Stavropoulos Aggelis, Varras Michail, Vasilakaki Thivi, Varra Viktoria-Konstantina, Varra Fani-Niki, Tsavari Aikaterini, Nonni Aphrodite, Kavantzas Nikolaos, Lazaris Andreas C
Forth Obstetrics and Gynecology Department, 'Elena Venizelou' General Hospital, Athens 11521, Greece.
Fifth Obstetrics and Gynecology Department, 'Elena Venizelou' General Hospital, Athens 11521, Greece.
Oncol Lett. 2020 Aug;20(2):1033-1054. doi: 10.3892/ol.2020.11690. Epub 2020 May 30.
Endometrial carcinoma is one of the most common types of gynecological cancer. A total of 99 cases of primary endometrial carcinoma were investigated for survivin expression by immunohistochemistry. Furthermore, the association between concomitant survivin, PTEN and p53 expression, and clinicopathological parameters was examined. Immunopositivity for survivin was identified in 88% of cases. Concomitant survivin, PTEN and p53 expression (staining scores and intensity) was observed in 60% of endometrial adenocarcinomas. A significant association was identified between the sum of staining intensity and scores of survivin immunopositive cells, and patient age (P=0.028), histological grade (P<0.001), clinical stage (P=0.018) and fallopian tube and/or ovarian invasion (P=0.039). A negative tendency for correlation was observed between surivin and PTEN immunostaining scores (P=0.062; ρ=-0.238). Specimens with high scores of survivin expression tended to show decreased scores of PTEN immunostaining, and vice versa. However, in circumstances with an increased co-expression of survivin and PTEN, a statistically significant association with histological types was observed (P=0.020). A statistically significant positive correlation was identified between survivin and p53 sum co-expression (P=0.008; ρ=0.300). Furthermore, a significant association was identified between survivin and p53 concomitant sum expression and age of patients (P=0.001), histological type (P=0.020), clinical stage (P=0.037), histological differentiation (P=0.001) and presence of fallopian tube and/or ovarian invasion (P=0.026). The present findings suggested that survivin may be an indicator of unfavorable outcome in older patients with endometrial carcinoma, in specific circumstances that are dependent on different concomitant genetic alterations and different combinations of molecular signaling pathways. Increased expression levels of survivin and PTEN may serve a role in the development of more aggressive endometrial carcinoma during their interaction. In addition, protein expression levels of survivin and p53 are positively correlated and may share a common molecular pathway to promote endometrial carcinogenesis. These findings provided evidence that survivin and p53 combined may be useful markers for the prediction of tumor behavior and prognosis.
子宫内膜癌是最常见的妇科癌症类型之一。通过免疫组织化学方法对99例原发性子宫内膜癌病例进行了生存素表达情况的研究。此外，还检测了生存素、PTEN和p53表达之间的相关性以及与临床病理参数的关系。88%的病例中检测到生存素免疫阳性。60%的子宫内膜腺癌中观察到生存素、PTEN和p53的共同表达（染色评分和强度）。生存素免疫阳性细胞的染色强度和评分总和与患者年龄（P = 0.028）、组织学分级（P < 0.001）、临床分期（P = 0.018）以及输卵管和/或卵巢侵犯情况（P = 0.039）之间存在显著相关性。生存素和PTEN免疫染色评分之间观察到负相关趋势（P = 0.062；ρ = -0.238）。生存素表达高分的标本往往显示PTEN免疫染色评分降低，反之亦然。然而，在生存素和PTEN共表达增加的情况下，与组织学类型存在统计学显著相关性（P = 0.020）。生存素和p53共表达总和之间存在统计学显著正相关（P = 0.008；ρ = 0.300）。此外，生存素和p53共同表达总和与患者年龄（P = 0.001）、组织学类型（P = 0.020）、临床分期（P = 0.037）、组织学分化（P = 0.001）以及输卵管和/或卵巢侵犯情况（P = 0.026）之间存在显著相关性。目前的研究结果表明，在特定情况下，生存素可能是老年子宫内膜癌患者预后不良的一个指标，这些情况取决于不同的伴随基因改变和分子信号通路的不同组合。生存素和PTEN表达水平的增加在它们相互作用过程中可能在更具侵袭性的子宫内膜癌的发生发展中起作用。此外，生存素和p53的蛋白表达水平呈正相关，可能共享一个促进子宫内膜癌发生的共同分子途径。这些发现提供了证据，表明生存素和p53联合可能是预测肿瘤行为和预后的有用标志物。
