Correlation Analysis Of Clinicopathological Features And Expression Of ER,PR,p53 And Ki67 In Endometrial Carcinoma In Yi And Han Nationality

Part One Analysis of clinicopathological characteristics and prognosis of patients with endometrial carcinoma in Yi and Han nationalityObjective: To analyze the clinicopathological and prognostic characteristics of patients with endometrial carcinoma in Yi and Han nationality.Methods: The clinicopathological data of Yi and Han patients who underwent initial full-stage endometrial cancer surgery at the Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital)from December 2012 to December 2019 were retrospectively collected and collated,and the recurrence and death-related conditions of the patients were collected through follow-up visits and entered into an Excel sheet to establish a database.Statistical analysis was done on the clinicopathological and prognostic data of endometrial cancer in both ethnic groups.The differences in data distribution between the different variables of the two ethnic groups were analyzed.Univariate and multivariate Cox regression analysis was used to analyze the related factors affecting prognosis,and P<0.05 suggested that the differences were statistically significant.Log-rank test was used to analyze the related factors affecting prognosis,P<0.05 indicates that the difference is statistically significant.Kaplan-Meier method was used for survival analysis,and Graph Pad Prism8.0 software was used to draw survival curve.Results:1.From December 2012 to December 2019,a total of 1030 patients who underwent initial EC staging surgery in Yunnan Cancer Hospital were included in the study,including 966 cases of Han nationality and 64 cases of Yi nationality.The number of cases admitted to the two ethnic groups is increasing year by year.2.The average in cidence of Yi patients is 49.89 ±8.96 years old,and the average age of Han patients is 52.61 ±8.32 years old.The age group with the largest number o f cases in Yi nationality is 40-49 years old,accounting for 40.6%,while the age group with the largest number of cases in Han nationality is 50-59 years old,accounting for 47%.There is a statistical difference in the distribution of onset age between t he two ethnic groups(P=0.005).3.The number of non-menopausal cases in Yi nationality of EC patients accounted for 62.5% of Prida,while the number of postmenopausal cases in Han nationality of EC patients accounted for 51.7%of Prida.There was a statistic ally significant difference in the distribution of menopausal status between the two ethnic groups(P=0.028).4.Among Yi nationality of EC patients,irregular vaginal bleeding during premenopause is the main clinical symptom,accounting for 59.4%,while Han nationality of EC patients have the most cases of postmenopausal vaginal bleeding,accounting for 4 7.6%.There is a significant difference in the distribution of main clinical symptoms between the two ethnic groups(P=0.035).5.There was no significant differe nce in pathological type,FIGO stage,degree of tumor differentiation,depth of myometrial invasion,LVSI,tumor size and cytological distribution of peritoneal lavage fluid between Yi and Han nationality of EC patients.6.The 5-year DFS of Yi and Han nation ality EC patients were 93.9%and 95.3%,The 5-year OS of Yi and Han nationality with EC patients were93.9% and 95.3%.There was no significant difference in prognosis between the two ethnic groups(P>0.05).7.Age≥60 years old,menopause,number of deliveries≥3 times,higher surgical and pathological stage,non-EEC,poorly differentiated tumor,invasion of deep muscle layer of tumor(≥1/2 muscle layer)and positive cytology of peritoneal lavage fluid were risk f actors for DFS in Yi and Han nationality with EC patients.Among them,menopause(HR=2.299,95%C I: 1.007～5.250,P=0.048)and non-EEC(HR=3.015,95%CI: 1.400-6.492,P=0.005)and positive cytology of peritoneal lavage fluid(HR=3.802,95%CI:1.287-11.233,P=0.016)were independent risk factors for DFS in patients.8.Age≥60 years old,menopause,more than 3 deliveries,higher surgical and pathological stage,non-EEC,poorly differentiated tumor,invasion of deep muscle layer of tumor(≥1/2 muscle layer)and positive cytology of peritoneal lavage fluid were risk factors for OS in Yi and Han nationality with EC patients.Non-EEC(HR=2.501,95%CI:1.045～5.988,P=0.040)and positive cytology of peritoneal lavage fluid(HR=4.080,95%C I:1.149～14.494,P=0.030)were independent risk factors for OS in patients.Conclusion(s):1.The number of new cases of EC patients in Yi and Han nationality showed an increasing trend year by year,The age of onset of EC in Yi nationality is younger than that in Han nationality.Most of the EC patients of Yi nationality were not menopausal at the first diagnosis,while most of the Han patients were menopausal.The main clinical symptoms of the EC patients of Yi nationality are irregular vaginal bleeding in premenopausal period,while those in Han nationality are postmenopausal vaginal bleeding.2.The overall prognosis of stage Ⅰ and Ⅱ EC patients in Yi and Han nationality were good,the 5-year DFS rates were 93.9% and 95.3%,and the 5-year OS rates were 96.4% and 96.7%.There was no significant difference in prognosis between the two ethnic groups.3.Menopause,non-EEC in pathological types and positive cytology