Correlation Between ERRγ And Clinical Characteristics And Myometrial Invasion Of Endometrioid Endometrial Carcinoma With Metabolic Syndrome

Objective: To analyze the clinical characteristics of patients with both endometrioid endometrial carcinoma(EEC)and metabolic syndrome(MetS),and to investigate the expression of the metabolism-related gene—estrogen-related receptor γ(ERRγ)in EEC with MetS and its correlation with clinical characteristics and prognosis.Methods:1.1.A total of 473 patients diagnosed with EEC and hospitalized in Fujian Maternal and Child Health Hospital from June 2012 to December 2018 were included.Among them,89 patients with MetS comprised the observation group and 384 patients the control group.The clinical data and prognostic characteristics of the two groups were analyzed retrospectively.To analyze the relationship between RBC and Hb and MetS-related components,red blood cell count(RBC)and hemoglobin(Hb)levels were divided into quartiles.2.A total of 79 EEC tissue samples were collected between 2012 and 2018.The expression of ERRγ in the tissues was analyzed by immunohistochemistry.The relationship between ERRγ and RBC,MetS and their components were analyzed.The risk correlation between ERRγ and EEC myometrial invasion was analyzed.Results:1.The RBC and Hb levels were significantly higher in the observation group than in the control group(P = 0.008;P = 0.024).The RBC and Hb values increased with the number of MetS components.2.The risk of deep myometrial invasion in the observation group was significantly higher than in the control group(OR = 2.857,95% confidence interval [CI] =1.738-4.698,P < 0.001).There was no significant difference in International Federation of Gynecology and Obstetrics(FIGO)stage,lymphatic invasion,and histological grade between the two groups.In the observation group,the lowest RBC level(Q1)was a risk factor for deep myometrial invasion(P < 0.05).3.The expression of ERRγ was positive in EEC tissues,and the expression of ERRγin the tissues of the patients with MetS was higher than in those without MetS.The expression level of ERRγ was negatively correlated with RBC,and the expression of ERRγ in the low RBC group was higher than that in the normal RBC group.Further,high expression of ERRγ was associated with deep myometrial invasion;the expression of ERRγ in the deep myometrial invasion group was higher than that in the superficial myometrial invasion group.Therefore,ERRγ may be an independent risk factor for EEC myometrial invasion.Conclusion:1.Increased blood RBC is one of the characteristic manifestations in EEC patients with MetS.Low RBC levels are an early indicator for myometrial invasion in EEC with MetS.2.The expression of ERRγ protein is increased in EEC patients with MetS,and the high expression of ERRγ may inhibit erythropoiesis,which is a risk factor for myometrial invasion of EEC.Targeted inhibition of ERRγ may be a novel strategy for the treatment of EEC invasion and metastasis.