The diagnostic and prognostic significance of L1 cell adhesion molecule, Sperm-associated antigen 9 and P53 expression in endometrial lesions (immunohistochemical study)

Abstract

Background Endometrial carcinoma is the most common invasive neoplasm of the female reproductive tract. L1 cell adhesion molecule (L1CAM), Sperm-associated antigen 9 (SPAG9), and P53 have a role in the process of tumorigenesis and progression of several human malignant tumors, however, the role of them in cancer of endometrium is still not clear. Aim The study was performed to evaluate L1CAM, SPAG9, and P53 expression about different clinicopathological parameters in endometrial endometrioid adenocarcinoma. Methods The immunohistochemical study was performed on 50 cases of endometrial lesions including endometrial hyperplasia without atypia (10 cases), endometrial hyperplasia with atypia (10 cases), and endometrial endometrioid carcinoma (30 cases). Immunohistochemical staining techniques were used to evaluate the role of L1CAM, P53, and SPAG9 in endometrial endometrioid adenocarcinoma (EEC) and their relation to different clinicopathological data and patient’s survival followed for 36 months. Results This study declared that both L1CAM and SPAG9 were found to be upregulated in EEC. Their over-expression was related to adverse clinicopathological parameters including high tumor grade, deep myometrial invasion, lymphovascular Invasion (LVI), and advanced tumor stage, while there was no significant relation between their expression and tumor size, cervical affection, and lymph node involvement. A high statistically significant link between L1CAM expression and poor patient survival was detected. Mutant type P53 was significantly related to adverse clinicopathological data as high tumor grade, deep myometrial invasion, lymphovascular space invasion (LVSI), and high tumor stage. There was a positive significant relation between mutant type P53 and high SPAG9. Conclusions The early identification of EEC in asymptomatic high-risk women may benefit from L1CAM and SPAG9 testing in combination with P53 protein. Also, they could be viewed as separate predictive variables in the EEC and might play a crucial part in the EEC’s chemoresistance.