The Expression And Significance Of S100A4 In Endometrial Adenocarcinoma And Its Lymph Nodes

Objective:This article aims to understand the expression of S100A4 protein in endometrial adenocarcinoma and its lymph nodes,analyze the relationship between the positive expression of S100A4 protein and clinical pathological features,and the effect of S100A4 positive expression on the postoperative disease-free survival time of tumor patients.The aim of this article is to explore the relationship of S100A4 Expression and prognosis of endometrial adenocarcinoma.Methods:A total of 48 patients with endometrial carcinoma who underwent surgical treatment in The First Affiliated Hospital of Shanxi Medical University from January 2013 to December 2015 and who can obtain complete pathological data and follow-up data were selected.No drug therapy and radiotherapy and chemotherapy were performed before surgery.No history of tumors in other parts,no history of retroperitoneal surgery,strict surgical staging and histological grade according to the International Association of Obstetrics and Gynecology(FIGO 2009)criteria,including 32 patients with stage I,11patients with stage II,and 5 patients with stage IIIC,All patients underwent radical surgery for endometrial carcinoma.A total of 406 tissue paraffin specimens and paraffin-embedded lymph node tissues were collected.Among them,215,123,and 68lymph nodes were obtained in patients with stage I,II,and IIIC,and sixteen metastatic lymph nodes were included in 68 lymph nodes in stage IIIC.A total of 10 patients with concomitant uterine fibroids or hysteropexy hysterectomy were selected as a control group.Postoperative pathology confirmed that the endometrium was normal endometrium.A lymph node biopsy was performed in patients with lymph node enlargement in the same period as a lymph node control.A total of 20 cervical lymph nodes were collected.Pathological examination confirmed inflammatory lesions.The expression of S100A4 protein in endometrial carcinoma and its lymph nodes was studied using immunohistochemistry(IHC)method.The postoperative follow-up and telephone follow-up were used for all postoperative patients to obtain the prognosis.The time of surgery was taken as the starting time,and the time of relapse was used as the termination time.Follow-up was until December 2017.All data were analyzed using statistical SPSS23.0 software.The correlation between S100A4 expression and clinicopathological parameters was analyzed by Chi-square test and Fisher's exact test.The relationship between the positive expression of S100A4 protein and the postoperative disease-free survival time was calculated by using the Kaplan-Meier method to draw the survival curve.The difference between the survival curves was determined by the log-rank test.The size of test was?=0.05.Results:1.Expression of S100A4 in endometrial carcinoma:S100A4 was not expressed in the normal endometrium of the control group,while the positive rate of the endometrial adenocarcinoma in the experimental group was as high as 89.6%(43/48).The positive expression rates of patients in stage II,stage III,and stage IIIC were 84.4%(27/32),100%(11/11),and 100%(5/5),respectively,with no statistically significant difference(?~2=1.747,P=0.45).2.The relationship between the expression of S100A4 in the lymph node of patients with endometrial adenocarcinoma and the pathological stagingThe expression of S100 A4 protein in pelvic lymph node of endometrial carcinoma differed according to the surgical pathological stage.The positive expression rate of S100A4 in endometrial carcinoma lymph nodes at different stages was 8.8%(19/215)in phase I and 13.8%(17/123)in phase II,23.1%(12/52)of patients in stage IIIC without metastasis,and 93.8%(15/16)in stage IIIC with metastasis were significant(?~2=58.60,P<0.001).Among the patients in stage IIIC with lymph node metastasis,the positive rate of S100A4 protein expression was statistically significant compared with patients in non-metastasis group(?~2=25.53,P<0.001).3.Correlation of S100A4 protein expression with clinical pathological factors in lymph node tissues of endometrial carcinomaIn the lymph node tissues of patients with endometrial cancer,the expression of S100A4 was not related to the patient's age,BMI,whether or not with hypertension,diabetes mellitus,and lymphocytic infiltration,(P>0.05),and histologic grade(P=0.013),surgical pathological stage(P=0.033),depth of tumor muscular infiltration(P=0.004),and whether lymph node metastasis(P=0.047)were significantly related.Compared with patients whose S100A4 negative expression,S100A4-positive endometrial cancer patients with higher histological grade,later surgical pathological stage,are more prone to deep muscular infiltration,more likely to be associated with lymph node metastasis.4.The relationship between the expression of S100A4 in lymph node tissues of endometrial carcinoma and the postoperative disease-free survival timeThe 1-,2-,and 3-year survival rates of the S100A4 protein positive expression group were 88.23%,76.47%,and 58.82%,respectively,while the S100A4 protein negative expression group was 93.54%,90.32%,and 83.82%,respectively.Survival curve analysis showed that the overall disease-free survival rate was different between the two groups.The disease-free survival rate of the S100A4-negative group was significantly higher than that of the S100A4-positive group(?~2=4.68,P=0.03),and the median disease-free survival time estimated in the S100A4-positive group was 33months.Conclusion:1.S100A4 protein can be partially expressed in conventional non-metastatic lymph nodes(HE-negative lymph nodes),and patients with positive S100A4 protein expression have a shorter postoperative disease-free survival time,suggesting that S100A4 may be associated with micrometastasis of endometrial cancer,and may be an important predictor of prognosis in patients with endometrial cancer.2.The expression of S100A4 in endometrial cancer tissues was not related to the surgical pathological stage,suggesting that S100A4 protein has little relationship with the occurrence and development of endometrial cancer.3.The expression of S100A4 in Endometrial adenocarcinoma lymph nodes was correlated with histological grade,surgical pathological stage,myometrial invasion depth and lymph node metastasis.The positive expression of S100A4 protein suggested that there may be micrometastasis.Indicating that patients with higher histological grade,later surgery stage of the disease,deeper muscle infiltration are more likely to have lymph node micrometastasis.