| Background and Objective Endometrial carcinoma is one of the three malignant tumors of the female reproductive system,it is a kind of epithelial malignant tumor.On the basis of the clinical and endocrine characteristics of endometrial carcinoma,endometrial carcinoma was generally divided into two types: type I and II.The incidence of endometrial cancer is gradually increasing around the world,relevant data show that endometrial cancer is the most common malignant tumor of female genital tract after 2008 in China.More recent studies have reported five year survival rate of early endometrial cancer(FIGO I,II)was up to more than 90%,while the survival rate of patients with stage III and IV of FIGO was only about 57% to 66% and 20% to 26%.With the development of the research,people discovered that endometrial carcinoma is influenced by many factors,involving various signal transduction pathways,such as different oncogenes,tumor suppressor genes and transcription signals.Endometrial cancer not only has a great impact on women's health,but also increase the economic burden.Currently,main treatment of endometrial cancer is surgery,simultaneously radiotherapy,chemotherapy and endocrine therapy are used for supplementation,however the patient has also a poor prognosis.Early detection and effective treatment is very significant for improving the prognosis of patients,therefore,it is particularly important to clarify the etiology and pathogenesis of endometrial cancer,which could help to facilitate targeted therapy of endometrial carcinoma in clinical practice.Presently,few domestic and abroad researches were concerned on expression of thyroid transcription factor-1(TTF-1)in endometrial carcinoma.However,the conclusions of these studies were not consistent,and the correlative biological mechanisms of TTF-1 expression in endometrial tissue remained indistinct.In this paper,through detecting the positive rate of TTF-1 in normal endometrium,endometrial hyperplasia,endometrial carcinoma,to explore the differences of the TTF-1 expression in above-mentioned endometrial tissues,to study the connection between the expression of TTF-1 and the clinicopathological characteristic of patients.Material and Methods Assigning 73 cases of paraffin embedded specimens of Pathology Department,these specimens were obtained from January 2010 to June 2015,which came from Affiliated Hospital of Dali University.Normal endometrium(n=11),endometrial hyperplasia(n=17)and endometrial carcinoma(n=45)were included.Two highly qualified pathologist confirmed the assigned specimens,all cases of endometrial hyperplasia and carcinoma were classified according to the criteria from the World Health Organization.Normal endometrium was used for the control group,endometrial hyperplasia and carcinoma were regarded as the experimental group.All specimens were obtained from patients who had not received any preoperative radiotherapy,chemotherapy or surgery(except for diagnostic surgery).Routine HE staining was performed on 73 cases,simultaneously immunohistochemistry was used to detect the expression of TTF-1 in the 73 cases of paraffin tissue samples,and statistical analysis was carried out based on the clinical and pathological data.Results 1.Basic clinical information Normal endometrium(n=11),age ranging from 25 to 57 years old,median age was 45 years old.Endometrial hyperplasia(n=17),age ranging from 36 to 56 years old,median age was 46 years old.Endometrial carcinoma(n=45),age ranging from 31 to 78 years old,median age was 56 years old.There were 21 cases of Han nationality,14 cases of Bai nationality,10 cases of other nationalities among the assigned endometrial carcinoma.And there were 26 cases with detailed menstrual history,19 cases with undetailed menstrual history in all the selected endometrial carcinoma.The general clinical data had no significant difference(P> 0.05),that is to say,the assigned cases coincided with the experimental conditions.2.Clinical pathological information According to the WHO classification criteria,in all assigned specimens of endometrial carcinoma,there were 25 cases with well differentiated endometrial carcinoma,at the same time,13 cases were regarded as moderately differentiated endometrial carcinoma and 7 cases were regared as poorly differentiated endometrial carcinoma.According to the criteria of FIGO in 2014,the surgical stage of endometrial carcinoma included stage Ia(n=32),stage Ib and above(n=13).In the assigned endometrial carcinoma,there were 35 cases that the myometrial invasion was less than 1/2,and there were 10 cases that the myometrial invasion was greater than or equal to 1/2.Simultaneously,there were 2 cases with vascular metastasis and others had no metastasis.3.Immunohistochemistry staining results 3.1 Expression of TTF-1 in three different types of endometrial tissue TTF-1 staining was positive in 5 of 11(45%)normal endometrium,the TTF-1 positive rate was 35%(6/17)in endometrial hyperplasia,and the TTF-1 expression was 16%(7/45)in endometrial carcinoma.The expression of TTF-1 between normal endometrium and endometrial carcinoma(P=0.030),it had a statistical difference.The expression of TTF-1 between normal endometrium and endometrial hyperplasia,the p-value was 0.701.At the same time,the expression of TTF-1 between endometrial hyperplasia and endometrial carcinoma,the p-value was 0.089,they had no statistical difference yet.The positive rate of TTF-1 was in 7 of 45(16%)endometrial carcinoma,moreover,the expression of TTF-1 was in 6 of 33(18 %)type I endometrial carcinoma,one of 12(8 %)type II endometrial carcinoma.The expression of TTF-1 between type I and type II endometrial carcinoma had no statistical difference(p=0.655).3.2 Relationship between TTF-1 expression and clinicopathological features of endometrial carcinoma The results showed that there was a statistical difference in the expression of TTF-1 between well-differentiated and moderately differentiated endometrial carcinoma(P=0.012).Statistical association was not detectable between TTF-1 expression and patients,age(P=0.465),nationalities(P =0.826),surgical stage(P=0.180),the depth of myometrial invasion(P=0.660),metastasis(P=0.290).Conclusions 1.The expression of TTF-1 between normal endometrium and endometrial carcinoma,it had a statistical difference,which reaffirmed that TTF-1 could have an impact on the development of endometrial carcinoma,as a kind of biological factor.2.There was a statistical difference in the expression of TTF-1 between well-differentiated and moderately differentiated endometrial carcinoma,the results suggest that TTF-1 may have a bearing on the malignant degree and the clinical stage,and have an impact on the prognosis of endometrial carcinoma.3.A certain proportion of endometrial carcinoma would express TTF-1,when the TTF-1 is detected in the tumor with unknown primary site,as far as clinicians are concerned,it is necessary to identify whether the tumor is a source of endometrial carcinoma. |
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