Correlation Between Expression Of ER,PR,Ki-67,Vimentin And Prognosis In Endometrial Lesions

Objective:To detect the expression of ER,PR,Ki-67 and Vimentin in endometrial lesions,and to study the correlation analysis of prognosis.Methods:Selected from January 01,2008 to January 01,2014,hospitalized in the Department of Gynecology in the First Affiliated Hospital of Shihezi University Medical College,had primary surgery for surgical pathological staging,at the same time,the postoperative pathological type was 200 patients with type I endometrial adenocarcinoma,to analyze the patient's clinical data and follow-up medical records.At the same time,grouping is based on pathological diagnosis,follow-up was performed on 200 patients with type I endometrial adenocarcinoma,35 patients with endometrial atypical hyperplasia and 20 patients without atypical proliferative endometrium.In the first year after surgery,every 3 months were followed up,no abnormalities were followed up every six months,followed by annual follow-up.The end point of follow-up was January 1,2019,and patients who were followed up for 60 months completed the QOL score of the epidemiological survey.At the same time,the paraffin block of endometrial lesions in the selected case is retrieved,by measuring the expression of ER,PR,Ki-67,Vimentin in endometrial lesions,the measurement data is indicated by x~_±S,the count data were expressed as the ratio and composition ratio(%).The?2 test was used for comparison.The relationship between different immunohistochemical factors and different pathological features was analyzed by ANOVA and Logistic regression model,to further analyze the risk factors for quality of life affecting endometrial disease 5 years after surgery;the survival rate was calculated by Kaplan-Meier method and the survival curve was drawn,simultaneous comparison with log-rank test,multivariate analysis using Cox regression model,all are P<0.05 is statistically significant.To explore the prognostic relevance of ER,PR,Ki-67,Vimentin and endometrial lesions,and to guide the treatment options and prognosis management of patients with endometrial lesions under different pathological features and different expression of immunohistochemical factors.Result:1.Expression of ER,PR,Ki-67 and Vim in different types of endometrial lesions:The expression of PR in different types of pathological tissues was not statistically significant.The positive expression rate of ER in atypical hyperplastic endometrium and atypical proliferative endometrium was significantly higher than that in type I endometrial adenocarcinoma,but The positive expression rate of ER in atypical proliferative endometrium was higher than that in atypical proliferative endometrium;The positive expression of Ki-67and Vim in type I endometrial adenocarcinoma was significantly higher than that in non-typical proliferative endometrium and atypical proliferative endometrium,however,the positive expression rate of Ki-67 and Vim in the non-typical proliferative endometrium was higher than that in the non-typical proliferative endometrium.2.In type I endometrial adenocarcinoma,there is a relationship between different pathological features and immunohistochemical factors.ER positive expression rate has significant differences in FIGO stage,histological grade,etc;PR positive expression rate was significantly different in histological grade,myometrial invasion,lymph node metastasis,etc;The positive expression rate of Ki-67 and the positive expression rate of Vimentin were significantly different in each clinicopathological feature.3.ANOVA inferred:FIGO stage,histological grade,myometrial invasion,lymph node metastasis,PR expression,Ki-67 expression,Vim expression,menopausal status,and treatment methods are related to prognosis quality of life in patients with type I endometrial adenocarcinoma,and BMI,menopausal status,age,ER expression,PR expression,Ki-67 expression,Vim expression,etc.are also associated with the prognosis quality of life in patients with endometrial atypical hyperplasia.Log-rank test:menopausal status,FIGO stage,histological grade,depth of myometrial invasion,lymph node metastasis,Ki-67 expression,Vim expression,and treatment mode also affect 5-year overall survival and disease-free survival of type I endometrial adenocarcinoma,it was also found that ER expression,PR expression and Vim expression had significant differences in 5-year overall survival rate and disease-free survival rate(P<0.05),and Ki-67expression only had a significant difference in 5-year overall survival(P<0.05),but had no effect on 5-year disease-free survival.4.Multivariate analysis:Logistic regression model display:FIGO stage IV,histological grade G3,myometrial invasion depth?50%,Vim positive expression,PR negative expression are independent risk factors affecting postoperative quality of life in patients with type I endometrial adenocarcinoma.Cox regression analysis shows that FIGO stage and lymph node metastasis are independent risk factors for the5-year overall survival rate of type I endometrial adenocarcinoma,At the same time,FIGO staging is an independent risk factor for the 5-year disease-free survival rate of prognosis of type I endometrial adenocarcinoma.Conclusion:1.The positive expression of ER,Ki-67,and Vim is significantly different in the FIGO stage of type I endometrial adenocarcinoma,multivariate analysis showed that FIGO stage was an independent risk factor for the 5-year survival quality of type I endometrial adenocarcinoma.2.Determining the factors that influence the prognosis of patients with endometrial cancer,individualized treatment should be implemented to reduce the risk of recurrence and death.