| Objective: Endometrial carcinoma is a malignant tumor,which occurred in endometrial epithelial.It is the third malignant tumor of female reproductive tract following the ovarian epithelial tumor and the cervical cancer[1],And the morbidity of the endometrial carcinoma accounts for 20% to 30% in the malignant tumor of female genital tract.Until now the exact pathogenesis of the endometrial carcinoma is unclear.It is general believed that it has some connection with the standard of estrogen.According to whether relied on estrogen or not,the endometrial carcinoma is divided into two types: estrogen dependent type(type I)and estrogen independent type(type II).The andenocarcinoma of uters was the most common pathological type in type I of endometrial carcinoma.Studys have found that the onset of the type I endometrial carcinoma may be related to long-stem estrogen exposure without progesterone antagonist [2].But the specific mechanism is unclear.In addition to the delay menopause and the application of estrogen-drugs,obesity and diabetes are also the risk factors of type I endometrial carcinoma [3].So it is known as an illness of affluence.In developed countries such as Europe and the United States,the incidence of endometrial cancer is high.Epidemiological investigation showed that in 2008 the new cases of endometrial carcinoma in United States were up to 40100[4].But as the development of the society,the incidence of endometrial cancer in developing countries is increasing year by year.Type II endometrial carcinoma commonly occured at the elderly thin women.The specific reason is unclear,and the pathologic type is rare.It is in middle or the late stage when diagnosed.So the prognosis of type II endometrial carcinoma is poor..The main target of this study was by investigating the expression of ?-catenin?E-cadherin and cyclooxygenase-2 protein in normal endometrium and type I endometrial adenocarcinoma to analyze the relationship among the three proteins in the endometrial cancer and the relevance of each other,by using the three indicators to analyze the relationship and and clinical significance of the activity of Wnt signaling pathway and the expression of COX-2 in type I endometrial cancer,in hope of finding the pathogenesis of type I endometrial carcinoma.To guide the prevention,early diagnosis,targeted therapy and prognosis of type I endometrial cancer.Methods:1 This study chose the paraffin section from January 2014 to September 2015 in hebei general hospital of gynecology inpatient by curettage ? hysteroscope and surgical resection.There were eighteen cases of normal endometrium and forty cases of endometrial carcinoma(Dividing the endometrial carcinoma into groups according to the 2009 International Federation of Gynecology and Obstetrics(FIGO)surgical pathological stage,there were 15 cases in stage I endometrial carcinoma,15 cases in stage II and 10 cases in stage III.Divided the endometrial carcinoma into groups according to the myometrial invasion,there were 24 cases in the less than 1/2 muscular infiltration group and 16 cases in the equal to or more than 1/2 muscular infiltration group.Divided into the groups according to whether the presence of lymph node metastasis or not,there were 32 cases in non-lymph node metastasis group and 8 cases in the lymph node metastasis group).2 Immunohistochemical staining SP method was used to detect the expression and the relationship of the ?-catenin,E-cadherin and cyclooxygenase-2 in 18 cases of normal endometrium tissues and 40 cases of endometrial carcinoma tissues.To explore the relationship and clinical significance of Wnt signaling pathway and COX-2 in endometrial carcinoma,to provide the theoretical basis to explore the pathogenesis of endometrial carcinoma and provide the clinical guidance for the prevention,early diagnosis,targeted therapy and prognosis of endometrial carcinoma.3 Analyse the data using SPSS 17.0,and it is the statistically significant when P<0.05.Result:1 The positive expression of ?-catenin protein in normal endometrium was mainly in the cell membrane,a little number in the cytoplasm,almost no expression in the nuclei.In this study,we regarded the expression of the ?-catenin in the cell membrane as positive expression,and in the cytoplasm and nuclei as negative expression or ectopic expression.E-cadherin protein definitely expressed in the membrane of endometrial glandular cells and there was no expression in the cytoplasm and nuclei.There was no expression of the COX-2 proteins in the normal endometriun tissues,but highly expressed in the cytoplasm of the endometrial cancer.2 The positive expression rate of ?-catenin protein and E-cadherin proteins from the normal endometrium to endometrial cancer tissues decreased gradually.The ectopic expression of ?-catenin increased as the development of endometrial carcinoma.There was no positive expression of COX-2 proteins in the normal endometrium,but the positive expression rate of COX-2 was increased gradually as the development of endometrial carcinoma.The positive expression of protein ?