The prognostic significance of co-expression of α-SMA and Trichrome in the tumor microenvironment of poorly differentiated endometrial carcinoma

Abstract Backgroud: In recent years, the relationship between tumor microenvironment (TME) and adjuvant therapy has become a research hotspot. α-SMA is heterogeneous in different tumors. Type I collagen deposition influenced the access of immune cells to cancer cells. This study aims to describe the prognostic significance of co-expression of α-SMA and Trichrome in the tumor microenvironment of poorly differentiated endometrial carcinoma. Methods A total of 45 cases of poorly differentiated endometrial carcinoma (EC) from March 2013 to December 2020 was collected in the study. There were 17 cases of grade 3 endometrioid endometrial carcinomas (EECs), 16 cases of endometrial serous carcinomas, and 12 cases of endometrial clear cell carcinomas. The expression of α-SMA, CD10, and desmin was detected in the tumor microenvironment (TME) by the immunohistochemical method. Trichrome was detected to identify collagen in TME by a special dyeing method. Between-group comparison in categorical variables was assessed via using Fisher’s exact test. The overall survival was analyzed by a Kaplan-Meier curve. Results The total expression rate of α-SMA in endometrial carcinoma was 71.1%. The expression rate of α-SMA was 82.4%, 62.5%, and 66.7% positively expressed in EEC, serous carcinoma, and clear cell carcinoma, respectively. CD10 and desmin were negative in all EC TME. Both α-SMA and Trichrome positive groups showed significantly higher mortality rates ( p = 0.042) and poorer prognosis ( p = 0.041) than both α-SMA and Trichrome negative groups. Conclusions The co-expression of α-SMA and Trichrome is of great significance in predicting the poor prognosis of endometrial cancer.