Expression Of Thymidylate Synthase,Thymidine Phosphorylase And Proliferative Cell Nucleax Antigen And Their Relationship With Endometrial Carcinoma

Background and Objective: Endometrial carcinoma, cervical cancer and ovarian tumor are the three most common malignant tumors in female reproductive duct . Endometrial carcinoma usually occurs in the menopausal and postmenopausal periods and seriously threatens the health of senior women. The incidence of endometrial carcinoma is highly increasing in the recent years because of life lengthening, obesity and hormone replacement therapy. EMC main therapies include surgery, radiation and systemic chemotherapy. Nowadays significant advances have been made in surgical management and adjuvant treatment of EMC patients. Despite these developments in treatment, there is a high risk of advanced stages, distant metastasis and local recurrence of EMC so that some patients will die from this disease. It's a difficult problem for clinic doctor to heal patients and better their living quantity after therapy. So people pay great attention to prognostic indicators of EMC. Their studies main include clinic pathological features and biological indicators, especially the latter. This study is undertaken to detect the protein expression and correlationship of thymidylate synthase, thymidine phosphorylase and proliferative cell nucleax antigen in endometrial carcinoma in order to study their relationship with the clinicopathologic and the prognosis of endometrial carcinoma and to provide thetheoretical basis and strategies for clinical biotherapy and preventions.Materials and MethodsThe specimens were individed into experimental group and control group. Theexperimental group was obtained from forty-eight patients with endometrial carcinoma (FIGO, stage â… :38 cases, stage â…¡: 8 cases, stage â…¢:2 cases. ) ; Fifteen cases of normal endometrial, ten endometrial hyperplasias were also studied as control group. All the cases were enrolled from the Second Affiliated Hospital of Zhengzhou University and not treated by chemotherapy, radiotherapy and sex hormone therapy before operation. All the surgically resected specimens were fixed with 10% formalin, paraffin embedded, and serially sectioned for histopathological diagnosis, immunohistochemical analysis. Immunohistochemistry (SP method) was applied to determine the protein expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and proliferative cell nucleax antigen (PCNA). The data was analyzed by SPSS10.0 statistical software. The x2 test, Fisher's Exact Test were used for the statistics (P<0.05 was considered significant).ResultsWith the lesions progressed from normal endometrium to endometrial hyperplasia and to endometrial carcinoma, an increasing tendency of TS expression was observed, and the positive rates were 13.3%, 20% and 52.1% respectively. The differences were significant (P<0.05), TS expression was significantly correlated with three clinic pathological features : histological type (P= 0.021) , depth of invasion (P= 0.010) , clinical stage (P= 0.047) .With the lesions progressed from normal endometrium to endometrial hyperplasia and to endometrial carcinoma, an increasing tendency of TP expression was observed, the positive rates were20%, 30% and 60.4% respectively. TP expression was not correlated with clinic pathological features (P>0.05) .With the lesions progressed from normal endometrium to endometrial hyperplasia and to endometrial carcinoma, an increasing tendency of PCNA expression was observed, and the positive rates were 20%, 20% and 77.1% respectively. PCNA expression was correlated with differentiation (p=0.027) and myometrial invasion (P=0.001).Expression of TP was positively correlation with PCNA (P=0.000).ConclusionWith the every lesion progressed in the endometrial carcinogenesis, the expression rates of TS, TP and PCNA were increasing. There was a high coincidence among them. Expression of TS in the endometrial carcinogenesis was correlated with Clinic pathological features, which indicated that TS was maybe a prognostic indicator. Expression of TP was positively correlation with PCNA.TP was not an independent prognostic indicator. It is important to detect TP, TS and PCNA together in order to survey the development and prognosis of endometrial carcinoma, which provides the theoretical basis and strategies for clinical biotherapy and preventions.