| BackgroundEndometrial cancer is a malignant tumor which occurs in the endometrium.It is one of the most common tumors in the female reproductive system,and it is the third most co-mmon gynecologic malignant tumor.With the development of society and the improve-ment of economic conditions,the incidence of endometrial cancer is increaseing year by year,and it is rising in the range of our country.Human OLFM4(olfacto-medin4)is also known as anti apoptotic molecule GW112,is a member of the olfactory mediated protein family that contains the"domain olfactomedin"domain,and play an important role in maintaining the stability of a variety of biological functions of cells,including neural crest formation,cell adhesion,cell cycle regulation,apoptosis,and so on.In many tumor tissues,it has been found overexpressed,such as lung cancer,breast cancer,prostate cancer,gastric ca-ncer,pancreatic cancer,colon cancer,and so on,and it is necessary to study the development of endometrial adenocarcinoma and the relationship between OLFM4 protein expression and the development of endometrial adenocarcinoma.ER and PR are the material basis of the female reproductive organ receiving sex hormone regulation,and the content and of the two receptors in different tissues varied with the level of estrogen and progesterone.The incidence of endometrial adenocarcinoma is associated with high estrogen stimulated en-dometrial hyperplasia,and lack of progesterone antagonism.Objective1.This study was in order to investigate the relationship and clinical significance of estrogen receptor(ER),progesterone receptor(PR)and OLFM4 expression with biological behavior in endometrial adenocarcinoma.2.This study was also in order to clear and definite the correlation between OLFM4and endometrial carcinoma as the pathologic stage,histological differrentiation degree,depth of muscular invasion,and lymph node metastasis.3.And this study will also investigate whether OLFM4 is involved in the occurrence,development and expression of estrogen and progesterone in endometrial adenocarcinoma and its correlation with the regulation of estrogen and progesterone.It has important clini-cal reference value for the gene therapy of endometrial adenocarcinoma,judging the prog-nosis and understanding the biological behavior of malignant tumor.Research methodsThe application of digital access system access to all cases in Tai'an Central Hospital case,continuously collect cases of department of gynaecology ward,and all patients were the first time in hospital surgical treatment,and after the operation of the pathological diag-nosis of endometrial adenocarcinoma,date from January1,2010 to July1,2015 in Tai'an Central Hospital.34 cases of the selected criteria were screened for the study,and postope-rative pathological diagnosis of patients were recorded in detail,including the histological grade of tumor,infiltration of the muscle layer,operation and pathological stage,lymph node metastasis.The expression of ER,PR and OLFM4 in endometrial carcinoma was detected by immunohistochemical staining and immunohistochemical staining,then analyze the relationship and clinical significance between the expression and the histological grade,surgical pathologic stage,depth of invasion and lymph node metastasis.Immunohistoche-mical staining was used to detect the expression of OLFM4,ER and PR in 21 cases of normal endometrium,22 cases of simple hyperplasia and atypical hyperplasia of endometri-um.We used Excel Micro-soft 2007 to establish a database,SPSS 17 for statistical ana-lysis,and x~2test of OLF M4 protein,ER,PR and the relationship between different clinical pathological charac teristics,and the relationship between the expression of the three.Result1.In 21 cases of normal endometrial tissue,22 cases of endometrial simple and atypical hyperplasia tissue,34 cases of endometrial adenocarcinoma,the positive expression rates of OLFM4 protein were 19.0%(4/21),36.4%(8/22)and 52.9%(18/34),and the positive expression rates of ER protein were95.2%(20/21),68.2%(15/22)and 50.0%(17/34),the positive expression rates of PR protein were 95.2%(20/21),63.6%(14/22)and47.1%(16/34).The positive expression rate of OLFM4 protein was increaseed by normal endometrial tissue,atypical hyperplasia tissue and endometrial carcinoma.The positive expression rate of PR and ER protein showed a dereasing trend.The positive expression rate of OLFM4protein in simple and atypical hyperplasia endometrium tissue was higher than that in