[Impact of Endometriosis on the Therapeutic Effect of Hysteroscopic Fallopian Tube Catheterization Combined With Laparoscopy in Infertile Patients With Proximal Tubal Obstruction].

Objective: To investigate the impact of endometriosis on the therapeutic effect of hysteroscopic fallopian tube catheterization combined with laparoscopy in infertile patients with proximal tubal obstruction. Methods: We conducted a retrospective analysis of patients who underwent hysteroscopic fallopian tube catheterization combined with laparoscopy for infertility caused by proximal fallopian tube obstruction between January 19, 2016 and March 20, 2020 at the Department of Reproductive Endocrinology, West China Second Hospital, Sichuan University. During the operation, hydrotubation was performed to verify whether there was proximal tubal obstruction. Then, the patients were categorized into an endometriosis group and a non-endometriosis group according to whether their proximal tubal obstruction was combined with endometriosis. The baseline data were balanced by propensity score matching and the rate of successful surgical unblocking of proximal tubal obstruction in infertile patients by hysteroscopic fallopian tube catheterization combined with laparoscopy was calculated. Treating cases lost to follow-up in both groups as non-pregnant cases according to the principle of intention-to-treat analysis, we followed up the pregnancy outcomes after surgery. The primary indicators included overall successful surgical unblocking rate, clinical pregnancy rate, and spontaneous pregnancy rate, while the secondary indicators included live birth rate, miscarriage rate, ectopic pregnancy rate, and the mean time to spontaneous pregnancy after surgery. The primary indicators included overall successful surgical unblocking rate, clinical pregnancy rate, and spontaneous conception rate, while the secondary indicators included live birth rate, miscarriage rate, ectopic pregnancy rate, and the mean time to spontaneous pregnancy after surgery. Results: After propensity score matching, 113 cases were included in each of the two groups, with the overall successful surgical unblocking rate being 72.6%. The successful surgical unblocking rate of patients in the endometriosis group was higher than that of the non-endometriosis group, with the difference being statistically significant (78.8% vs. 66.4%, P<0.05). A total of 38 patients were lost after follow-up matching. Postoperative follow-up was performed to date and, through intention-to-treat analysis, the spontaneous conception rate was found to be higher in the endometriosis group than that in the non-endometriosis group (44.2% vs. 30.1%, P<0.05), while the mean time to spontaneous pregnancy after surgery was shorter in the endometriosis group than that in the non-endometriosis group (46 months vs. 53 months, P<0.05). There was no significant difference in clinical pregnancy rate, live birth rate, miscarriage rate, and ectopic pregnancy rate between the endometriosis group and the non-endometriosis group ( P>0.05). Conclusion: When infertility caused by proximal tubal obstruction is combined with endometriosis, performing hysteroscopic fallopian tube catheterization combined with laparoscopy contributes to the improvement of reproduction outcomes.

Increased Expression of TGF-ß1 Contributes to the Downregulation of Progesterone Receptor Expression in the Eutopic Endometrium of Infertile Women with Minimal/Mild Endometriosis.

Endometriosis is a hormone-dependent disease associated with impaired immunoregulation. In our recent study, we have characterized the trascriptomic transformation of eutopic endometrium from patients with minimal/mild endometriosis and controls across the menstrual cycle. However, the regulatory mechanism of altered immune microenvironment in eutopic endometrial stromal cells (ESCs) remains unclear. Here, we want to explore the regulation of immune cell to progesterone resistance and endometrial receptivity in the eutopic ESCs by cytokine (TGF-ß1), and to understand the effect of TGF-ß1 on the decidualization of the eutopic ESCs. Primary culture of eutopic ESCs was performed to explore the effects of TGF-ß1 on the expression of Smad and progesterone receptor (PR) and the in vitro decidualization. Additionally, co-immunoprecipitation (Co-IP) was used to explore the direct interaction between Smad and PR. We found an attenuate expression of PRB protein (p=0.026) after using TGF-ß1 in eutopic ESCs, although the difference of PRA before and after treatment was not significant (p=0.678). Similarly, the results of qRT-PCR showed that the mRNA level of PR (p<0.001), PRB (p=0.003) and HOXA10 (p<0.001) decreased significantly after TGF-ß1 treatment, but that increased (p<0.023, for all) after SB431542 treatment in the eutopic ESCs. Moreover, TGF-ß1 has a negative effect on the in vitro decidualization of eutopic ESCs (p=0.003). And the group with treatment of both TGF-ß1 and SB435142 in eutopic ESCs showed significant decidual-like changes with increased prolactin level (p=0.01). We did not observe any physical interaction between the PR and p-Smad3/Smad3 proteins by using Co-IP. By activating TGF-ß/Smad signaling in eutopic ESCs, elevated TGF-ß1 from CD45+ immune cells could attenuate expression of PR, and further decrease endometrial receptivity.

Single-cell transcriptome analysis reveals endometrial immune microenvironment in minimal/mild endometriosis.

