Expression of ER, PR, C-erbB-2 and Ki-67 in Endometrial Carcinoma and their Relationships with the Clinicopathological Features

  • Yu, Cui-Ge (Department of Gynecology and Obstetrics, Shaanxi Provincial People's Hospital) ;
  • Jiang, Xiang-Yang (Department of Gynecology and Obstetrics, Shaanxi Provincial People's Hospital) ;
  • Li, Bin (Department of Gynecology and Obstetrics, Shaanxi Provincial People's Hospital) ;
  • Gan, Lu (Department of Gynecology and Obstetrics, Shaanxi Provincial People's Hospital) ;
  • Huang, Jian-Feng (Department of Gynecology and Obstetrics, Shaanxi Provincial People's Hospital)
  • Published : 2015.10.06


Background: To analyze the expression of estrogen receptors (ER), progesterone receptors (PR), C-erbB-2 and Ki-67 in endometrial carcinoma (EC) and their relationships with the clinicopathological features. Materials and Methods: Sixty-seven EC samples, 53 normal endometrial samples and 53 atypical hyperplasia endometrial samples were all selected in Shaanxi Provincial People's Hospital from Jun., 2012 to Jun., 2014. The expression of ER, PR, C-erbB-2 and Ki-67 in EC tissue, normal endometrial tissue and atypical hyperplasia endometrial tissue was respectively detected using immunohistochemical SP method. The relationships between the expression of ER, PR, C-erbB-2 and Ki-67 and the patients' clinicopathological features as well as their correlations in EC tissue were also analyzed. Results: The positive expression rates of ER and PR in EC tissue were 44.8% and 41.8%, respectively, dramatically lower than in atypical hyperplasia endometrial tissue and normal endometrial tissue (P<0.01). The positive expression rates of C-erbB-2 and Ki-67 in EC tissue were 80.6% and 64.2%, respectively, significantly higher than in atypical hyperplasia endometrial tissue and normal endometrial tissue (P<0.01). In EC tissue, the expression of ER and PR was closely associated with the differentiated degrees and depth of myometrial invasion (P<0.05), while that of C-erbB-2 and Ki-67 with the clinical staging, differentiated degrees, depth of myometrial invasion and presence or absence of lymph node metastasis (P<0.05). Spearman correlation analysis further displayed that the expression of ER was positively correlated with PR (r=0.393, P=0.001), but negatively with C-erbB-2 and Ki-67 (r=-0.469, P=0.000; r=-0.329, P=0.007); The expression of PR was negatively correlated with C-erbB-2 and Ki-67 (r=-0.273, P=0.025; r=-0.251, P=0.041), but that of C-erbB-2 positively with Ki-67 (r=0.342, P=0.005). Conclusions: Abnormal expression of ER, PR, C-erbB2 and Ki-67 might play an important role in endometrial malignant transformation and cell differentiation, so their joint detection is likely to be a comprehensive combination of immune factors, which is of great importance for EC prognosis.


Estrogen receptors;progesterone receptors;C-erbB-2;Ki-67;endometrial carcinoma


  1. Binder PS, Mutch DG (2014). Update on prognostic markers for endometrial cancer. Womens Health (Lond Engl), 10, 277-88.
  2. Faria SC, Sagebiel T, Balachandran A, et al (2015). Imaging in endometrial carcinoma. Indian J Radiol Imaging, 25, 137-47.
  3. Gurda GT, Baras AS, Kurman RJ (2014). Ki-67 index as an ancillary tool in the differential diagnosis of proliferative endometrial lesions with secretory change. Int J Gynecol Pathol, 33, 114-9.
  4. Hong B, Le Gallo M, Bell DW (2015). The mutational landscape of endometrial cancer. Curr Opin Genet Dev, 30, 25-31.
  5. Ioachin E (2005). Immunohistochemical tumour markers in endometrial carcinoma. Eur J Gynaecol Oncol, 26, 363-71.
  6. Ito K, Sasano H, Yabuki N, et al (1997). Immunohistochemical study of Ki-67 and DNA topoisomerase II in human endometrium. Mod Pathol, 10, 289-94.
  7. Kajo K, Vallova M, Biro C, et al (2015). Molecular pathology of endometrial carcinoma - a review. Cesk Patol, 51, 65-73.
  8. Kuramoto H, Hata H, Kato Y, et al (1989). Mechanism of action of endocrine therapy of endometrial carcinoma. Gan To Kagaku Ryoho, 16, 1851-7.
  9. Morrison C, Zanagnolo V, Ramirez N, et al (2006). HER-2 is an independent prognostic factor in endometrial cancer: association with outcome in a large cohort of surgically staged patients. J Clin Oncol, 24, 2376-85.
  10. Seki A, Nakamura K, Kodama J, et al (1998). A close correlation between c-erbB-2 gene amplification and local progression in endometrial adenocarcinoma. Eur J Gynaecol Oncol, 19, 90-2.
  11. Sharifah NA, Lee BR, Clarence-Ko CH, et al (2008). C-erbB-2 onco-protein expression in breast cancer: relationship to tumour characteristics and short-term survival in Universiti Kebansaan Malaysia Medical Centre. Asian Pac J Cancer Prev, 9, 663-70.
  12. Srijaipracharoen S, Tangjitgamol S, Tanvanich S, et al (2010). Expression of ER, PR, and Her-2/neu in endometrial cancer: a clinicopathological study. Asian Pac J Cancer Prev, 11, 215-20.
  13. Takahashi R, Mabuchi S, Kawano M, et al (2015). Prognostic significance of systemic neutrophil and leukocyte alterations in surgically treated endometrial cancer patients: a monoinstitutional study. Gynecol Oncol, 137, 112-8.
  14. Thompson SK, Sullivan TR, Davies R, et al (2011). Her-2/neu gene amplification in esophageal adenocarcinoma and its influence on survival. Ann Surg Oncol, 18, 2010-17.
  15. Uharcek P (2008). Prognostic factors in endometrial carcinoma. J Obstet Gynaecol Res, 34, 776-83.
  16. Zhao FJ, Zhang SL, Ma L, et al (2009). Inhibitory effects of c-erbB-2 antisense oligonucleotide transfection on uterine endometrial cancer Ishikawa cell lines. Eur J Gynaecol Oncol, 30, 54-9.

Cited by

  1. Non-endometrioid and high-grade endometrioid endometrial cancers show DNA fragmentation factor 40 (DFF40) and B-cell lymphoma 2 protein (BCL2) underexpression, which predicts disease-free and overall survival, but not DNA fragmentation factor 45 (DFF45) underexpression vol.18, pp.1, 2018,
  2. Impact of Hormone Receptor Status and Ki-67 Expression on Disease-Free Survival in Patients Affected by High-risk Endometrial Cancer vol.28, pp.3, 2018,