Analysis of influencing factors of loss of MMR protein expression in postmenopausal patients with endometrial carcinoma
Objective To explore the influencing factors of loss of mismatch repair(MMR)protein expression in postmenopausal patients with endometrial carcinoma.Methods A total of 62 postmenopausal patients undergoing surgery for endometrial cancer were selected.Based on the expression of mismatch repair proteins,22 patients with loss of one or more mismatch repair proteins were included in the microsatellite instability(MSI)group,and 40 patients with no loss of four mismatch repair proteins were included in the microsatellite stability(MSS)group.The clinical data[age,age of menopause,body mass index(BMI),endometrial thickness,gravida,serum carcinoembryonic antigen(CEA),testosterone(T)]of the two groups were analyzed statistically.The influencing factors of mismatch repair protein expression in postmenopausal endometrial carcinoma patients were analyzed by Logistic regression.The predictive value of serum T and CEA levels on the loss of mismatch repair protein expression in postmenopausal patients with endometrial carcinoma was analyzed.Results There were no significant differences in age,age of menopause,endometrial thickness and gravida between the two groups(P>0.05).The serum CEA,T level and BMI in MSI group were(13.81±1.06)ng/ml,(59.94±9.16)ng/dl and(27.18±2.59)kg/m2,and those in MSS group were(10.98±1.84)ng/ml,(52.16±11.31)ng/dl and(24.75±0.86)kg/m2.Compared with MSS group,the serum CEA and T level and BMI in MSI group were higher,and the differences were significant(P<0.05).Serum CEA,T and BMI levels of postmenopausal patients with endometrial carcinoma were taken as covariables,and the expression of mismatch repair protein was taken as dependent variables(MSS=1,MSI=0).Logistic regression analysis showed that elevated serum CEA,T and BMI levels were influencing factors for loss of mismatch repair protein expression in postmenopausal patients with endometrial carcinoma[OR(95% confidence interval)=0.217(0.093,0.507);0.860(0.773,0.956);1.326(1.036,1.697);P<0.05].The loss of mismatch repair protein expression in patients with endometrial carcinoma was taken as state variable and serum T and CEA levels as test variables,and receiver operating characteristic(ROC)curve was drawn.The results showed that the area under the curve(AUC)of serum T and CEA levels in predicting the loss of mismatch repair protein expression in postmenopausal patients with endometrial carcinoma were 0.750 and 0.893,and all of them had predictive value.Conclusion Serum CEA and T levels are closely related to the loss of mismatch repair protein expression in postmenopausal patients with endometrial carcinoma,and the increase of their levels is an important factor affecting the loss of MMR protein expression in patients.Clinically,serum CEA and T levels can be detected to evaluate the possibility of loss of mismatch repair protein expression to speculate on the prognosis and optimize the therapeutic methods.
Endometrial carcinomaTestosteroneCarcinoembryonic antigenMismatch repair protein
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