normal endometrial tissue,and there were differences between the two groups,but not stati-stically significant(P>0.05).The positive expression rate of OLFM4 protein in endometrial cancer group was higher than that in the normal endometrium group,and the difference had a statistically signifycant between the two groups(P<0.05).The positive expression rate of OLFM4 protein in simple and atypical hyperplasia endometrium tissue was higher than that in normal endometrium,but there was no significant difference between the two groups(P>0.05).The expression level of OLFM4 protein was significantly differrent between the three groups,with statistical significance(P<0.05).There were differrences between the abo-ve comparison but no statistical significance,which may be related to the small sample size.The positive expression rate of PR protein in simple and atypical hyperplasia endome-trium tissue was lower than that in normal endometrium,the difference was statistically significant between the two groups(P<0.05).The positive expression rate of PR protein in endometrial cancer group was lower than that in simple and atypical hyperplasia group,but there was no significant difference between the two groups(P>0.05).The positive expre-ssion rate of PR protein in endometrial adenocarcinoma was lower than that in normal endometrial tissue,the differrence was statistically signifycant between the two groups(P<0.05).The positive expression rates of PR protein in the three groups were statistically signifycant(P<0.05).The positive expression rate of ER protein in simple and atypical hyperplasia endometrium tissue was lower than that in normal endometrium,and the differ-ence was statistically significant between the two groups(P<0.05).The positive expression rate of ER protein in endometrial carcinoma group was lower than that in simple and atypical hyperplasia group,but there was no significant difference between the two groups(P>0.05).The positive expression rate of ER protein in endometrial adenocarcinoma was lower than that in normal endometrial tissue,and the difference was statistically significant between the two groups(P<0.05).The positive expression rates of ER protein in the three groups were statistically significant(P<0.05).2.The positive expression rate of OLFM4 protein in 34 cases of endometrial adenoca-rcinoma was related to the degree of invasion,lymph node metastasis,and not related to the pathologic stage of endometrial carcinoma and degree of tissue differentiation.In 18 cases of I stage and 16 cases of II~III stage endometrial cancer,the positive expression rates of OLFM4 protein were55.6%(10/18)and 50.0%(8/16),and there was no significant difference between the two groups(P>0.05).According to the histologycal differentiation of endome-trial carcinoma,the differentiation degree of endometrial carcinoma was divided into high differentiation group,middle differentiation group and low differentiation group,and the positive expression rates of OLFM4 protein in the three groups were56.3%(9/16),50.0%(5/10)and 50.0%(4/8),and there was no significant difference between the two groups(P>0.05).According to the depth of muscular invasion,endometrial carcinoma was divided into<1/2muscular layer group and?1/2 muscular layer group,and the positive expression rates of OLFM4 protein in the two groups were 70.6%(12/17)and 35.3%(6/17),and the difference was statistically significant between the two groups(P<0.05).In the patients with endometrial adenocarcinoma,it was divided into the group with lymph node metastasis and without lymph node metastasis,the positive expression rates of OLFM4 protein were16.7%(1/6)and 60.7%(17/28),and the difference was statistically significant between the two groups(P<0.05).3.In 34 cases of endometrial adenocarcinoma,the positive expression rate of PR prot-ein was related to clinical stage,histological differentiation and lymph node metastasis,and was not related to the degree of invasion.In 18 cases of I stage and 16 cases of II~III stage endometrial cancer,the positive expression rates of PR protein were 66.7%(12/18)and25.0%(4/16),and the difference was statistically significant between the two groups(P<0.05).In the patients with endometrial adenocarcinoma,within lymph node metastasis group and without lymph node metastasis group,the positive expression rates of PR protein were16.7%(1/6)and53.6%(15/28),and the differrence was statistically significant between the two groups(P<0.05).According to the histological