Abstract
Background:Ezrin is a cell membrane-cytoskeleton linker that is essential to maintain the normal cell shape and the integrity of cell-cell adhesion. Overexpression of ezrin is correlated with poor prognosis in several malignancies. Aim: To evaluate the expression of ezrin in hyperplastic and neoplastic endometrial tissues and to correlate its expression with the clinical and pathological parameters of endometrial carcinoma. Methods: Tissue sections of 66 specimens including 37 endometrial carcinoma, 16 atypical endometrial hyperplasia and 13 benign endometrial hyperplasia were evaluated for ezrin expression by immunohistochemistry. Results: Ezrin expression was detected in all endometrial carcinoma specimens and in 90% of hyperplasia. There was redistribution of ezrin from membranous expression in endometrial hyperplasia to diffuse cytoplasmic expression in endometrial carcinoma (p < 0.0001). Expression of ezrin was significantly higher in atypical compared to benign hyperplasia (p < 0.001) and it was relatively higher in endometrial carcinoma compared to atypical endometrial hyperplasia (p=0.086). Among the carcinoma specimens, expression of ezrin was significantly associated with invasion of myometrium (p=0.001), higher FIGO stage (p=0.008) and the presence of vascular tumor emboli (p=0.001). Muscle-invasive tumor cells expressed significantly higher levels of ezrin compared to non-invasive cells of the same tumor tissue (p < 0.0001). Tumor size, tumor grade and villoglandular morphology did not correlate significantly with ezrin expression. Conclusion: Ezrin was overexpressed in endometrial carcinoma and its expression was associated with the invasive potential of tumor cells.
Highlights
Ezrin is a member of Ezrin-Radixin-Moesin (ERM) family of proteins
The expression was demonstrated as a brownish cytoplasmic and membranous staining (Figure 1) with a significant tendency at concentration to luminal border of endometrial glands in cases of endometrial hyperplasia compared to cytoplasmic expression in cases of endometrial carcinoma [χ2 [1] =14.9, p
When evaluated by Western blot analysis and immunehistochemistry in another study 16, ezrin protein was higher in tissues of endometrial adenocarcinoma and atypical endometrial hyperplasia compared to normal endometrial tissue and simple endometrial hyperplasia
Summary
Ezrin is a member of Ezrin-Radixin-Moesin (ERM) family of proteins These proteins are critical for the integrity and stability of surface epithelium. Ezrin is expressed as a single isoform in mammals with a structurally conserved 30kDa composite domain 4. It is a cell membranecytoskeleton cross-linker that is enriched in microvilli and surface epithelia. Ezrin is a cell membrane-cytoskeleton linker that is essential to maintain the normal cell shape and the integrity of cell-cell adhesion. Expression of ezrin was significantly associated with invasion of myometrium (p=0.001), higher FIGO stage (p=0.008) and the presence of vascular tumor emboli (p=0.001). Conclusion: Ezrin was overexpressed in endometrial carcinoma and its expression was associated with the invasive potential of tumor cells
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