The Expression And Significance Of ZEB1 Protein In Endometrial Carcinoma

Objective:to investigate the expression of Zinc finger E-box-binding protein 1(ZEB1) in normal endometrial of proliferative phase, endometrial endometriod adenocarcinoma and type II endometrial carcinoma,as well as the significance of ZEB1 in the initiation,growth and prognosis of endometrial carcinoma.Method: the author randomly selected 60 cases of tissues in endometrial endometroid adenocarcinoma which have been confirmed by pathological diagnosis,as well as their clinical data.These cases were devided into two groups which contained 30 cases of FIGO grade 1 and 30 cases of FIGO grade 2-3.There were 30 tissues of normal endometrial of proliferative phase,acted as matched group.The author also collected 20 specimens of type II carcinoma which included 12 cases of endometrial serous carcinoma,3 cases of clear cell carcinoma,and 5 cases of other pathological patterns.The expression level of ZEB1 protein was detected by immunohistochemical SP method,and the clinical data was analysed,too.Results:1.ZEB1 showed a nuclear pattern of expression in all cases;In the normal endometrial of proliferative phase,the expression of ZEB1 was limited in the endometrial stroma and myometrium,but not in the normal endometrial epthelium.As the same as in the normal endometrial, no matter in group G1 or group G2-G3 of endometrial endometroid adenocarcinoma,the expression was also limited in tumor-associated stroma,not in glandular epthelium;But the positive rate increased in the process from the normal endometrial of proliferative phase,group G1,to group G2-G3.The expression level of the normal endometrial of proliferative phase was the lowest by 20%(6/30).Although they had the same positive location,the expression level in group G1 and group G2-3 was significant higher where the rate was 53%(16/30) and 86%(26/30)when compared with normal endometrial, P<0.05.The expression level in group G2-3 was also sinificant higher than that in group G1,both in the pecentage cell stanin and intensity,P<0.05.2.The expression level of ZEB1 was related with the depth of myometrium invasion and FIGO clinical stage when it was analysed with clinical data.However,there were no significant evidences indicating that it related with age and lymph node metastasis in this study.The positive rate in the patients with myometrium invasion≥1/2(90%) was higher than that with myometrium invasion<1/2(60%),P<0.05.The positive rate in the patients of FIGO stage I was significant higher than in whom of FIGO stage II-IV,P<0.05.3.The positive rate of ZEB1 in the 20 cases of type II was 75%,there was no statistically differences when compared with endometrial endometroid adenocarcinoma group.The expression of ZEB1 was also limited in the tumor-associated stroma in 12 cases of endometrial serous carcinoma and 1 case of mucinous adenocarcinoma.But in small-cell carcinoma and part of clear-cell carcinoma tissues,ZEB1 expression was no longer confined to the stroma, but can be anomalously expressed in the malignant epithelium.Conclusion:1.The expression level of ZEB1 in endometrial endometriod adenocarcinoma was higher than that in normal endometrial,and the group G1 had a lower expression level than the group G2-3,this pattern shows that the expression level of ZEB1 is up-regulated when the tumor has a poor differentiation,which may suggest that ZEB1 may take participate the initiation and the progress in endometrial carcinoma.2.In the endometrial carcinoma,the expression level of ZEB1 has a positive relationship with the myometrial depth invasion and clinical pathological stage.It may indicate that the expression level of ZEB1 may play an important role as a potential approach in assessing the condition and prognosis of patients with endometrial carcinoma.3.In the type II endometrial carcinomas which are more aggressive,the positive rate is lower than that in the endometrial endometriod adenocarcinoma,but there are no siginificant statistically differences,and the distribution of ZEB1 is aberrant.It shows that the ZEB1 may involve in the invasion and metastasis in type II endometrial carcinomas,but the mechanism is still unknown.Therefore,we need to collect more cases and continue to explore.