of peritoneal lavage fluid were independent risk factors for DFS of EC patients in Yi and Han nationality.Non-EEC in pathological types and positive cytology of peritoneal lavage fluid were independent risk factors for OS of EC patients in Yi and Han nationality.Part Two Study on the relationship between the expression of ER,PR,p53,Ki67 and clinicopathological features and ethnic groups in endometrial carcinoma of Yi and Han nationalityObjective: To explore the correlation between the expression of ER,PR,p53,Ki67 and clinicopathologica l features and ethnic groups in patients with endometrial carcinoma in Yi and Han nationality.Methods: From December 2012 to February 2022,the clinicopathological data of Yi and Han patients who underwent comprehensive staging surgery for endometrial cancer in Yunnan Cancer Hospital were collected.According to the inclusion and exclusion criteria,44 patients of Yi nationality and 43 patients of Han nationality were selected as research objects.Using SPSS23.0 to analyze the relationship between the expre ssions of ER,PR,P53,Ki67 in cancer tissues of 87 patients and clinicopathological features and ethnicity.Results:1.There was no significant difference in the expression of ER between Yi and Han EC patients with different pathological types,FIGO stages and depth of myometrial invasion(P>0.05).In histological grade,the higher the grade,the more negative expression of ER,and th ere was significant difference(P<0.001).The expression of ER was negatively correlated with tissue grade(rs=-0.469,P<0.001).The expression of ER in Yi EC patients was positive in 26 cases,accounting for 59.1%,while in Han EC patients,negative expression was found in 37 cases,accounting for 86%.There was significant statistical difference in ER expression between Yi and Han nationality with EC patients(P<0.001).2.There was no significant difference in the expression of PR between Yi and Han EC patients with different FIGO stages an d depth of myometrial invasion(P>0.05).But there was significant difference in PR expression bet ween Yi and Han EC patients with different pathological types.The expression of PR was negatively correlated with pathological types,and rs=-0.295,P=0.005.There was a significant difference in the expression of PR between Yi and Han EC patients with diff erent histological grades(P<0.001).The expression of PR was negatively correlated with histological grade,and rs=-0.437,P<0.001.The expression of PR was mainly positive in Yi EC patients,accounting for 70.5%,while negative expression was mainly found in Han EC patients,accounting for 90.7%.There was significant statistical difference in the expression of PR between Yi and Han nationality with EC patients(P<0.001).3.There was no significant difference in the expression of p53 between Yi and Han nationality with EC patients with different pathological types,FIGO stages,depth of myometrial invasion and histological grades(P>0.05).The expression of p53 "++" and "+++" was zero in all highly differentiated tumors of Yi and Han EC patients.The expression of p53 "++" and "+++" in Han EC patients were zero,while in Yi EC patients,p53 "++" and "+++" were all expressed,accounting for 15.9%.There was a significant difference in the expression of p53 between Yi and Han nationality with EC patients(P=0.046).4.There was no significant difference in Ki67 expression between Yi and Han EC patients with different pathological types,FIGO stages and depth of myometrial invasion(P>0.05).There was a significant difference in the expression of Ki67 between Yi and Han EC patients with different histological grades(P=0.012).The expression of Ki67 was positively correlated with histological grade,and rs=0.345,P=0.001.There was a significant difference in the expression of Ki67 between Yi and Han EC patients(P=0.024).The expression of Ki67 in Yi EC patients was mainly low(<35%),accounting for 65.9%,while in Han EC patients,the expression of Ki67 was mainly high(≥ 35%),accounting for 58.1%.5.The expression of ER was positively correl ated with the expression of PR,and rs=0.833,P<0.001.The expression of ER was negatively correlated with the expression of Ki67,and rs=-0.273,P=0.01.There was no correlation between the expression of ER and the expression of p53(P > 0.05).6.The expression of PR was negatively correlated wi th the expression of Ki67,and rs=-0.287,P=0.007.There was no correlation between the expression of PR and the expression of p53(P >0.05).7.There was no correlation between the expression of p53 and the expression of Ki-67(P >0.05).Conclusion(s):1.The expressions of ER,PR,p53 and Ki-67 were statistically different between Yi and Han nationality with EC patients.2.The positive rate of p53 in EC patients of Yi nationality was higher than that of Han nationality with EC patients,but the proportion of Ki67 low expression(<35%)was higher than that of Han nationality with EC patients.The expression of p53 and Ki67 in Yi and Han nationality with EC patients showed inconsistent.3.The expressions of ER,PR,and Ki-67 in Yi and Han nationality with EC patients were all related to tissue grades,and there was a correlation between them.The combined detection of these three immune markers can provide some basis for the treatment and prognosis evaluation in Yi and Han nationality with EC patients.