Expression And Clinical Significance Of ER,PR And Four Mismatched Repair Proteins In Endometrial Carcinoma

Objective:To investigate the expression of ER,PR and four mismatch repair(MMR)proteins in endometrial cancer and their clinical and pathological characteristics.In order to provide experimental basis for clinical prognosis evaluation,treatment and screening of patients with suspicious Lynch syndrome.Materials and methods:Pathological and clinical data of 146 patients with endometrioid adenocarcinoma treated by operation in the Second Hospital of Dalian Medical University from July2016 to December 2018 were collected,and the relationship between ER and PR expression in the tissue of endometrial carcinoma and the surgical pathological stage and histological stage was analyzed retrospectively.The mismatched repair proteins were detected in 84 patients,and the expression and deletion of four kinds of mismatched repair proteins in endometrial cancer were statistically analyzed,and their relationship with surgical pathological staging,histological grading,infiltration depth,ER and PR expression were analyzed.SPSS 19.0 statistical software was used for data analysis,and P<0.05 was considered statistically significant.Results:1)In this study,the age of onset ranged from 30 years old to 84 years old,with an average age of 55.96 years old.Among them,the incidence of endometrial cancer was more common between 50 and 59 years old,accounting for 45.21%2)In this study,the menopausal age range of the patients was 40-56 years old,the average age of menopause was 46.85 years old,42 cases of premenopausal patients,accounting for 28.77%,104 cases of postmenopausal patients,accounting for 71.23%.3)There were statistically significant differences in ER positive expression rates amongsurgical stages,histological grades and muscle invasion depth(P < 0.05).It was negatively correlated with the surgical stage,histological grade and the depth of muscle invasion.4)There were statistically significant differences in the PR positive expression rates in the operative stages,histological grades and the depth of muscle invasion(P < 0.05).It was negatively correlated with the surgical stage,histological grade and the depth of muscle invasion.5)In 84 cases of endometrial cancer,the MMR protein deletion rate,MLH1 protein deletion rate,MSH2 protein deletion rate,MSH6 protein deletion rate,and PMS2 protein deletion rate were 41.67%(35/84),16.67%(14/84),9.52%(8/84),7.14%(6/84),and 29.76%(25/84)respectively.There were statistically significant differences in the expression of MMR protein in different operative stages and histology(P < 0.05).It was negatively correlated with surgical staging and histological grading.The expression rates of MMR protein deletion in superficial and deep muscle layer infiltration were39.28% and 46.43%,respectively,and the difference was statistically significant(P <0.05).6)The missing expression rate of MMR protein in patients with positive expression of ER and PR was 32.81%,and that in patients with negative expression was 76.92%,the difference was statistically significant(P<0.05).Conclusion:1)Abnormal expression of ER and PR is closely related to the biological behavior of endometrial cancer.Low or no expression of ER and PR suggested poor differentiation,high malignancy and poor prognosis.The expression of ER and PR has guiding significance for clinical endocrine therapy.The deletion of MMR protein is related to the level of ER and PR,and the low expression or no expression of ER and PR indicates that the expression of MMR protein may be missing,which needs to be vigilant against Lynch syndrome associated endometrial cancer.2)The absence of MMR protein indicates poor differentiation of tumor tissue,high degree of malignancy,deep muscle infiltration and poor prognosis.3)Immunohistochemical detection of ER,PR and mismatch repair protein in preoperative diagnostic curettage is of certain significance in guiding the treatment of tumors and predicting the prognosis of tumors.4)The expression deficiency of MMR protein can be used as a screening method for patients with Lynch syndrome,which can effectively guide clinical treatment and follow-up,so as to reduce the risk of cancer of patients and their family members.