Expression And Significance Of Mismatch Repair Protein And Kras Protein In Endometrioid Adenocarcinoma

Objective:Detect the expression of mismatch repair proteins and Kras in Endometrial hyperplasia without atypical,Endometrial hyperplasia with atypical and Endometrioid adenocarcinoma.Contrast and analysis the significance of MSI and Kras in endometrial lesions,discover the relationship between them.To explore the possible mechanism of their role in the occurrence and development of endometrial lesions,and to provide a new idea for the diagnosis of endometrial lesions.Methods:A total of 108 cases of endometrial were performed from January 2014 to October 2017 in Zhangzhou Cancer Hospital.Endometrial hyperplasia was not associated with atypical 30 cases,hyperplasia with atypical 30 cases,and Endometrioid adenocarcinoma 48 cases.All tissues were examined for the expression of four mismatch repair proteins(MLH1,MSH2,PMS2,MSH6)and Kras using an automated immunohistochemical instrument.Analyzed and discussed the results of immunohistochemistry combined with the clinical data of all patients.Results:(1)The rate of loss of expression of endometrioid adenocarcinoma mismatch repair protein was 29.2% for MLH1,23% for MSH2,10.4% for MSH6,and 41.7%for PMS2,which was significantly higher than that for endometrial hyperplasia with atypical group MLH1 6.7% and MSH2 10%.,MSH6 10%,PMS2 16.7% and hyperplasia without atypical group MLH1 0%,MSH2 3.3%,MSH6 3.3%,PMS23.3%.Among the mismatch repair proteins MLH1,MSH2 and PMS2,there was a statistically significant difference in the rate of loss of expression among the three groups(P<0.05).The rate of loss of expression of MSH6 was not statistically significant among the three groups,P=0.189.(2)Endometrial hyperplasia without atypical MSI-H 0%,MSI-L 6.7%,and MSS 93.3%.Endometrial hyperplasia with atypical MSI-H 6.7%,MSI-L 26.7%,and MSS 66.6%.endometrioid adenocarcinoma MSI-H 25%,MSI-L 35.4% and MSS39.5%.Studies showed that the three phenotypes of microsatellite instability were statistically significant in endometrial hyperplasia without atypical,hyperplasia with atypical and endometrioid adenocarcinoma,P<0.05.(3)The MSI phenotype in the endometrioid adenocarcinoma group was not statistically different between different ages and different degrees of tumor differentiation,P>0.05.(4)The expression rates of Kras protein in endometrial hyperplasia without atypical hyperplasia with atypical and endometrioid adenocarcinoma were 3.3%,50%,and 97.9%,respectively,and the expression of the three groups showed an increasing trend.There was a statistically significant difference between groups,P<0.05.(5)All cases with MSI were associated with Kras protein expression,but the number of cases with both MSI and Kras expression was not statistically different among the three groups,P>0.05.Conclusion:(1)The rate of loss of expression of mismatch repair proteins(MLH1,MSH2,MSH6 and PMS2)showed an increasing trend in endometrial hyperplasia,endometrial hyperplasia with atypical and endometrioid adenocarcinoma,suggesting that microsatellite instability may be uterine Important molecular events in progression of endometrioid adenocarcinoma.(2)The expression of Kras protein in endometrial hyperplasia,endometrial hyperplasia with atypical and endometrioid adenocarcinoma showed an increasing trend,indicating that the expression of Kras protein plays an important role in the occurrence of endometrioid adenocarcinoma.(3)The MSI phenotype in endometrial hyperplasia was significantly correlated with the high expression of Kras protein.The number of cases with MSI and accompanied by Kras expression showed an increasing trend in endometrial hyperplasia,endometrial hyperplasia with atypical and endometrioid adenocarcinoma,suggesting the combined detection of mismatch repair protein deletion and Kras protein expression May help diagnose endometrial lesions.