Correlation Analysis Of Expression Of E-Cadherin And N-Cadherin With Clinicopathological Features In Endometrial Carcinoma With MMR Deficiency

Objective To investigate the correlation between E-cadherin and N-cadherin in patients with endometrial carcinoma of mismatch repair(MMR)protein-deficient.To analyze the correlation between their differential expression and clinicopathological features.Methods A total of 40 patients who hospitalized surgical treatment in the Department of Gynecology,General Hospital of Ningxia Medical University from January 2016 to June 2018 and were postoperative pathological confirmed as endometrial carcinoma with MMR(-)were selected.Another control group include 40 cases of endometrial carcinoma with MMR(+)were recrolled as peer.Immunohistochemical staining of paraffin-embeded specimans sections was performed with E-Cadherin and N-Cadherin monoclonal antibodies,and the quantitative and qualitative expression was comparatively analyzed.The correlation between the differential expression of E-Cadherin,N-Cadherin and clinicopathological parameters including age,pathological type,clinicopathological stage(FIGO stage),histological differentiation,depth of uterine invasion,whether the tumor reached the lower uterine segment,vaginal cuff and parametrial soft tissue invasion,Lymph-Vascular Space Invasion(LVSI)and lymph node metastasis were comparatively analyzed.Results 1.The clinical features of MMR(-)EC were significantly different from those of MMR(+)EC in pathological type,FIGO stage,histological differentiation and LVSI(P = 0.000,P = 0.015,P = 0.001,P = 0.048).However,there was no significant difference in age,depth of myometrial invasio,tumor involvement of the lower uterine segment,vaginal cuff andparametrial soft tissue invasion,lymph node metastasis(P > 0.05).2.In MMR(-)and MMR(+)EC,the positive expressiom rate of E-cadherin was 67.5% vs 90.0%,the positive expressiom rate of N-cadherin was 67.5% vs 37.5%,showing statistical differences(P = 0.001,P = 0.000).The staining intensity of E-cadherin in MMR(-)EC was lower than that in MMR(+)EC,the staining intensity and the positive cells number evaluation of N-cadherin were higher than that in MMR(+)EC,showing statistical differences(P = 0.045,P = 0.021,P = 0.000).The positive cells number evaluation of E-cadherin showed a decreasing trend in MMR(-)EC,but the differences were not statistically significant(P > 0.05).3.In MMR(-)/MMR(+)EC,the positive expression of E-cadherin in patients with age >50 years old,endometrioid adenocarcinoma,FIGO stage I,myometrial invasion depth < 1/2,lower site tumor not infiltration in uterine cavity,vaginal and paracervical invasive,and LVSI(-),showing statistical differences(P = 0.04,P = 0.047,P = 0.033,P = 0.031,P = 0.010,P = 0.022,P = 0.04),not related to the histological differentiation or lymph node metastasis(P > 0.05).The positive expression of N-cadherin was significantly increased in patients of endometrial carcinoma with aged > 50 years,FIGO stage I,poorly differentiated,myometrial invasion depth < 1/2,tumor not reaching the lower uterine segment,vaginal and paracervical invasive,LVSI and no lymph node metastasis,showing statistical differences(P = 0.029,P = 0.017,P = 0.026,P = 0.006,P = 0.006,P = 0.009,P = 0.03,P = 0.036),there was no significant correlation with pathological type(P = 0.065).4.The expression of E-cadherin and N-cadherin was negatively correlated in MMR(-)EC(r =-0.678,P = 0.000),the staining intensity and the positive cells number evaluation of E-cadherin decreased,while the staining intensity and the positive cells number evaluation of N-cadherin was in the opposite trend,both of which were significantly negatively correlated(r =-0.751,P =0.002,r = 0.706,P = 0.003).The expression of E-cadherin increased in age,pathological type,FIGO stage,histological differentiation,lower site tumor infiltration in uterine cavity,vaginal and paracervical invasive,LVSI and lymph node metastasis(r > 0.5,P < 0.05),although there wasno significant difference in the correlation between E-cadherin expression and the depth of infiltration of myometrium its expression still decreased,showing a moderate correlation(r > 0.5,P > 0.05).The staining intensity of N-cadherin and the positive cells number evaluation increased in age,pathological type,FIGO stage,histological differentiation,depth of infiltration of myometrium,vaginal and paracervical invasive and LVSI(r > 0.5,P < 0.05),but there was no significant correlation with lower site tumor infiltration in uterine cavity and lymph node metastasis(r<0.5,P>0.05).Conclusion 1.Compared with MMR(+)EC,MMR(-)EC have different clinicopathological features.With the more common of type II endometrial carcinoma,a later clinical stage,a lower tumor differentiation and a higher incidence of LVSI.2.Compared with MMR(+)EC,E-cadherin expression decreased and N-cadherin expression increased in MMR(-)EC,showing differentia of epithelial-mesenchymal transformation.