The Expression Of GSK-3? And E-cadherin In Endometrial Cancer And Its Significance

Background:The incidence of endometrial cancer in China has been increasing year by year in recent 20 years.In particularly,the incidence rate of first-tier cities such as Beijing and Shanghai has jumped to the top of gynecological tumors.What is worrying is that its current mortality rate has surpassed its morbidity growth rate,however,its pathogenesis is still not very clear,which poses great challenges for treatment.In recent years,many scholars have been trying to explore its pathogenesis,metastatic path and targeted therapy at the molecular level,implementing precise individualized treatment methods.Dr.Jim Wells led his team to apply Wnt/GSK-3?signaling path-way and epithelial mesenchymal transition(EMT)theory,to change the induced environment of cell differentiation,to use human pluripotent stem cells(hPSCs),the result was that the human stomach tissue was cultured successfully in vitro.The success of the experiment has caused people to think from many aspects how Wnt,GSK-3?,E-cadherin and EMT regulate stimulation and how they affect the differentiation,proliferation and apoptosis of cells.At present,the research is still in the exploration stage,and we hope that the problems will be interpreted by more large sample data,so that new treatment methods will be found for diseases such as tumors in the future.Objective:To expore the expression levels of GSK-3?and E-cadherin in endometrial adenocarcinoma(EAC)tissues,to analyze the relationship between the expression levels of two genes and biological characteristics and prognosis.Methods:From 2010 to 2013,86 specimens of normal and diseased endometrial tissue were collected from Department of Gynaecology the First Affiliated Hospital of Henan University of Science and Technology.According to the histological type,they were divided into three groups:normal proliferative endometrium group(12 cases),endometrial atypical hyperplasia group(19 cases),endometrial adenocarcinoma group(55 cases).The expression of GSK-3?protein and E-cadherin protein in three groups was detected by immunohistochemical SP technique.The staging of endometrial adenocarcinoma was performed using surgical pathological staging(FIGO,2009):37cases from stage I to stage II,18 cases from stage III to stage IV,including 17 cases of lymph node metastasis.None of the patients with tissue specimens had any other malignant tumors.The patients were not treated with radiotherapy or chemotherapy before surgery.The specimens were confirmed by pathology after operation.The selected cases were fixed in 10%formalin solution,embedded in paraffin,and serially sliced to a thickness of 4?m.Statistical analysis was performed using SPSS19.0 software.The count data were expressed in frequency or percentage.The comparison was performed by?~2 test or Fisher's accuracy test,Spearman rank sum method was used for correlation analysis,and Kaplan-meier method was used for survival analysis,applying P<0.05 as the difference was statistically meaning.Results:GSK-3?is mainly located in the cytoplasm,and the positive expression is yellow,brownish yellow and tan.The positive rates of GSK-3?in the normal proliferative endometrium group,endometrial atypical hyperplasia group and endometrial adenocarcinoma group were 83.3%,78.9%and 36.4%respectively.The difference among the three groups was statistically significant(?~2=15.640,P<0.05).The expression of GSK-3?in endometrial adenocarcinoma tissues decreased with the progression of surgical pathological staging(P<0.05),but it was not associated with histological pathological grade,muscle layer infiltration,lymph node metastasis or age.(P>0.05).E-cadherin is mainly located in the cell membrane,and the positive expression is yellow,brownish yellow and tan.The positive rates of E-cadherin in the normal proliferative endometrium,endometrial atypical hyperplasia group,and endometrial adenocarcinoma group were 91.7%,73.7%and 21.8%,respectively.The difference among the three groups was statistically significant(?~2=28.959,P<0.05).The expression of E-cadherin in endometrial adenocarcinoma tissues decreased with the increase of pathological grade(P<0.05),but not with surgical pathological stage,invasive muscle depth,lymph node metastasis and age(P>0.05).Spearnman correlation analysis showed that there was a positive correlation between the expression of GSK-3?and E-cadherin in 55cases of endometrial adenocarcinoma(r_s=0.516,P<0.05).Conclusion:1.The positive expression of GSK-3?and E-cadherin in the normal proliferative endometrium,endometrial atypical hyperplasia group and endometrial adenocarcinoma group showed a decreasing trend.It is suggested that both GSK-3?and E-cadherin may play the role of tumor suppressor genes.2.The positive expression of GSK-3?in endometrial adenocarcinoma decreased with the increase of surgical pathological staging.The positive expression of E-cadherin in endometrial adenocarcinoma decreased with the increase of pathological grade.The positive expression of GSK-3?and E-cadherin was not significantly associated with lymph node metastasis and age.It is suggested that both may play a role in the progression of endometrial adenocarcinoma invasion..3.GSK-3?and E-cadherin promote each other,and may play independent and synergistic tumor suppressor genes in the occurrence and development of endometrial adenocarcinoma;they may provide reference value for the mechanism,treatment and prognosis of endometrial adenocarcinoma,and they were expected to become a molecular targeted therapeutic points and tumor markers.