The Expression And Clinical Nursing Significance Of Mismatch Repair Protein In Endometrial Carcinoma

Objective1.To describe the expression of MMR protein in endometrial carcinoma.2.To analyze the differences of MMR protein proficiency and deficiency in the metabolic indexes of endometrial carcinoma,compare the differences of MMR protein proficiency and deficiency in the metabolic indexes of endometrial carcinoma at different ages,and provide a basis for nurses to implement targeted dietary guidance.3.To analyze the clinicopathological characteristic of endometrial carcinoma between MMR protein proficiency and deficiency,and to provide a basis for prognosis and follow-up visit for nurses.Methods1.110 patients with endometrial carcinoma for surgery in Changzhou First People's Hospital and Changzhou Maternal and Child Health Care Hospital from January 2016 to December 2018 were included in the study.2.Immunohistochemistry was used to detect the expression of MMR protein in the paraffin block specimens of 110 patients with endometrial carcinoma.3.Compared with patients of different ages,the differences of MMR protein proficiency and deficiency in metabolic indexes,including blood pressure(SBP,DBP),glucose metabolism(FBG),lipid metabolism(TC,TG,HDL,LDL),protein metabolism(TP,ALB,PA),and liver function indexes(ALT,AST,GGT).4.To compare the clinicopathological characteristics of MMR protein expression deficiency and deficiency,including pathological type,lymphatic metastasis,histological differentiation,pathological stage,and infiltration depth.Results1.A total of 110 patients with endometrial carcinoma were included,and 3 patients were not shown test results due to insufficient specimens.Among the 107 patients of endometrial carcinoma,MMR protein proficient in 84 patients(78.50%),one or more subtypes of MMR protein deficient in 23 patients(21.50%).In different subtypes of MMR protein deficient,the quantity of each deficient subtypes:MLHl and PMS2 co-expression deficient was deficient in 14 patients(60.87%),MSH2 and MSH6 co-expression deficient was deficient in 5 patients(21.74%),MSH6 deficient was deficient in 2 patients(8.70%),MLH1 deficient was deficient in 1 patient(4.35%),PMS2 deficient was deficient in 1 patient(4.35%).There was no statistical difference in the general index(age,BMI,menopause,malignant tumor family history)between MMR protein proficiency and deficiency(P>0.05).2.The expression of MMR protein in endometrial carcinoma in different age groups was different in metabolic index.In patients aged 56-60 with endometrial carcinoma,ALB in the MMR protein deficient group was lower than that in the proficient group(P<0.05).In patients aged 61-65 with endometrial carcinoma,PA in the deficient group was significantly lower than that in the proficient group(P<0.05).There was no significant difference in metabolic indexes at other ages(P>0.05).3.Differences in the clinicopathological characteristics of endometrial carcinoma with different MMR protein expression.Among the 23 cases with MMR protein deficient group,19 cases(82.61%)had no lymphatic metastasis,and 4 cases(17.39%)had lymphatic metastasis.Among the 84 cases with MMR protein proficient group,81 cases(96.43%)had no lymphatic metastasis,and 3 cases(3.57%)had lymphatic metastasis.The incidence of lymphatic metastasis of endometrial carcinoma in the deficient group was significantly higher than that in the proficient group(P<0.05).Among the 23 cases with MMR protein deficient group,the pathological type was the degree of tissue differentiation of endometrioid carcinoma(20 cases):4 cases of high grade G1 type(20.00%),13 cases of medium grade G2 type(65.00%),and 3 cases of low grade G3 type(15.00%).Among the 84 cases with MMR protein proficiency,the pathological type was endometrial carcinoma(75 cases),and the differentiation of G1,G2 and G3 was 45 cases(60.00%),20 cases(26.67%)and 10 cases(13.33%),respectively.G1 in the deficient group was significantly lower than that in the proficient group(P<0.01),and G2 was significantly higher than that in the proficient group(P<0.01).There was no significant difference in pathological type,pathological stage and infiltration depth between the deficient group and the proficient group(P>0.05).Pathological stage ? in deficient group was significantly lower than that in proficient group(P<0.05).Conclusions1.The deficient expression rate of MMR protein in endometrial carcinoma is 21.50%.Among the deficient subtypes of MMR protein,the quantity of MLH1 and PMS2 protein co-expression deficient is the majority.2.The expression of MMR protein is related to metabolism,with differences at different ages.In EC patients aged 56-60,ALB in the deficient group is lower.In EC patients aged 61-65,PA is lower in the deficient group.For endometrial carcinoma patients with MMR protein deficiency in 56-60 and 61-65 age groups,protein intake should be enhanced in diet management.3.MMR protein deficiency is more prone to lymphatic metastasis.The pathological grading of endometrial carcinoma and MMR protein deficiency are higher.Endometrial cancer patients with MMR protein deficiency should pay attention to lymphatic metastasis in follow-up.