Relationship Between Angiopoietin-2 Expression And Microvessel Density In Endometrial Adenocarcinoma

Endometrial carcinoma is one of the three commonest gynaecological malignancies in female genital tract. For these years, because many factors such as the average life span of women become longer, the use of exogenous estrogen extensively and so on, the morbidity of endometrial carcinoma shows ascending tendency, and 20% of women with endometrial cancer still die within 5 years of diagnosis, do a big harm to women's healthy. At present, many research indicate that the growth,the invasion and the metastasis of the tumor closed related to the generate of tumor blood vessel. Many researches showed that Angiopoietin-2(Ang-2) are critically involved in tumor angiogenesis, have intimate relationship with tumor clinical stage and prognosis. The expression of Ang-2 protein up-regulation in malignancies than in corresponding normal tissues. Ang-2 protein play an important role in tumor angiogenesis and the development of tumor.In this study, we investigate the expression of Ang-2 in normal endometrium,atypical hyperplasia endometrium and endometrial adenocarcinoma, and analyze its relationship with MVD (microvessel density), to investigate the role of Ang-2 in generate and develop of endometrial adenocarcinoma. This experiment use immunohistochemistry method, use CD34 antibody marked MVD, and investigate the relationship with Ang-2, in order to find a new way in diagnose,treatment,prognosis of endometrial adeno -carcinoma.The study included 58 patients treated by dilatation & curettage or hysterectomy from Jan 2005 to Dec 2006 at the department of Obstetrics and Gynecology in the Second Clinical Hospital of Jilin University. Pathologically proved 10 cases of normal endometrium and 10 cases of atypical hyperplasia endometrium. In addition , there were also 38 patients treated for endometrial adenocarcinoma. Clinical stage and histological grade was evaluated in the adenocarcinoma group according to FIGO's standard (2000):30cases of First and Second Stage,8 cases of Third and Forth Stage.18 cases of G1;10 cases of G2;10 cases of G3. All patients included in our study had not used any hormonal contraceptive medicine or devices three months before operation. Immunohistochemical staining for Ang-2 were performed by SABC. The staining intensity was expressed with histological score(H-Score).SPSS12.0 statistical software was used for statistical analysis. The significance of differences between individual groups was assessed with t-test,χ2-test,Spearman analysis and so on.The result of our experiment showed in normal endometrium Ang-2 expressed in low levels, the existence of Ang-2 in normal endometrium showd that the Ang-2 maybe take part in the angiogenesis of endometrium in menstrual cycle. But in endometrial adenocarcinoma, the expression of Ang-2 up-regulate obviously compared to normal endometrium samples(p<0.05),this suggest that the up-regulate of Ang-2 in endometrial adenocarcinoma maybe related to the generate and develop of endometrial adenocarcinoma. Our experiment suggest that in endometrial adenocarcinoma samples, Ang-2 protein expression is no relationgship among the different histological grade descends (p>0.05), were significantly associated with the presence of myometrial invasion and surgical pathologic staging and lymph node metastasis(p<0.05). This suggested the up-regulated expression of Ang-2 are closely related with the invasion and metastasis in endometrial adenocarcinoma, and Ang-2 play an important role in progression of endometrial adenocarcinoma.CD34 were expressed in normal endometrium,atypical hyperplasia endometrium and endometrial adenocarcinoma, MVD show a high expression tendency gradually(p<0.05),suggest that the generation of tumor microvascular play an important role in tumor development.Our experiment suggest that in endometrial adenocarcinoma samples, MVD protein expression is no relationship among the different histological grade descends (p>0.05), were significantly associated with the presence of myometrial invasion and surgical pathologic staging and lymph node metastasis(p<0.05). This suggested the tumor's blood vessel forming is an important factor to invasion and metastasis in endometrial adenocarcinoma, and the high expression of MVD demonstrate the bad prognosis of endometrial adenocarcinoma. So we can use the quantity of vascular to evaluate the prognosis of endometrial adenocarcinoma. Our experiment result showed the positive correlation was found between Ang-2 expression and microvessel density in endometrial adenocarcinoma(rs=0.895,P<0.01). That showed Ang-2 might be an important factor of promoting angiogenesis in endometrial adenocarcinoma and play an important role in the generation,development of endometrial adenocarcinoma blood vessel. Our experiment confirmed the dependability of Ang-2 expression and MVD, and was related closely with pathological grade and lymphoid metastasis in endometrial cancer.The up-regulate expression of Ang-2 was correlate with the angiogenesis of endometrial adenocarcinoma, and play an important role in the development of tumor. Thus we expected Ang-2 might become a new molecule target in the aspects of early diagnosis therapy method and prognosis assess of endometrial cancer.