Expression Of C-erbB-2 And TTF-1 In The Endometrial Carcinoma And Their Relationship With The Clinical Prognosis

Objective: To examine the expression of human epidermai growth factor receptor-2(C-erbB-2)and thyroid transcription factor-1(TTF-1)in normal endometriun,atypical hyperplasia and endometrial carcinoma,and to discuss the relation between the two factors and clinical pathological features(pathologocal type,pathological staging,histological grade,depth of invation,lymphatic metastasis)and prognosis.Methods: We randomly selected 80 patients diagnosed endometrial carcinoma from October 2010 to October 2012.They all had undergone the first surgery at the Affiliated Hospital of Qingdao University,and had not received any radiotherapy,chemotherapy or endocrine therapy.We selected 30 patients with atypical hyperplasia,30 patients with normal endometrium(18 patients with proliferative stage and 12 patients with progestational stage)who had undergone panhysterectomy because of benign lesions such as uterine fibroid or adenomyosis as control groups during the corresponding period.Then examine the expression of C-erbB-2 and TTF-1 in the three groups by immunohistochemistry and analyze the relationship between the five-year survival rate and expression of C-erbB-2 or TTF-1.Results:1.The positive expression rates of C-erbB-2 in EC,atypical hyperplasia and normal endometrium were separately 56.65%,36.67% and 16.67%(P < 0.05).The positive expression of C-erbB-2 was associated with pathological stage,histological grade,myometrial infiltration and lymphatic metastasis(P < 0.05),while not with pathological type(P>0.05).2.In EC,atypical hyperplasia and normal endometrium,the positive expression rates of TTF-1 were separately 33.75%,53.33% and 70.00%(P<0.05).The negative expression of TTF-1was correlated with pathological stage,histological grade,myometrial infiltration(P<0.05),while not with lymphatic metastasis and pathological type(P>0.05).3.In endometrial carcinoma,32 cases were expressed with C-erbB-2(+)but TTF-1(-),14 cases were expressed with C-erbB-2(-)but TTF-1(+).Both were expressed positively in13 cases,while both were in negative expression in 21 cases.The expression of C-erbB-2was not associated TTF-1 in endometrial carcinoma(P=0.303).4.The 5-year overall survival rate was lower in C-erbB-2 positive group than that in negative group(P<0.05).But the difference of 5-year overall survival rate between TTF-1positive and negative group was not statistically significant(P>0.05).Conclusions:1.With the later pathologiccal stage,the worse histological grade,the deeper invasion and the presence of lymph node metastasis,the positive expression of C-erbB-2 gradually increased.Suggesting that C-erbB-2 plays a positive regulatory role in the development of endometrial carcinoma.2.The expression of TTF-1 was down-regulated,while the tumor stage was later,the histological grade was worse and the invasion was deeper.It is suggested that the low expression of TTF-1 was involved in the occurrence and development of endometrial carcinoma,and the intensity of expression gradually weakened with the increase of malignant degree of the tumor.And TTF-1 plays a negative regulatory role in the development of endometrial carcinoma.3.While the positive espression of C-erbB-2 was higher,the five-year postoperative survival rates were lower,the prognosis was worse.It is suggested that the up-regulation of C-erbB-2 was associated with the poor prognosis of endometrial carcinoma.