-catenin in normal endometrium tissues was highly statistically significant than the endometrial cancer(P<0.001).The positive expression of ?-catenin protein of the normal endometrium tissues,and the stage I of endometrial carcinoma,stage II and stage III were:100%,73.33%,20%,10%,respectively.The expression of ?-catenin protein showed significant difference between stage I,II,III and the normal endometrium tissues(P<0.05).The expression of ?-catenin of the stage I endometrial carcinoma was significantly higher than the stage II group(P=0.003).The expression of ?-catenin showed no significant difference between stage II and stage III(P=0.626).Divided the type I endometrial carcinoma into the groups according to the myometrial invasion,the experiment found that the positive expression of ?-catenin of the less than 1/2 muscular infiltration was significantly higher than the equal to or more than 1/2 muscular infiltration(P<0.008).It was found that the positive expression of the ?-catenin protein in the non-metastasized group was significantly higher than the lymph node metastasis group(P=0.016).The positive expression of E-cadherin protein in normal endometrium tissues was statistically significant higher than the endometrial carcinoma(P<0.001).The positive expression of the E-cadherin in the normal endometrium tissues,stage I,stage II and stage III of type I endometrial carcinoma were:100%,86.67%,33.33%,0%,respectively.The expression of E-cadherin protein showed significant difference between stage I,II,III and the normal endometrium tissues(P<0.05).The positive expression of E-cadherin showed significant difference between stage I and stage II endometrial carcinoma(P=0.003).The positive expression of E-cadherin of the stage II endometrial carcinoma was no different from stage III(P=0.061).Divided the groups according to the myometrial invasion,the experiment found that the positive expression of E-cadherin in the less than 1/2 muscular infiltration was significantly higher than the equal to or more than 1/2 muscular infiltration(P<0.001).It was found that the expression of the E-cadherin in the non-metastasized group was significantly higher than the lymph node metastasis group(P=0.005).The positive expression of COX-2 protein of the type I endometrial carcinoma was significantly higher than the normal endometrium tissues(P<0.001).The positive expression of the COX-2 in the normal endometrium tissues,stage I,stage II and stage III of type I endometrial carcinoma were:11.11%,46.67%,73.33%,100%,respectively.The expression of COX-2 protein showed significantly difference between stage I,II,III and the normal endometrium tissues(P < 0.001).The expression of COX-2 showed no significantly difference between the stage I and the stage II of emdometrial cancer(P=0.136).The positive expression of COX-2 showed no difference between stage II and stage III(P=0.125).The experiment found that the positive expression of COX-2 in the less than 1/2 muscular infiltration group was significantly less than the equal to or more than 1/2 muscular infiltration(P=0.005).The expression of COX-2 in the non-metastasized group showed no difference with the lymph node metastasis group(P=0.079).3 The expression of ?-catenin protein was positively correlated with that of E-cadherin in endometrial carcinoma(r=0.752,P<0.001).The positive expression of ?-catenin protein was negatively correlated with the expression of COX-2 protein(r=-0.882,P < 0.001),and the E-cadherin was also negatively correlated with COX-2(r=-0.718,P<0.001).Conclusion:1 With the development of the endometrial carcinoma,the positive expression of ?-catenin and E-cadherin decreased gradually.But the ectopic expression of ?-catenin was increased.This indicated that the activity of Wnt signaling pathway was increased as the development of endometrial carcinoma.So we could speculate that Wnt signaling pathway is associated with the occurrence and development of endometrial carcinoma.2 The expression of COX-2 was highy expressed in type I endometrial carcinoma,but there was almost no expressed in normal endometrium.There was no in correlation with the surgical pathological stage and the lymphatic metastasis,but in correlated with myometrial invasion.So it was believed that maybe COX-2 was no relationship with the occurence of type I endometrial carcinoma,but was associated with the progression of endometrial carcinoma.3 The protein level of COX-2 was negatively correlated with ?-catenin and E-cadherin.As the development of the type I endometrial carcinoma,the positive expression of ?-catenin and E-cadherin decreased,and the ectopic expression of ?-catenin increased.This represented that the activity of Wnt signaling pathway was increase.So during the occurrence and the development of type I endometrial carcinoma,the activity of the Wnt signaling pathway and the positive expression of COX-2 had the synergy. |
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