The Expression And Significance Of β-catenin、Survivin、Cox-2、MMP-2in EIN And Endometrioid Adenocarcinoma

Objective:Endometrial carcinoma is one of the three common malignant tumors in female genital tract, during which mostly are endometrioid adenocarcinomas.In recent years, there is a growing trend in its incidence. So the study on its generation and development plays an important role. Endometrial hyperplasia can also be called endometrium with over-hyperplasia or endometrial hyperplasia syndrome and WHO divided them into pure hyperplasia, complex hyperplasia, pure non-typical hyperplasia and complex atypical hyperplasia,in the common views, the complex atypical hyperplasia is regarded as the precancerous lesion of endometrioid adenocarcinoma. However, in the novel views, there are a lot of drawbacks when regarding endometrioid adenocarcinoma as precancerous lesion,for example low repeatability and strong subjectivity and so on. Accordingly, a novel conception, endometrial intraepithelial neoplasia, EIN, is raised in recent years, for that it has both high repeatability and strong objectivity to regard EIN as the precancerous lesion. But the inner molecular mechanism is still in the preliminary stage. This research detects the expression levels of β-catenin,Cox-2,Survivin and MMP-2and analyzes their correlations with immumohistochemistry(IHC), and discusses the value of each immune parameter on pathological diagnosis among benign endometrial hyperplasia, EIN and endometrioid adenocarcinoma.Method:Reviewed routine HE slices of dilation and curettage of endometria specimens, which were from General Department of Pathology in General Hospital of Tianjin Medical University from2008to2010,then selected10endometrial slices in the proliferation period,20slices of simple endometrial hyperplasia,20slices of complex endometrial hyperplasia and Simple proliferation and complexity hyperplasia as a group that is40slices of benign endometrial hyperplasia;Picked out46slices of EIN from the pathological slices with endometrial hyperplasia which were again reviewed select25ones;Selected25slices of endometrioid adenocarcinomas.Test the expression levels of P-catenin, Survivin, Cox-2, MMP-2in each experimental group respectively. And analyzed with statistical analysis.Results:1.β-catenin wsa normally membran expressed on the endometrium in the proliferation period, and highly expressed in the benign endometrial hyperplasia, but abnormally expressed that was to say highly expressed in the cytoplasm in endometrial intraepithelial neoplasia. When it came to say its expression, there were significant differences between benign endometrial hyperplasia and endometrial intraepithelial neoplasia (P<0.01);there was no difference between endometrial intraepithelial neoplasia and endometrioid adenocarcinoma (P>0.05).2.Cox-2was highly expressed in endometrial intraepithelial neoplasia and endometrioid adenocarcinoma, but was lowly expressed in benign endometrial hyperplasia and endometrium in the proliferation period. Its positive expression in endometrial intraepithelial neoplasia and endometrioid adenocarcinoma was higher than benign hyperplasia and the normal endometrium, what was significantly different in statistics (P<0.01);there were significant differences between benign endometrial hyperplasia and endometrial intraepithelial neoplasia (P<0.05)however, there were no difference between endometrial intraepithelial neoplasia and ndometrioid adenocarcinoma (P>0.05).3.Survivin was lowly expressed in benign endometrial hyperplasia and endometrium in the proliferation period, however, highly expressed in endometrial intraepithelial neoplasia and ndometrioid adenocarcinoma and the positive rates had statistically significant differences (P＜0.05), there were significant differences between benign endometrial hyperplasia and endometrial intraepithelial neoplasia (P＜0.05); but no difference between endometrial intraepithelial neoplasia and endometrioid adenocarcinoma (P>0.05).4.MMP-2was lowly expressed in benign endometrial hyperplasia and endometrium in the proliferation period, but was highly expressed in EIN and endometrioid adenocarcinoma. There were significant differences of their expressions between benign endometrial hyperplasia and endometrial intraepithelial neoplasia(P<0.05), but no difference between endometrial intraepithelial neoplasia and endometrioid adenocarcinoma (P>0.05). Conclusions:1.β-catenin was membrane expression in endometrium in the proliferation period and benign endometrial hyperplasia;but it was abnormally elevated cytoplasm expression in EIN and endometrioid adenocarcinoma: the menbrane was negative expression.Through which identify the endometria tumor and non-tumor lesion, β-catenin may be a useful indicator.2.There were similar trends on expression of Survivin and Cox-2in this experiment of the four groups: they were significantly more expressed in EIN and endometrioid adenocarcinoma and lower expression in proliferation endometrial and endometrial benign endometrial hyperplasia.The expression of Cox-2and Survivin were positively related. Suggest that happening of ndometrioid adenocarcinoma is a cancer progression because Cox-2and Survivin work each other in coordination.3.The positive expression of MMP-2in p the proliferation period,benign endometrial hyperplasia, EIN and endometrioid adenocarcinoma was more and more higher.MMP-2has its unique structure,perhaps not only playing a role in tumor invasion and metastasis, play a role in happening of ndometrioid adenocarcinoma.