| Objective: Endometrial carcinoma is one of the most common malignant tumor in female reproductive system. In recent years, we have witnessed an increasing tendency in the incidence and fatality rate of endometrial carcinoma,more and more young women have suffered the disease. It seriously threatens women's health. Therefore, it is very helpful to earlier diagnosis and treatment of endometrial carcinoma to the search for effective indicators which be used for monitoring the progress of endometrial carcinogenesisis, and is a pressing task. Ezrin, also known as cytovillin, is the prototype member of the ERM family. Ezrin is also a linking protein between cytoskeleton and the plasma membrane. Membrane proteins such as CD44 and E-Cadherin are linked to actin cytoskeleton by Ezrin. Ezrin regulates many cell activities such as morphogenesis, moltility, adhesion and signal transduction of cells, which are closely correlated with tumorigenesis, progression and metastasis of malignant tumors. Akt2, one of protein kinase B, is a family of Ser/Thr protein kinases. At present, the studies found that Akt2 overexpression and activation in a variety of tumors. In resent years, Ezrin and Akt2 have become new hot points of research. In this study, we detect the expression of Ezrin and Akt2 in endometrial carcinoma, atypical endometrial hyperplasia, simple endometrial hyperplasia, and proliferative endometrium with immunohistochemistry to elucidate their functions and relationship in the occurrence and development of endometrial carcinoma and explore the new ideas in the early diagnosis and treatment of endometrial carcinoma.Methods:The expressions of Ezrin and Akt2 in 48 cases of endometriod adenocarcinoma, 32 cases of atypical endometrial hyperplasia, 27 cases of simple endometrial hyperplasia and 19 cases of proliferative endometrium were assess with S-P immunohistochemical method. We both use the known breast cancer samples as the positive control group of Ezrin and Akt2, and take PBS to instead a resistance as negative control of Ezrin and Akt2. The positive immunoreaction of Ezrin and Akt2 were mainly distributed in the cytoplasm of carcinoma cells as granular brown staining. The stained results of Ezrin and Akt2 are measured by the Product of the precent of Postive stain and Percentage of Positive cell numbers in all congeneric cells .The experimental datas were treated by SPSS13.0, p < 0.05 is considered significantly statistic differences.Results:1 The expression of Ezrin in different pathological changes of endometrial carcinogenesisExpression of Ezrin at the protein level is significantly increased from normal proliferative endometrium, simple endometrial hyperplasia, atypical endometrial hyperplasia, to endometrial adenocarcinoma (21.1%,22.2%,53.12%,75.00%).No significant difference in Ezrin expression was found between the proliferative endometrium and simple endometrial hyperplasia (p>0.05).The positive expression of Ezrin in endometriod adenocarcinoma was respectively higher than that in proliferative endometrium, simple endometrial hyperplasia and atypical endometrial hyperplasia(p<0.05).2 The relationship between the expression of Ezrin in endometriod adenocarcinoma and the clinicopathologicIn endometriod adenocarcinoma cases, the expression of Ezrin was closely related with differentiation of tumor. The positive expression rate of Ezrin in gradeâ…¡andâ…¢cases was significantly higher than that in gradeâ… (94.4%vs66.7%, p<0.05).The positive expression of Ezrin was related with clinical stage.The positive expression rate of Ezrin in stageâ…¢andâ…£cases was significantly higher than that stageâ… andâ…¡(90.48%vs 62.96%, p<0.05). The positive expression rate of Ezrin was not related with lymph node metastasis in endometriod adenocarcinoma (p>0.05).3 The expression of Akt2 in different pathological changes of endometrial carcinogenesisExpression of Akt2 at the protein level is significantly increased from normal proliferative endometrium, simple endometrial hyperplasia, atypical endometrial hyperplasia, to endometrial adenocarcinoma (31.58%,37.04%,56.25%,66.67%).The positive expression of Akt2 in endometriod adenocarcinoma was significantly higher than that in proliferative endometrium and simple endometrial hyperplasia (p<0.05). No significant difference in Akt2 expression was found between the atypical hyperplasia and endometriod adenocarcinoma(p > 0.05).No significant difference in the expression of Akt2 was found between the proliferative endometrium and simple endometrial hyperplasia (p>0.05).4 The relationship between the expression of Akt2 in endometriod adenocarcinoma and the clinicopathologicIn endometriod adenocarcinoma cases, the expression of Akt2 was closely related with lymph node metastasis. The positive rates of Akt2 expression in the cases of lymph node metastasis were much higher than those of the controls (p<0.05).5 The relationship between Ezrin and Akt2 in endometrial carcinogenesisStatistical analysis showed that there was positive correlation between Ezrin and Akt2 expression in endometriod adenocarcinoma(r=0.954, p<0.05).Conclusions:1 The positive expression of Ezrin in endometriod adenocarcinoma was higher than that in atypical hyperplasia, indicating Ezrin as a diagnostic indicator in the early stage of endometrial adenocarcinoma.2 In endometrial adenocarcinoma, the expression of Ezrin was related with histological grade and clinical stage. The positive rates of Ezrin expression in the cases of higher histological grades and advanced TNM stages were much higher than those of the controls. Ezrin may play an important role in the carcinogenesis of endometrial adenocarcinoma. The monitoring of Ezrin is expected to be a good indicator of evaluation malignancy and prognosis of endometrial adenocarcinoma.3 The positive expression of Akt2 was related with lymph node metastasis in endometrial adenocarcinoma. The results indicated that it may be used as a marker of predicting lymph node metastasis in endometrial adenocarcinoma. The clinician will have a good surgical plan whether we should dissect the pelvic lymph node judging by the expression of Akt2.4 Positive correlations were observed between the expression of Ezrin and Akt2 in endometrial adenocarcinoma. They may have synergistic effect in the carcinogenesis of endometrial adenocarcinoma. They may be valuable indicators of early diagnosis and evaluation of prognosis and tumor malignancy. |
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