Maspin and GLUT-1 expression in endometrial carcinomas and prognostic relevance

INTRODUCTION: Although the expression of both maspin and GLUT-1 have been shown to increase in many human cancers such as endometrioid carcinoma, their long-term prognostic relevance has not yet been established. The aim of our study is to investigate the overexpression of maspin and GLUT-1 in malignant endometrial tissues, to evaluate its role in the neoplastic progression to an endometrioid carcinoma, to establish prognostic clinical parameters and to predict survival.
METHODS: The sample participants comprised of 68 patients with endometrioid adenocarcinoma and 68 patients with benign endometrial tissues. The immunostaining pattern for maspin was accepted as nuclear. Nuclear staining of tumoral tissues and normal endometrial tissues were scored according to cell ratios as follows: negative staining <25%; positive staining 25% - 100%. The linear staining pattern for GLUT-1 was accepted as membranous. The percentage of positively stained tumor cells in the tissue samples were semi-quantitatively determined with negative staining <5% and positive staining 5% - 100%. The follow-up period ranged from 6 to 60 months with a mean of 53,8 months. Primary end points were determined as all-cause mortality.
RESULTS: The immunohistochemical expression of GLUT-1 and Maspin were significantly higher in endometrioid carcinoma (p<0.001). There was no statistically significant difference between survival and GLUT-1. Although the survival in patients with maspin staining was lower, statistical significance was not reached (p=0.08). In patients with positive maspin staining, the prognosis is much worse. While GLUT-1 plays an important role in the progression and metastasis of tumors, its activity was not observed in tissues with overexpressed maspin.
DISCUSSION AND CONCLUSION: While GLUT-1 is an important immunostaining marker for tumor progression and metastasis, maspin has been identified to be more effective as a prognostic parameter in endometrioid carcinoma.

Endometriyum kanserinde maspin ve GLUT-1 ekspresyonu ve prognoz iliþkisi

GÝRÝÞ ve AMAÇ: Hem maspin hem de GLUT-1 ekspresyonu, endometrioid karsinom gibi birçok insan kanserlerini arttýrdýðý gösterilmiþ olmasýna raðmen, bunlarýn uzun dönemde hastalýðýn prognozuyla ilgisi belirlenmemiþtir.Çalýþmamýzýn amacý, malign endometrial dokularda maspin ve GLUT-1'in aþýrý ekspresyonunu araþtýrmak, endometrioid karsinoma gibi neoplastik dokularda progresyondaki rolünü deðerlendirmek, saðkalýmý öngörmedeki rolünü araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya endometrioid adenokarsinomlu 68 hasta ve iyi huylu endometrial dokuya sahip 68 hasta olmak üzere iki grup alýndý. Maspin için immünohistokimyasal boyama nükleer ( çekirdek) olarak kabul edildi. Tümör dokularýnýn ve normal endometriyal dokularýn nükleer boyanmasý, hücre oranlarýna göre þu þekilde skorlandý: negatif boyama <% 25; pozitif boyama % 25 -% 100. GLUT-1 için boyama modeli membranöz olarak kabul edildi. Doku örneklerinde pozitif boyanmýþ tümör hücrelerinin yüzdesi yarý nicel olarak <% 5 negatif boyama ve % 5 -% 100 pozitif boyama ile belirlendi. Takip süresi 6 ila 60 ay arasýnda ve ortalama 53,8 ay idi.Birincil son noktalar tüm nedenlere baðlý ölüm olarak belirlenmiþtir.
BULGULAR: GLUT-1 ve Maspin'in immünohistokimyasal ekspresyonu endometrioid karsinomda belirgin bir þekilde daha yüksekti (p <0.001). Saðkalým ile GLUT-1 arasýnda istatistiksel olarak belirgin bir fark yoktu.Maspin boyalý hastalarda saðkalým oraný düþük olmasýna raðmen istatistiksel olarak anlamlý fark elde edilmedi (p = 0,08). Maspin pozitif olan hastalarda prognoz çok daha kötüdür. GLUT-1, tümörlerin prognozunda ve metastazýnda önemli bir rol oynarken, aþýrý eksprese maspinli dokularda aktivitesi gözlenmedi.
TARTIÞMA ve SONUÇ: GLUT-1, tümör ilerlemesi ve metastazý için önemli bir immün boyama belirteci iken, maspin endometrioid karsinomda prognostik bir parametre olarak daha etkili olduðu tespit edilmiþtir.