Expression And Clinical Significance Of HER2,p53,ERCC1 And Other Molecular Indexes In Endometrial Carcinoma

Objective:In China,endometrial carcinoma is the second major malignant tumor of the female fertility system.Its morbidity is now progressively increasing,and its age of occurrence is getting more and more youthful.In addition,with the improvement of molecular assay technology in recent years,western immunohistochemical indicators are more and more widely used to instruct the adjuvant treatment after surgery and evaluate the patient’s prognosis.In this study,five tumor-related molecular indicators(ER,PR,p53,Ki67,HER2)and three drug resistance-related molecular indicators(ERCC1,P-gp,GST-π)were chosen to explore their association with the progression of endometrial carcinoma and patient outcomes,with the purpose of identifying risk factors related to high-risk endometrial carcinoma and suggesting a better evaluation scheme for the management and prognosis of EC patients.Method:In this article,endometrial carcinoma patients who were admitted to Northern Jiangsu People’s Hospital from June 2014 to June 2022 were accepted as the study participants,and 291 cases matching the criteria were obtained and their general data and the clinicopathological features were analyzed in a retrospective manner,and the patients who underwent surgery from June 2014 to December 2019 were tracked.In this research,the Spearman correlation was used to make a comparison between the molecular indicators and the corporative clinicopathological characteristics of EC and to analyse the correlation amongst HER2,p53 and ERCC1;next,logistic multi-factor assessment was used to specify the unfavourable factors that influence lymph node migration;and finally,Kaplan-Meier profiles were mapped and LogRank examination was performed.The Cox ratio hazard regression method was used to probe into the risk elements of influencing PFS and OS in EC patients.Result:1.The association of clinical pathology with molecular parameters:the concentration of ER and PR was found to be negatively related to the pathologic typing,hierarchical histology,FIGO grade,penetration depth and infiltration of the vasculature(P<0.05),whereas the concentrations of HER2 and p53 were shown to be positively linked to the above-mentioned symptoms(P<0.05),and the levels of Ki67 were shown to be positively related to the hierarchical histology,FIGO grade,penetration depth and infiltration of the vasculature(P<0.05).Furthermore,the low expression of PR and high expression of Ki67 and HER2 were most likely to be found in post-menopausal women(P<0.05),and the high expression of Ki67,p53 and HER2 was observed to be linked to lymph node invasion(P<0.05).What’s more,the concentration of ERCC1 was found to be negatively correlated with the FIGO grade of the tumor(P<0.05),and the high concentration of GST-π was seen to be linked to type II endometrial carcinoma(P<0.05),whereas the expression level of P-gp was not significantly different in the clinicopathological features(P>0.05).2.The associations among HER2,p53 and ERCC1:p53 was shown to be actively linked to HER2 expression(P=0.001,Rs=0.195)and p53 was shown to be meaningfully linked to ERCC1 expression(P<0.001,Rs=0.253),but there was no significant correlation between HER2 and ERCC1(P=0.238,Rs=0.076).3,Hazard parameters for endometrial carcinoma with lymph node migration:the histological grading,pathological typing,tumor stage,invasion depth of the muscular layer,vascular invasion and expression levels of HER2,Ki67 and p53 were all unfavourable factors for lymph node migration in EC(P<0.05),with high expression of HER2 and p53 and late tumor stage being independent risk factors for lymph node migration in EC.4.Analysis of prognosis of endometrial carcinoma:advanced tumor FIGO stage and high expression of HER2 were both unfavourable independent risk elements for PFS and OS,and that low expression of ER was also a negative factor for PFS.Conclusion:1.The expression status of ER and PR was found to be negatively correlated with histologic grading,FIGO stage,depth of myofibrotic infiltration and choroidal invasion,while the expression levels of p53,HER2 and Ki67 were shown to be positively correlated with histologic grading,FIGO stage,depth of myofibrotic infiltration,choroidal invasion and lymph node migration.The downward regulation of ER and PR and the upregulation of p53 and HER2 were all associated with endometrial cancer type Ⅱ.In addition,the expression level of ERCC1 was negatively linked to the FIGO stage of the tumour,high expression of GST-π was associated with type Ⅱ endometrial cancer,and the expression of P-gp was not apparently related to the pathological features of endometrial carcinoma.2.There is a clear positive correlation of p53 and HER2,and of p53 and ERCC1,focusing on patients with HER2 overexpression in mutant p53 and combining the expression status of p53 and ERCC1 may gain more clinical value.3.Up-regulation of HER2 and p53 in expression levels and advanced tumor FIGO stage were shown to be risk elements for the onset of lymph node metastasis in endometrial cancer.4.Upregulation of HER2 expression level and advanced tumor stage are independent hazard factors for adverse PFS and OS,in addition,ER downregulation is also a risk element for PFS.