The Expression And Significance Of ER, PTEN, Bcl-2, Bax And PCNA, TUNEL In Various Endometriums

Objective:To analyze the expression of ER, PTEN, bcl-2, bax, PCNA and TUNELin the gland epithelial cells of various endometriums,then to investigate the following questions:(1) Gradualistic changes of ER and PTEN expression in the development of EAC.The effects of estrogen on PTEN expression.The relationship between ER,PTEN expression and clinicopathological characters of EAC.(2) Detecting bcl-2 and bax expression in different endometriums,the relationship between them and clinicopathological parameters of EAC.(3) The expression of PCNA and TUNEL in various endometriums.To investigate the relationship between PCNA,TUNEL expression and clinicopathological characters of EAC.(4) With these results,we want to make clear the roles that every index plays in the pathogenesis and progression of EAC and its possible molecular mechanism.Another purpose is to put ours discovers into the clinicopathological diagnosis, therapy and prognosis.Methods:We apply immunohistochemistry technique to detect ER, PTEN, bcl-2,bax,PCNA and TUNEL expression in 10 NE(PE and SE, respect tively 5 cases),60 EH(SH,CH and AH,respectively 20 cases) and 20 EAC.A11 data were processed by SPSS version 11.5 analysis software. Results:1. In NE,ER expression in PE are higher than that in SE (P<0.01).ER expression are different in various endometriums,EH>NE>EAC (P<0.05).There are some differences among the ER expression of various histological types of EH.Those are:SH> CH> AH(P<0.05).ER expression are not correlated with ages, DMI and pathological stages(p>0.05), but ER expression are associated with HG:WDEA >MDEA >LDEA(P<0.05).2. PTEN are mostly located in the nucleus and plasm of gland epithelial cells of the endornetrium.The differences are not significant for the PTEN expression in PE and SE(p>0.05).PTEN expression are gradually decreased from NE,EH to EAQand the differences are significant(p<0.01).The differences are significant between AH/SH and AH/CH (p<0.01). As for SH and CH,the differences are not significant(p>0.05).Though[<50]>[=50],[=l/2] >[>l/2],the differences of PTEN expression are not significant in different ages types and DMI(p>0.05).With the differentiation becoming poor and the clinical stages elevating,PTEN expression are decreasing,those are: I>II>III~IV; WDEA>MDEA>LDEA;but the differences are not significant(p>0.05).3. AS for the correlation analysis,Our results shows no correlation betwween PTEN and ER expression in the epithelial cells of both AH and EAC(p>0.05).4. bcl-2 expression are higher in PE than SE,however,bax are higher in SE than PE.Statistics shows that bcl-2 have no negative correlation with bax.5. bcl-2 and bax become increasing from SH,CH to AH(P<0.05). bcl-2 and bax are higher in AH than SH and CH,and the differences are significant (respectively, P<0.01,P<0.05).6. In the EAC, bcl-2 expression have no significant differences among different ages groups and DMI(P>0.05).But bcl-2 expression are associated with the HG and clinical stages:WDEA0.05).With the differentiation becoming poor and the myometrial invasion deeping,bax expression are decreasing,and its expression are associated with the HG and DMI:well>moderate>low(P<0.01); [>l/2] >[=l/2] (P<0.01).There are positivecorrelations between expression of bcl-2 and bax in EAC(rs= 0.997,p<0.01).7. PCNA expression are increasing from NE,EH to EAC.Those are: EAC>AH>CH>SH>NE(P<0.05).In the EAC,PCNA expression are associatedwith DMI,HG and clinical stages.Those are: [>l/2]>[=l/2], LDEA>MDEA>WDEA,III> I ,III> II ,and with the myometrial invasion deeping,differentiation becoming poor and the clinical stages elevating,PCNA expression are increasing.Though PCNA expression of the [=50] ages group are higher than the [<50] group,the differences are not significant(p>0.05).8. We have only found some dispersed apoptostic cells in SE,but have not in PE. TUNEL expression are increasing from NE,EH to EAC.Those are:EAC>EH>NE(P<0.05).AH>CH>SH(P<0.01). In the EAC.TUNEL expression are associated with HG and clinical stages: WDEA> MDEA>LDEA, I > II >III,and with the differentiation becoming poor and the clinical stages elevating, TUNEL expression are decreasing(p<0.01). Though [=50]>[<50}; [>l/2]> [=1/2], the differences are not signify cant(p>0.05).9. There are negative correlations between expression of PCNA and TUNEL in AH and EAC(r=-0.943,p<0.01;r=-0.976,p<0.01,respectively). Conclusions:1. ER may have some functions in the NE.ER expression are different in various endometriums:EH>NE>EAC,SH>CH>AH(P<0.05),which suggested ER put important effect in development of EAC.ER expression are not associated with ages.myometrial invasion and clinical stages,but it is correlated with HG. With the differentiation becoming poor, ER expression are decreasing,which provided important evidence for pathological diagnosis.2. PTEN expression are gradually decreased from NE, EH to EAQand the differences are significant,which suggested loss of PTEN expression are involved in the development of EAC.From SH,CH to AH,PTEN expression are also gradually decreased, suggesting loss of PTEN expression put important effect in progression of EH. The differences of PTEN expression are not significant in different ages types,DMI,HG and clinical stages,which means PTEN are not correlated with histopathological characters.PTEN also has no relation with ages.3. No correlation between PTEN and ER expression in the epithelial cells of both AH and EAC.lt is possible that PTEN expression are not affected by estrogen.4. bcl-2 and bax have become increasing from SH.CH to AH(P<0.05), which suggested they participate in the origin of precancerous lesions.5. In EAC,bcl-2 expression have no correlations with ages and myometrial invasion,but it is associated with the HG and clinical stages:WDEA MDEA>WDEA; III> I ,III> II; [>l/2]>[=l/2].With the results,we suspected PCNA put important effect in progression of EAC and could be an important parameter for the clinical diagnosis and prognosis of patients.8. TUNEL expression are increasing from NE, EH to EAC. Those are:EAC>AH>CH>SH>NE.We suspected apoptostic cells are increasing with the hyperplasia of epithelial cells.TUNEL expression are associated with HG and clinical stages,and with the differentiation becoming poor and the clinical...