| Endometrial adenocarcinoma is the commonest malignancy of the female genital tract.lt was often occured the women who were in menopause and postmenopause above the fifty, which was one of the three familiar malignancy of the female genital tract. In these years, the incidence of disease has been raising up in worldwide owing to the increase of fat people and application of hormone replacement therapy. In spite of significant advances in surgery and the use of new,more effective chemotherapeutic regimens,that late stage endometrial adenocarcinoma is hard to cure forces us to explore new ways. For these days, the study about angiogenesis in disease is quite fast, especially the effect on the growth .progression and transmition of tumors is interested in the people, angiogenesis has been an expected cure target from the prognosis index before.With the lucubration of the carcinogenesis, it was gradually realized that angiogenesis had a close correlation to carcinoma. The growth and progression of tumors is dependent on the process of angiogenesis,which provides oxygen and nutrient and cleans metabolite for the tumors. Endometrial adenocarcinoma has the characteristic of angiogenesis with the mass tumors. A significant difference was observed between the high microvessel density and the low groups, and the quantity of microvessel has the relationship with the recrudescence and livability, there was a of in the same The adenocarcinoma endometrial patients who were dead and nonrecrudescence after operation had a significant difference of microvessel density with the same stage and grade. In the cells of primary maligmant tumors,a lot of positive and negative regulators evoke and regulate the formation of new blood vessel ,and tumor microvessles net.The "angiogenic switch" is verynecessary for the growth rate of tumors. Vascular endothelial growth factor (VEGF) can enhance the permeability of venule and venous. It can also accelerate the division and proliferation of endothelial cells, which will make calcium aggregation in cytoplasm ,induce new blood vessel formation and growth, invasion and metastasis of tumors. Endostatin was first isolated from the supernatant of an in vitro culture of a murine hemangioendothelioma cell line (EOMA cells) by O' Reilly et al. Endostatin can inhibit the growth of endothelial cells in vitro,and systemic administration has been shown to inhibit the growth of established tumors and metastasis in vivo. In this study, the expression of endostatin ,VEGF and microvessel density have been examined by immunohistochemistry, and the correlations among them and their cliniclpathological parameters with adenocarcinoma endometrial have been analysed, and discuss the possibly effect and the potential clinical application value of them in the pathogenesis of adenocarcinoma endometrial.Materials and MethodsThe samples were retrieved from the files of paraffin blocks from operations and live from the First Affiliated Hospital of Zhengzhou University between 1998-2003. All specimens were fixed in buffered-formalin and embedded in paraffin for routine pathological examination. And the adenocarcinoma endometrial that clinical data whole were 46 cases. All the samples hadn't received radiotherapy .chemotherapy or other treatment. The patients age were among 26-75, and the middle age is 54. According to the stages of operation-pathology standard of FIGO in 1989, 21 were stage I ,17 were stage II ,8 were stage III -IV. Histologically, 24 were high differentiation adenocarcinoma endometrial, 18 were middle differentiation, 4 were low differentiation; 34 endometrial hyperplasia were divided into three types by ISGP in 1988, 10 were simple hyperplasia, 17 were complex hyperplasia, 7 were atypical hyperplasia. 12 were normal endometrium samples.Immunohistochemistry staining were used to detect the expression of endostatin , VEGF and microvessel density in 12 normal endometrium , 34 endometrial hyperplasia and 46 adenocarcinoma endometrial,the correlations among them and their cliniclpathological parameters with adenocarcinoma endometrial have been analysed.Statistical analysisStatistical analysis was performed by the SPSS 11.0 software package , Differences among groups were analyzed by using analysis of the Chi-squared test and rank sum test , enumeration data was analyzed by using analysis of t-test , one-way ANOVA or nonparametriz test , All of the P values resulted form two-sided statical test . Statisticallysignificant level was considered as "alpha equals 0.05"( a =0.05). Results1. The levels of endostatin protein expression in adenocarcinoma endometrial showed a significant difference with endometrial hyperplasia and normal endometrium (P<0.001, P<0.001). However it was not a significant difference between normal endometrium and endometrial hyperplasia (P=0.630)., 2. The levels of VEGF protein expression in adenocarcinoma endometrial showed a significant difference with endometrial hyperplasia and normal endometrium (P<0.001, P<0.001).And it was not a significant difference between normal endometrium and endometrial hyperplasia (P=0.367).3. The levels of MVD showed a significant difference between endometrial adenocarcinoma and normal endometrium, endometrial adenocarcinoma and endometrial hyperplasial ,respectively(P<0.001, P<0.001).4. There were closed relationship between the expression of endostatin, VEGF and clinical stage (P<0.05) , but no relationship between the expression of endostatin, VEGF and histological grades, lymph node metastasis and myometrial invasion was found (P>0.05).5. MVD was significantly associated with clinical stage, histological grades, lymph node metastasis and myometrial invasion(P<0.001, P<0.001, P=0.001,P=0.009).6. The expression of endostatin was association with VEGF and MVD (rs=0.708, P<0.001; rs=0.335, P=0.007) , and an association was observed between the VEGF and MVD.Conclusions1. The expression of endostatin protein in endometrial adenocarcinoma was obviously higher than those in normal endometrium and endometrial hyperplasia, indicating that the variation of endostatin content may has a relationship with the development of endometrial adenocarcinoma and prognosis of the patients.2. The expression of VEGF protein in endometrial adenocarcinoma was higher than those in normal endometrium and endometrial hyperplasia, indicating that the variation of VEGF content may has a relationship with the development of endometrial adenocarcinoma and prognosis of the patients.3. The expression of MVD in normal endometrium and endometrial hyperplasia was lower in the endometrial adenocarcinoma, indicating that the angiogenesis has a relationship with thedevelopment of endometrial adenocarcinoma.4. The strongly expression of endostatin, VEGF and MVD in endometrial adenocarcinoma showed that angiogenesis was closed related to oncogenesis and progression of endometrial adenocarcinoma, and endostatin, VEGF may be play important roles in it. |
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