Kikalishvili N, Beriashvili R, Muzashvili T, Burkadze G
Tbilisi State Medical University, Georgia.
Georgian Med News. 2018 Mar(276):117-123.
Endometrial neoplasia is the most common malignant tumor of female genital system in developed countries. The incidence of endometrial cancer has increased in the last years and despite advances in diagnosis and treatment, the death rates have steadily been increasing over the past 20 years. Therefore aspects of endometrial cancer development, pathogenesis and effective treatment is especially urgent to this day, as much of the risk for endometrial cancer development is influenced by the environment and lifestyle. Endometrial stem cells take the special place among somatic stem cells of female reproductive system-the detection of them and identification of their location in the complex cellular hierarchy still remains challenging. Further study of endometrial stem cells will clarify their role in gynecologic pathologies associated with hyper-proliferative states of endometrium. The aim of our study was to explore the specificities of endometrial proliferative/stem cell index distribution under endometrioid carcinoma of different grade of malignancy. The study represents a retrospective research. The coded and depersonalized material data from Acad. N. Kipshidze Central University Clinic was used in the study. 3 study groups - 1st study group "Endometrioid Carcinoma Grade 1" (14 cases), 2nd study group "Endometrioid Carcinoma Grade 2" (23 cases) and 3rd study group "Endometrioid Carcinoma Grade 3" were selected from routine histopathology tissue specimens of uterus. Hematoxilyn-eosin technology and immunohistochemistry with proliferation marker ki67 and stem cell marker CD146 was performed. The proliferative/stem cell index was calculated by the ratio of Ki67-positive cell percentage value divided by CD146-positive cell percentage value. The study showed that in the 1st study group labeled as "Endometrioid Carcinoma Grade 1", the proliferative/stem cell index ranges between 21.7 and 25.5. Its mean average value in the age distribution subgroups accounts for: 1.1) reproductive age - 22.4; 1.2) menopause - 23.5; 1.3) post-menopause - 24.8. Proliferative/stem cell index reaches its maximum in the samples retrieved from post-menopause age, and decreases significantly in reproductive age individuals. In the 2nd study group labeled as "Endometrioid Carcinoma Grade 2", the proliferative/stem cell index increases and ranges within the interval 23.2-27.8. Its mean average value in the age distribution subgroups accounts for: 2.1) reproductive age -23.7; 2.2) menopause - 24.2; 2.3) post-menopause - 25.8. In the 3rd study group labeled as "Endometrioid Carcinoma Grade 3", the proliferative/stem cell index markedly increases and ranges within the interval 25.8-29.4. Its mean average value in the age distribution subgroups accounts for: 3.1) reproductive age - 28.4; 3.2) menopause - 28.5; 3.3) post-menopause - 28.5. It was found that average value of proliferative/stem cell index in the 1st and 2nd study groups (EC Grade 1/2) keeps the same tendencies of increase in age subgroups as well as at endometrial hyperplasia conditions - in particular in both study groups increase in value of the proliferative/stem cell index in age subgroups makes about 1% (1st study group-0,97%, 2nd study group-0,96%). What about 3rd study group (EC Grade 3) average value of proliferative/stem cell index in age subgroups is almost the same. It was found that average value of proliferative/stem cell index in endometrioid carcinoma most markedly differs from the norm in post-menopause period. The study showed that average value of proliferative/stem cell index in endometrioid carcinoma cases (EC Grade 1/2) tends to increase with age like endometrial hyperplasia conditions, in contrast with the norm, where it is observed to progressively decrease with aging. The attention should be given to the fact that the mean average value of proliferative/stem cell index in endometrioid carcinoma Grade 3 is almost constant.
子宫内膜肿瘤是发达国家女性生殖系统最常见的恶性肿瘤。近年来，子宫内膜癌的发病率有所上升，尽管在诊断和治疗方面取得了进展，但在过去20年中死亡率却一直在稳步上升。因此，时至今日，子宫内膜癌的发生发展、发病机制及有效治疗等方面的研究尤为迫切，因为子宫内膜癌发生的许多风险都受到环境和生活方式的影响。子宫内膜干细胞在女性生殖系统的体细胞干细胞中占据特殊地位——对其进行检测并确定它们在复杂细胞层级中的位置仍然具有挑战性。对子宫内膜干细胞的进一步研究将阐明它们在与子宫内膜过度增殖状态相关的妇科疾病中的作用。我们研究的目的是探讨不同恶性程度的子宫内膜样癌中子宫内膜增殖/干细胞指数分布的特点。该研究为回顾性研究。研究使用了来自N. Kipshidze院士中央大学诊所的编码且去个性化的材料数据。从子宫的常规组织病理学组织标本中选取了3个研究组——第1研究组“1级子宫内膜样癌”（14例）、第2研究组“2级子宫内膜样癌”（23例）和第3研究组“3级子宫内膜样癌”。采用苏木精-伊红技术以及使用增殖标志物ki67和干细胞标志物CD146进行免疫组织化学检测。增殖/干细胞指数通过Ki67阳性细胞百分比值除以CD146阳性细胞百分比值来计算。研究表明，在标记为“1级子宫内膜样癌”的第1研究组中，增殖/干细胞指数在21.7至25.5之间。其在年龄分布亚组中的平均平均值为：1.1）育龄期——22.4；1.2）围绝经期——23.5；1.3）绝经后期——24.8。增殖/干细胞指数在绝经后年龄的样本中达到最大值，而在育龄期个体中显著降低。在标记为“2级子宫内膜样癌”的第2研究组中，增殖/干细胞指数升高，范围在23.2 - 27.8之间。其在年龄分布亚组中的平均平均值为：2.1）育龄期——23.7；2.2）围绝经期——24.2；2.3）绝经后期——25.8。在标记为“3级子宫内膜样癌”的第3研究组中，增殖/干细胞指数显著升高，范围在25.8 - 29.4之间。其在年龄分布亚组中的平均平均值为：3.1）育龄期——28.4；3.
