| Objiective:To investigate the expression of mismatch repair protein in endometrial cancer tissues,and to analyze the clinical pathological characteristics and track the prognosis.To analyze the role of mismatch repair protein in the diagnosis,treatment and prognosis of endometrial cancer.To explore the analysis of clinicopathological characteristics and the lack of mismatch repair protein expression,to initially screen patients with genetic tendency for Lynch syndrome-related endometrial cancer,to diagnose Lynch syndrome patients as early as possible,and to reduce Lynch correlation among themselves and their family members Incidence of tumors and prevention to improve patient prognosis and patient survival.Method:In this study,332 patients with endometrial cancer confirmed by Dalian pathology and admitted to Maternal and Child Health Hospital from June 2016 to June2019 were selected,of which 10 patients did not perform MMR(Mismatch Repair)Detection,the remaining 322 patients with endometrial cancer were tested for MMR protein expression,including 303 cases of endometrioid carcinoma,10 cases of serous carcinoma,3 cases of carcinosarcoma and 6 cases of clear cell carcinoma.The clinical pathological characteristics of 322 patients were analyzed,and the relationship between the loss of MMR protein expression and the clinical pathological parameters of endometrial cancer was analyzed one by one.The prognosis-related conditions of 322 patients were followed up and whether patients with MMR protein deficiency were further improved.Statistical analysis was performed using SPSS 22.0 statistical software for data processing.Counting data were expressed by frequency and percentage(%).Chi-square test or Fisher's exact probability method was used for comparison between groups.The difference was statistically significant when P <0.05.Results:(1)Among the 322 patients,74 were missing one or more MMR protein expressions,with a total deletion rate of 22.98%,the MLH1 deletion rate(20/322,6.21%),and the PMS2 deletion rate(39/322,12.11%),the MSH2 deletion rate was(20/322,6.21%)and the MSH6 deletion rate was(32/322,9.94%).PMS2 expression deletion rate was the highest,and MLH1 and MSH2 expression deletion rates were the lowest.The combined deletion rate of MLH1 / PMS2(15/322,4.66%)and the combined deletion rate of MSH2 / MSH6(16/322,4.97%).(2)The deletion rates of MSH6 protein expression between the two groups of patients aged <50 years and aged ? 50 years was 10.3% and 9.8%,the difference was statistically significant(P<0.05);The total deletion rates of MMR protein in pathological tissues of endometrial cancer between BMI between 18.5-24.9kg/m2 and BMI ?25kg/m2 were 30.9% and 16.4%,the difference was statistically significant(P <0.01),the deletion rates of PMS2,MSH2,and MSH6 were compared between the two groups,the differences were statistically significant(P<0.05);the deletion rates of MSH2 protein expression between the two groups of patients whose tumor tissues did not reach the internal cervix and reached and exceeded the internal cervix were 5.2% and 11.5%,the difference was statistically significant(P<0.05);the deletion rates of PMS2 and MSH6 were compared between the two groups pathological tissues with tumor diameter?2cm and tumor diameter>2cm,the differences were statistically significant(P<0.05);the total deletion rates of MMR protein and the deletion rates of MSH2 and MSH6 were compared between the two groups of pathological tissues with muscular infiltration depths?1/2and>1/2,the differences were statistically significant(P<0.05);Among 303 patients with endometrioid carcinoma,the total deletion rate of MMR protein and the deletion rates of MLH1,PMS2,and MSH2 were compared between the two groups the highly differentiated and moderately-differentiated groups,the differences were statistically significant(P<0.05).Conclusions:(1)For patients <50 years of age,normal body mass index(BMI:18.5-24.9kg / m2),and endometrioid carcinoma is highly differentiated,there is a greater possibility of loss of MMR protein expression.(2)For patients whose tumor range exceeds the cervical ostium and tumor diameter> 2cm,and infiltration degree> 1/2,the possibility of loss of MMR protein expression is greater.(3)The clinical and pathological data of the patients combined with immunohistochemical detection of various MMR protein deletions are of guiding significance for the initial screening of patients with endometrial cancer associated with Lynch syndrome with a genetic predisposition and guiding the clinical treatment of the next step. |
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