The Expression And Significance Of P27,eIF4E,NF-kB,PTEN In Endometrial Intraepithelial Neoplasia And Endometrioid Carcinoma

Objective:Endometrial carcinoma is the most common malignant tumor of the female reproductive system in the developed countries.With the improvement of people's living standard and the change of living habits,the incidence of endometrial carcinoma is gradually increasing.The study of endometrial precarcinomaous lesions has been a hot and difficult point in the research of Obstetrics and Gynecology and pathology.For a long time,endometrial hyperplasia is considered the precarcinomaous lesion of endometrial carcinoma.The pathological classification of endometrial hyperplasia is multifarious.It was divided into simple hyperplasia,complex hyperplasia,simple atypical hyperplasia and complex atypical hyperplasia by WHO in 1994.The method was poor repeatability and strong subjectivity after years of clinical practice.The concept of endometrial intraepithelial neoplasia?EIN?was proposed by Mutter in 2000,and it was thought to be the precarcinomaous lesions of endometrial carcinoma.Because of the strict morphological diagnostic criteria of EIN,goodrepeatability andstrong objectivity,it has become a new bright spot in the fieldof endometrial precancerous lesions.This research aim at detecting the expression levels of P27,eIF4E,NF-?B,PTEN in proliferative endometrium,simple and complex endometrial hyperplasia,EIN,endometrioid carcinoma and analyzes their correlations,and explores their role in the occurrence and development of endometrial carcinoma.Method:Reviewed routine HE slices of curettage of endometrial specimens,which were from General Department of Pathology in General Hospital of Tianjin Medical University from 2013 to 2014,then selected 10 cases of proliferative endometrium,15 cases of simple endometrial hyperplasia,15 cases of complex endometrial hyperlasia;According to the EIN diagnostic criteria^[3]reviewed section,and found out 48 cases of EIN and randomly selected 25 cases;20 cases of endometrioid carcinoma.Immunohistochemical SP method was used to detect the expression of P27,eIF4E,NF-?B and PTEN in each experimental group.The date was analyzed by SPSS17.0 software package?Mann-Whitney U test,Wilcoxon test,Spearman correlation analysis?.Results:1.The expression of P27 in proliferative endometrium,simple hyperplasia,complex hyperplasia,EIN and endometrial carcinoma was gradually decreased.There were statistical significance in the EIN and the proliferative endometrium,simple hyperplasia and complex hyperplasia?P<0.01?.Although the positive rate of P27 in endometrial carcinoma is lower than the EIN,but it did not show statistical significance?Z=-1.777,P=0.076>0.05?.2.eIF4E was highly expressed in EIN and endometrial carcinoma,with low expression in proliferative endometrium,simple and complex hyperplasia,and a significant difference between groups?P<0.05?,EIN and endometrial carcinoma have statistically significant difference?P<0.05?.3.The positive rate of NF-nuclear factor kappa B in the proliferative endometrium,simple hyperplasia and complex hyperplasia,EIN increasingly in turn,and the difference was statistically significance?P<0.05?.There was no significant difference in endometrial carcinoma and EIN?P>0.05?.4.The positive rate of PTEN in proliferative endometrium was 100%,endometrial carcinoma and EIN?30%and 48%?were significantly lower than proliferative endometrium,simple hyperplasia and complex hyperplasia?P<0.01?,and the comparativedifferencesbetweengroupswerestatisticallysignificant?Z=-2.649,P=0.008<0.01?.Conclusions:1.The expression rate of P27 and PTEN in proliferative endometrium,simple and complex hyperplasia,EIN,endometrial carcinoma were gradually reduced,and showed significant differences between groups.At the same time,there was a positive correlation between P27 and PTEN.It was suggested that P27 and PTEN might gradually loss in the process of the development of endometrium hyperplasia,EIN and carcinoma.It illustrated that the function of P27 inhibition of cell cycle regulation was weakened,and PTEN inactivated gradually.Then speculated that it could affect the expression of related genes,which lead to cell proliferation is out of control,and promote to occurrence and development of endometrial carcinoma cooperatively.2.The expression of eIF4E and NF-nuclear factor kappa B in EIN and endometrial carcinoma was significantly higher than that in the proliferative endometrium,simple and complex hyperplasia.The significant difference of eIF4E was existed in each group,and the expression of the NF-nuclear factor kappa B was not significant difference in EIN and endometrial carcinoma.There was positive correlation between eIF4E and NF-nuclear factor kappa B.That eIF4E and NF-nuclear factor kappa B in the development of endometrial carcinoma were activated and promoted the transcription and translation of related protein,and then malignant protein production increased.It might exist in the mutual regulation and jointly promote the formation of endometrial carcinoma.3.The expression of PTEN and eIF4E was statistically significant difference in EIN and endometrial carcinoma,but P27 and NF-nuclear factor kappa B was not.The combination of PTEN and eIF4E may contribute to the detection of EIN and endometrial carcinoma,however,the effects remain to be studied.