Immunohistochemical expression of SNAIL and SLUG in endometrioid endometrial cancer and precursor lesions

Background: Endometrioid endometrial carcinoma is one of the most prevalent gynecologic cancers. The epithelial-mesenchymal transition is a multistep process involved in the development of cells that results in disappearance of intercellular adhesion in the epithelium and acquiring mesenchymal properties, hence influence cancer progression and metastasis. Loss of intercellular adhesion can be activated by different mechanisms, including transcriptional repression. However, the expression of transcriptional repressors in EEC and precursor lesions remain to be investigated. In the present study, we evaluated the immunohistochemical expression of proteins of transcriptional after repression snail and slug in EEC and its precursor lesions. Methods: It was a prospective nested case-control study on women from 35 to 70 years of age. Endometrial biopsies were obtained and processed for routine histological diagnosis. Immunohistochemical expression of snail and slug were evaluated. Results: A total of 39 EEC cases, 37 Endometrial hyperplasia and 19 normal controls were included in this study. Expression of snail was positive in 77% (30/39) and slug in 82% (32/39) of EEC cases while in precancer group snail was positive in 76% (28/37) and slug in 68% (25/37). In normal control snail was positive in 32% (6/19) and SLUG in 21% (4/19). Conclusion: Up-regulation of snail & slug observed in both precancer and cancer cases, suggesting their involvement from an early stage of carcinogenesis. Therefore therapies targeted at transcriptional repressors at an early stage of carcinogenesis, i.e., at precancerous lesions, could play a valuable role in reducing cancer progression and metastasis.