differentiation of endometrial carci-noma,the differentiation degree of endometrial carcinoma was divided into high differen-tiation group,middle differentiation group and low differentiation group,and the positive expression rates of PR protein in the three groups were68.8%(11/16)),30.0%(3/10)and25.0%(2/8),and the difference was statistically significant between the two groups(P<0.05).According to the depth of muscular invasion,endometrial carcinoma was divided into<1/2muscular layer group and?1/2 muscular layer group,and the positive expression rates of PR protein in the two groups were 58.8%(10/17)and 35.3%(6/17),and there was no statistically significant between the two groups(P>0.05).4.In 18 cases of I stage and 16 cases of II~III stage endometrial cancer,the positive expression rates of ER protein were 66.7%(12/18)and31.25%(5/16),and the differrence was statistically significant between the two groups(P<0.05).In the patients with endome-trial adenocarcinoma,within lymph node metastasis group and without lymph node metastasis group,the positive expression rates of ER protein were 33.3%(2/6 and 53.6%(15/28),and there was no statistically significant between the two groups(P>0.05).Ac-cording to the histological differentiation of endometrial carcinoma,the differentiation degree of endometrial carcinoma was divided into high differrentiation group,middle diff-erentiation group and low differentiation group,and the positive expression rates of ER protein in the three groups were75.0%(12/16),40.0%(4/10)and 12.5%(1/8),and the differ-ence was statistically significant between the two groups(P<0.05).According to the depth of muscular invasion,endometrial carcinoma was divided into<1/2muscular layer group and?1/2 muscular layer group,and the positive expression rates of ER protein in the two groups were 76.5%(13/17)and 23.5%(4/17),and the difference was statistically signi-ficant between the two groups(P<0.05).5.The results of this study showed that the positive expression of OLFM4 protein in endometrial adenocarcinoma was positively correlated with the positive expression of ER protein(r=0.302,P<0.001),the positive expression of PR protein was positively correlated,too(r=0.314,P<0.001).The positive expression of ER protein was positively correlated with the positive expression of PR protein in endometrial adenocarcinoma(r=0.895,P<0.001).Conlusion1.OLFM4 protein was lower expressed in normal endometrial tissue,higher expressed in simple hyperplasia and atypical hyperplasia of endometrium andendometrial adeno-carcinoma.And in endometrial adenocarcinoma,the expression of OLFM4,correlates close-ly with the depth of the muscle invasion and wether there is lymph node metastasis,and didn't have link with the degree of histological differentiation,surgical pathological stage.2.ER protein was higher expressed in normal endometrial tissue,lower expressed in simple hyperplasia and atypical hyperplasia of endometrium and endometrial adenocar-cinoma.And in endometrial adenocarcinoma,the expression of ER,correlates closely with the depth of the muscle invasion,the degree of histological differentiation,surgical patho-logical stage,and didn't have link with lymph node metastasis.3.PR protein was higher expressed in normal endometrial tissue,lower expressed in simple hyperplasia and atypical hyperplasia of endometrium and endometrial adenocar-cinoma.And in endometrial adenocarcinoma,the expression of PR,correlates closely with the degree of histological differentiation,surgical pathological stage and lymph node meta-stasis,but didn't have link with the depth of the muscle invasion.4.The positive expression of OLFM4 and ER in endometrial adenocarcinoma was positively correlated.5.The positive expression of OLFM4 and PR in endometrial adenocarcinoma was positively correlated.6.The positive expression of ER and PR in endometrial adenocarcinoma was po-sitively correlated.7.The expression of OLFM4 and ER,PR in endometrial adenocarcinoma tissue,has important clinical reference value in the genetic treatment of endometrial adenocarcinoma,the prognosis and the biological behavior of malignant tumor.SignificanceAt present,new tumor markers and therapeutic targets have become the focus of attention of researchers and clinicians in the research of endometrial cancer.Through this study,we can provide valuable molecular biological indicators for diagnosis,staging and prognosis of endometrial cancer. |
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