Archives of Gynecology and Obstetrics

, Volume 299, Issue 6, pp 1673–1682 | Cite as

Molecular expression characteristics confirm the malignancy concealed by morphological alterations in endometrial cancer after fertility-preserving treatment

  • Ting Wen Yi Hu
  • Lei Li
  • E. Yang
  • Dan Nie
  • Zheng Yu LiEmail author
Gynecologic Oncology



Fertility-preserving treatment (FPT) has been widely used for young patients with early stage endometrial cancer (EC). However, the literature on the effectiveness and safety of FPT remains controversial. The aim of this study was to investigate malignant transformation in EC after FPT by immunohistochemistry (IHC).


A retrospective analysis of pre- and post-treatment biopsy specimens from 24 patients with grade 1 endometrioid adenocarcinoma (EAC) or complex atypical hyperplasia (CAH) was performed. The expression levels of ARID1A, PTEN, and β-catenin were assessed by IHC.


The protein expression levels of ARID1A, PTEN, and β-catenin were not significantly different between pre- and post-treatment specimens. However, there was a significant difference between pre-treatment and normal specimens as well as between post-treatment and normal specimens. The protein expression of β-catenin was significantly increased in patients with progression compared with those without progression after FPT.


The morphologic normalization of patients with EC after FPT may not be accompanied by the absence of tumor malignancy, and β-catenin may serve as a biomarker for the response to FPT. These results may contribute to a better understanding of the malignant transformation of EC after FPT and the optimization of treatment strategies for young patients with birth plans.


Endometrial cancer Fertility-preserving treatment Molecular expression Malignant change 



We would like to thank all the clinical researchers and patients for contributing to this study.

Author contributions

ZyL: Hypothesis and project development; TwyH: Data collection, specimen collection, data analysis, and manuscript drafting; LL: Data analysis; EY: Data collection and specimen collection; DN: IHC and RT-PCR.


This study was supported by a grant from the Sichuan Youth Foundation of Science of Technology (Grant number: 2015JQ0026).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Ethics Committee of West China Second University Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

As this was a retrospective study, formal consent was not required. However, informed consent was obtained from each patient for specimen collection.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ting Wen Yi Hu
    • 1
    • 2
  • Lei Li
    • 3
  • E. Yang
    • 1
  • Dan Nie
    • 1
  • Zheng Yu Li
    • 1
    • 2
    Email author
  1. 1.Department of Gynecology and ObstetricsWest China Second University Hospital, Sichuan UniversityChengduPeople’s Republic of China
  2. 2.Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of EducationWest China Second Hospital, Sichuan UniversityChengduPeople’s Republic of China
  3. 3.Department of PathologyWest China Second University Hospital, Sichuan UniversityChengduPeople’s Republic of China

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