Analysis Of The Clinicopathological Features And Prognostic Factors Of Ki67,P53,HER2,ER,PR And Endometrial Carcinoma

Objective Endometrial cancer is one of the three major reproductive malignancies that threaten women's health.The incidence of endometrial cancer is increasing year by year.Endometrial cancer is a kind of hormone related malignant tumor.Its development mechanism is related to many tumor suppressor genes,proto oncogenes,other proliferating molecules and hormone receptors.In recent years,the role of immunohistochemical indexes in EC has been studied more and more widely,but most of them are single indexes.In this study,several immunohistochemical indexes,including Ki67,p53,HER2,ER,PR,were included to explore the relationship between them and the clinicopathological characteristics of EC patients and the prognosis of EC patients,so as to provide reference for clinical individualized treatment.Method 190 cases of endometrial cancer patients who met the inclusion criteria from March 2013 to August 2019 were collected from the Department of Obstetrics and Gynecology of Subei People's Hospital of Jiangsu Province.The clinicopathological data were analyzed retrospectively.SPSS24.0 was used to analyze the data.Result 1.Expression of Ki67 in EC and its meaning: the expression of Ki67 was positively correlated with the depth of muscular infiltration,lymph node metastasis,tumor histological grade,vascular infiltration and surgical pathological stage(P < 0.05),but no statistically significant correlation with the type of menopause and endometrial cancer.2.The expression of p53 in EC and its meaning: the expression of p53 was positively correlated with vascular invasion and tumor histological grade.The expression level of p53 increased with tumor histological grade and presence of vascular invasion(P<0.05).There was no significant correlation between the expression of p53 and menopause,endometrial cancer type,myometrial invasion depth,tumor stage and lymph node metastasis.3.Expression of HER2 in EC and its meaning: there was a positive correlation between HER2 expression and menopause and myometrial invasion depth(P < 0.05).There was no statistical significance between HER2 expression and endometrial cancer classification,tumor tissue classification,vascular invasion,tumor stage and lymph node metastasis.4.Expression of ER in EC and its significance: the expression of ER was negatively correlated with endometrial cancer classification,tumor tissue classification,depth of muscle infiltration,vascular infiltration,tumor stage and lymph node metastasis,and showed significant differences(P < 0.05).However,there was no significant correlation between the positive expression of ER and menopause.5.Expression of PR in EC and its significance: the expression of PR was negatively correlated with menopausal status,different types of endometrial cancer,tumor histological grading,depth of muscle layer invasion,vascular invasion,tumor stage and lymph node metastasis,with significant differences(P < 0.05).6.Single factor analysis showed that the prognosis of patients with endometrial carcinoma: type II EC,surgical pathological staging night,infiltration depth,a vascular infiltration,muscular,and lymph node metastasis positive,different surgical procedure and postoperative adjuvant therapy is not perfect,high P53 expression,HER2 expression,low ER and PR expression in patients with poor prognosis,with statistical difference(P < 0.05),and menopausal status,organization classification,Ki67 expression level not statistically related with prognosis.COX multivariate regression analysis of patients with endometrial cancer showed that: high expression of ER(OR:0.337,95%CI: 0.141-0.809,P < 0.05),high expression of HER2(OR: 6.635,95%CI:1.750-25.154,P < 0.05),type II endometrial cancer(OR: 17.341,95%CI:2.469-121.808,P < 0.05)and muscle infiltration ?1/2(OR: 20.004,95%CI :1.957-204.526,P < 0.05)the difference was statistically significant(P < 0.05).7.Combine immunohistochemical index of ER,PR,and HER2 expression level,the endometrial cancer is divided into four groups,group A: ER(-),PR(-),and HER2(-),group B: ER(-),PR(-),and HER2(+),group C: ER(+)and/or PR(+)and HER2(-),group D: ER(+)and/or PR(+)and HER2(+).The 3-year survival rates were 85.7%,50.0%,98.3% and 93.8%,respectively.The prognosis of group B was worse than that of other groups,and the difference was statistically significant(P=0.001).Conclution 1.The expressions of Ki67,P53,HER2,ER and PR are closely related to the biological behavior of endometrial malignant tumor cells,and the detection of the expression of these immune indicators can help to predict endometrial cancer,evaluate the prognosis of patients and provide individualized treatment.2.Type II endometrial carcinoma,late surgical pathological stage,deep muscle layer infiltration,vascular infiltration,positive lymph node metastasis,incomplete postoperative adjuvant therapy,high expression of P53,high expression of HER2,low expression of ER and low expression of PR suggest poor prognosis and are risk factors for the prognosis of endometrial cancer.3.In this study,ER,PR and HER2 expression levels were combined to predict the prognosis of patients with endometrial cancer,and the prognosis of patients with ER negative,PR negative and HER2 positive was worse than that of other groups.