Correlation Of Estrogen Receptor β5 Expression And Endometrial Carcinogenesis

Background and objective: Endometrial carcinoma is one of the most malignant cancers in women,which severely threatens women’s health,and has even become the most malignant tumor in gynecology in some developed countries.Although traditional surgery and radiotherapy and chemotherapy are currently the first-line EC treatment methods,they are traumatic and affect the quality of life of patients after treatment.Although progestogens can reverse endometrial lesions and now are currently an effective conservative treatment,there is a lack of effective evaluation indicators for the prognosis of conservative treatment.Previous studies have confirmed that estrogen receptor expression is associated with endometrial cancer,but few explore the correlation of their variants and endometrial cancer.We intend to explore the expression of estrogen receptor variant 5(ERβ5)of different endometrial lesions.Methods: 171 patients with and without endometrial lesions were selected and divided into 4 groups: 43 cases of normal endometrium,42 cases of endometrial hyperplasia without atypia,43 cases of atypical hyperplasia and 43 cases of endometrial cancer.We detected the expression of ERβ5 in these cases by immunohistochemical method.We used the statistical software Empower Stats 2.0 to analyze data,continuous variables were expressed as the means ± standard deviations and categorical variables were expressed as a frequency or percentages.We used the one-way ANOVA and Chi-square test to see if there were any significant differences between groups,and P values less than 0.05 were considered statistically significant.The diagnostic significance was estimated by the area below the curve.Results: 171 patients were participated in our study.The mean age was 48.05±9.30 years,and mean ERβ5 expression was 7.88%±8.57%.ERβ5 expression detected in different endometrial lesions was normal endometrium(NE)4.24%±5.17%,simple hyperplasia endometrium(EH)5.74%±6.50%,atypical hyperplasia endometrium(AH)9.69%±9.59%,neoplastic endometrium(EC)11.78%±10.00%.ERβ5 expression in AH and EC groups were obviously higher than EH and NE groups(P<0.01).Comparison between two groups showed that there was a statistical difference between NE and AH group(P=0.0111),between NE and EC group(P=0.0001),and between EH and EC group(P=0.0040).There was no significant difference in ERβ5expression among other groups.In endometrial cancer,ERβ5 expression in high,middle and low differentiation was 11.68%±6.74%,9.45%±11.37%,14.82%±11.38%,separately.Comparison between two groups showed that ERβ5 expression was not related to their histological differentiation(P>0.05).Diagnostic efficacy of ERβ5 in endometrial cancer was area under curve(AUC)0.72,and its optimal diagnostic value was: 5.84%,maximum AUC corresponding sensitivity 69.77%,specificity 69.53%,accuracy 69.59%,positive predictive value 43.48%,negative predictive value 87.25%,positive likelihood ratio 2.2898,negative likelihood ratio0.43,95% CI 0.64-0.80.Conclusion:1)The ERβ5 expression is correlated with the degree of endometrial lesions.2)The ERβ5 expression is not related to different histological differentiation of endometrial cancer.3)The ERβ5 has a certain diagnostic effect on distinguishing non-cancerous,precancerous and endometrial cancers,and can be used as an auxiliary means of pathological examination.