Abstract
BackgroundIt is well-known that the treatment and monitoring methods are limited for advanced stage of endometrial carcinoma. Biological molecules with expression changes during tumor progression become potential therapeutic targets for advanced stage endometrial carcinoma. Annexin A2 (ANXA2) has been reported to be overexpressed in recurrent endometrial carcinoma, and the expression of human epididymis protein 4 (HE4) is upregulated in endometrial carcinoma. What’s more, ANXA2 and HE4 interacted in ovarian cancer and promoted the malignant biological behavior. We speculated that their interaction may exist in endometrial carcinoma as well. We evaluated the expression and the correlation relationship of ANXA2 and HE4 in endometrial carcinoma.MethodsThe expression of ANXA2 and HE4 protein in 84 endometrial carcinoma, 30 endometrial atypical hyperplasia, and 18 normal endometrial tissue samples were then measured using an immunohistochemical assay in paraffin embedded endometrial tissues. The structural relationship between ANXA2 and HE4 was explored by immunoprecipitation and double immunofluorescent staining.ResultsANXA2 and HE4 co-localized in both endometrial tissues and endometrial carcinoma cells. ANXA2 and HE4 were expressed in 95.2 % and 85.7 % of the the endometrial carcinoma, respectively, which were significantly higher than normal endometrium (55.6 % and 16.7 %, both p < 0.05). The expression of ANXA2 and HE4 was significantly correlated with FIGO stage, degree of differentiation, myometrial invasion, and lymph node metastasis. ANXA2 was an independent risk factor for the prognosis of endometrial carcinoma (p < 0.05, hazard ratio [HR] = 8.004). The expression of ANXA2 and HE4 was positively correlated (Spearman correlation coefficient = 0.228, p < 0.05). HE4 was an independent factor for ANXA2 in multivariate linear regression model (p < 0.05).ConclusionWe revealed the co-localization of ANXA2 and HE4 in endometrial carcinoma. Expression levels of ANXA2 and HE4 were closely related to the malignant biological behavior of endometrial carcinoma, and ANXA2 was an independent risk factor for poor prognosis. The expression of ANXA2 and HE4 can affect each other.Electronic supplementary materialThe online version of this article (doi:10.1186/s13046-015-0208-8) contains supplementary material, which is available to authorized users.
Highlights
It is well-known that the treatment and monitoring methods are limited for advanced stage of endometrial carcinoma
Researchers have identified a large number of new biomarkers that can be used to evaluate the prognosis of endometrial carcinoma and monitor recurrences [7,8,9,10,11,12], and some molecules associated to the tumorigenesis of endometrial carcinoma [13]; no biomarker has been used in clinical application
Immunofluorescence revealed co-expression of Annexin A2 (ANXA2) labeled by red fluorescence and human epididymis protein 4 (HE4) labeled by green fluorescence in the cell membrane and cytoplasm of endometrial carcinoma cell lines (Fig. 2B) and different endometrial tissues (Fig. 3B), and the overlapping orange fluorescence observed at the expression sites suggested co-localization of ANXA2 and HE4
Summary
It is well-known that the treatment and monitoring methods are limited for advanced stage of endometrial carcinoma. What’s more, ANXA2 and HE4 interacted in ovarian cancer and promoted the malignant biological behavior We speculated that their interaction may exist in endometrial carcinoma as well. Treatment options are limited for patients with metastases in advanced stages or recurrent endometrial carcinoma; there is no significant effect using combined chemotherapy and radiotherapy or novel molecular-targeted drugs [2, 3]. Biological molecules with expression changes during tumor progression become potential therapeutic targets for advanced stage endometrial carcinoma. Researchers have identified a large number of new biomarkers that can be used to evaluate the prognosis of endometrial carcinoma and monitor recurrences [7,8,9,10,11,12], and some molecules associated to the tumorigenesis of endometrial carcinoma [13]; no biomarker has been used in clinical application
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