146 in PR negative endometrioid adenocarcinoma.Methods Selected 140 cases of paraffin specimens of endometrioid adenocarcinoma that was removed by surgery between June 2009 to June 2015 in the First Affiliated Hospital of Yangtze University and were diagnosed by two pathology Professors independently.None of the patients had received preoperative chemotherapy,radiotherapy or hormone therapy in this investigation.Patients' age ranged from 29 to 70(48.1 + 7.5).then tested the co-expression of PR and CD146 in 140 endometrioid adenocarcinoma by QDs double-tagging immunofluorescence,and statistical analysis on experimental and clinical data was conducted using SPSS 17.0 software.Results 1)Correlation of CD146 expression with clinicopathological parameters in PR positive endometrioid adenocarcinoma CD146 had different expressions in different groups among 78 PR positive endometrioid adenocarcinoma patients,CD146 expression in PR positive endometrioid adenocarcinoma had no correlation with histological grade,FIGO staging and lymphatic metastasis(p > 0.05).2)Correlation of CD146 expression with clinicopathological parameters in PR negative endometrioid adenocarcinoma CD146 had different expressions in different groups among 62 PR negative endometrioid adenocarcinoma patients.CD146 expression in endometrioid adenocarcinoma was associated with histological grade and FIGO staging(p < 0.05)which showed a positive correlation,but had no correlation with lymphatic metastasis.3)Correlation of co-expression of PR and CD146 with clinicopathological parameters in endometrioid adenocarcinoma PR and CD146 expression were different in different groups among all 140 endometrioid adenocarcinoma patients,and PR and CD146 expression in endometrioid adenocarcinoma was associated with histological grade,FIGO staging and lymphatic metastasis(p < 0.05)which showed a positive correlation.4)Correlation of CD146 and PR expression in endometrioid adenocarcinoma 78 PR positive cases,62 PR negative cases,77 CD146 positive cases and 63 CD146 negative cases were found among all 140 cases.And 40 CD146 positive cases were found in 78 PR positive cases,the CD146 express rate was 51.28% among PR positive endometrioid adenocarcinoma;37 CD146 positive cases were found in 62 PR negative cases,the CD146 positive express rate was 59.68% among PR negative endometrioid adenocarcinoma patients;CD146 expression in endometrioid adenocarcinoma samples showed no correlation with PR expression(P > 0.05).5)In addition,CD146 may express at variable levels,but the CD146 positive expression showed no significant correlation with the women's age.the percentage of CD146 positive patients is 68.8% and 53.2% before and after 38 years.Furthermore,the percentage of CD146 positive patients is 56.8% and 52.5% before and after 48 years,thus the percentage of CD146 positive patients is higher in younger patients Importantly,More over,66.7 % of stage I PR negative patients in the pre-ovarian age groups are also CD146 positive.Conclusion 1)PR positive and PR negative endometrioid adenocarcinoma may be two different subtypes of endometrioid adenocarcinoma,them may have different mechanisms,CD146 may be involved in the occurrence and development of PR negative endometrioid adenocarcinoma;2)PR and CD146 co-expression may be a prognostic indicator in patients with endometrial adenocarcinoma;3)CD146 can potentially be used as a new therapy target for treatment of early stage PR negative,younger EA patients who want to preserve fertility. |
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