The role of immunohistochemical adrenomedullin and Bcl-2 expression in development of type-1 endometrial adenocarcinoma: Adrenomedullin expression in endometrium

Pathol Res Pract. 2016 May;212(5):450-5. doi: 10.1016/j.prp.2016.02.021. Epub 2016 Feb 27.

Abstract

Background: Adrenomedullin (AM) is a pluripotent peptide first discovered from human pheochromocytoma. AM expression has been shown in various cancer types including endometrium cancer. Bcl-2 is an antiapoptotic protein which might be regulated by AM in hypoxic conditions. The aim of the present study was to investigate the role of AM and Bcl-2 expressions in carcinogenesis of type-1 endometrium cancer.

Materials and method: Study group consisted of 10 proliferative endometrium, 22 simple endometrial hyperplasia, 23 endometrial intraepithelial neoplasia (EIN) and 30 Grade 1 endometrioid adenocarcinoma patients. AM and Bcl-2 expressions were investigated by immunohistochemistry.

Results: Mean AM Allred score was 3±2.6, 5.6±1.6 and 5.7±2.5 in benign, EIN and adenocarcinoma groups, respectively. AM expression was significantly higher in EIN and adenocarcinoma groups than in benign endometrium group (p<0.05). Mean Bcl-2 Allred score was 6.4±2.1, 5.2±2.6, 2.3±2 in benign endometrium, EIN and adenocarcinoma groups, respectively. Mean Bcl-2 Allred score was similar between benign endometrium and EIN groups (p>0.05). However, it was significantly lower in adenocarcinoma group (p<0.05). An inverse correlation between AM and Bcl-2 expressions was found (r: -0.4, p<0.001).

Conclusions: Our findings showed that AM expression increased in progression from benign endometrium to EIN and type-1 adenocarcinoma while expression of Bcl-2 decreased in transition from EIN to carcinoma.

Keywords: Adenocarcinoma; Adrenomedullin; Bcl-2; EIN; Endometrium.

MeSH terms

  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / pathology
  • Adrenomedullin / metabolism*
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Endometrial Hyperplasia / metabolism
  • Endometrial Hyperplasia / pathology
  • Endometrial Neoplasms / metabolism*
  • Endometrial Neoplasms / pathology
  • Endometrium / metabolism*
  • Endometrium / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Neoplasm Grading
  • Proto-Oncogene Proteins c-bcl-2 / metabolism*

Substances

  • Proto-Oncogene Proteins c-bcl-2
  • Adrenomedullin