Endometriosis is a common inflammatory disorder in women of reproductive age due to an abnormal endometrial immune environment and is associated with infertility. This study aimed to systematically understand the endometrial leukocyte types, inflammatory environment, and impaired receptivity at single-cell resolution. We profiled single-cell RNA transcriptomes of 138 057 endometrial cells from endometriosis patients (n = 6) and control (n = 7), respectively, using 10x Genomics platform. We found that one cluster of epithelial cells that expressed PAEP and CXCL14 was mostly from the control during the window of implantation (WOI). This epithelial cell type is absent in the eutopic endometrium during the secretory phase. The proportion of endometrial immune cells decreased in the secretory phase in the control group, whereas the cycle variation of total immune cells, NK cells, and T cells was absent in endometriosis. Endometrial immune cells secreted more IL-10 in the secretory phase than in the proliferative phase in the control group; the opposite trend was observed in endometriosis. Proinflammatory cytokines levels in the endometrial immune cells were higher in endometriosis than in the control group. Trajectory analysis revealed that the secretory phase epithelial cells decreased in endometriosis. Ligand-receptor analysis revealed that 11 ligand-receptor pairs were upregulated between endometrial immune and epithelial cells during WOI. These results provide new insights into the endometrial immune microenvironment and impaired endometrial receptivity in infertile women with minimal/mild endometriosis.

Reproductive outcomes after uterine septum resection in patients with recurrent miscarriage or infertility: a retrospective study in Chinese women.

OBJECTIVE: Septate uterus is the most common structural uterine anomaly, which is related to the adverse pregnancy outcomes in women of childbearing age. This article provides a retrospective review of hysteroscopic uterine septum resection performed in our hospital during recent years, focusing on the patients with recurrent miscarriage and primary infertility, and also to identify which patients are more likely to benefit from the surgery. METHODS: This is a single-center retrospective study. Cases of women who underwent hysteroscopic septum resection at West China Second Hospital of Sichuan University from January 2014 to December 2019, retrieved through the medical record system, were divided into three groups: Group A was the recurrent miscarriage group, Group B had a history of pregnancy with spontaneous abortion once at most, and Group C was the primary infertility group. Each patient was followed up by telephone about further pregnancy, miscarriage and live birth for at least 1 year. RESULTS: A total of 176 surgical patients were included in this study. Group A, B, and C include 42, 74, and 60 cases, respectively. The postoperative pregnancy rates of the three groups were 71.4, 82.4, and 75.0%; live births rates were 50.0, 74.3, and 71.7%; and spontaneous abortion rates were 21.4, 17.6, and 13.3%. 62 patients had a complete uterine septum and 114 had a partial uterine septum. For patients with complete septate uterus, the preoperative pregnancy rate was 54.84% and the pregnancy rate increased to 85.48% after surgery; and yet the preoperative and postoperative pregnancy rates in patients with partial septate uterus were close (from 71.9 to 72.8%). CONCLUSIONS: After uterine septum resection, the pregnancy rate and spontaneous abortion rate in RSA patients were not significantly different from the other two groups, but the live birth rate was still significantly lower. Patients with complete uterine septum may benefit more from surgery. The surgical indications should be carefully and strictly evaluated.

miR-297 inhibits expression of progesterone receptor and decidualization in eutopic endometria of endometriosis.

AIM: Progesterone resistance is an epigenetic factor that reduces endometrial receptivity and causes implantation failure in women with endometriosis. In addition, dysregulated miRNAs contribute to the underlying pathogenic mechanisms of endometriosis. This study aimed to determine the effect of miR-297 on the progesterone receptor (PR) expression and on insufficient decidualization of endometrial stromal cells (ESCs) within the eutopic endometria of infertile women with minimal or mild endometriosis. METHODS: ESCs were isolated from infertile endometriosis and normal patients and were transfected with miR-297 mimic or miR-297 inhibitor or respective control. qRT-PCR and western blot were conducted to quantify the expression of miR-297 and PR. The effect of miR-297 on ESCs decidualization was investigated by induced decidualization in vitro. RESULTS: We observed an increase in miR-297 expression and a decrease in the expression of PR in the ESCs from endometriosis patients. Moreover, the expression of PR, most notably PRB, was found to be downregulated following transfection with miR-297 mimic and upregulated following treatment with miR-297 inhibitor. In addition, overexpressed miR-297 inhibited the decidualization of ESCs in vitro. We further determined that miR-297 exerts direct regulatory effects on PR expression. CONCLUSIONS: We demonstrated that miR-297 interferes with fertility by repressing the expression of PR and preventing efficient decidualization in eutopic endometria. Further, miR-297 directly contributes to progesterone resistance in minimal or mild cases of endometriosis. Thus, regulation of miR-297 may prove to be a promising therapeutic strategy for endometriosis.

Increased Expression of YAP Inhibited the Autophagy Level by Upregulating mTOR Signal in the Eutopic ESCs of Endometriosis.

We first reported that the Hippo-YAP signaling pathway plays a critical role in the pathogenesis of endometriosis (EMS). Autophagy is also related to the invasion ability of endometrial cells and is involved in the pathogenesis of EMS through multi-levels. However, the precise regulatory mechanism of YAP on autophagy in the eutopic endometrial stromal cells (ESCs) is still unclear. Primary eutopic ESCs of EMS patients (n = 12) and control patients without EMS (n = 9) were isolated and cultured to investigate the expressions of YAP and mTOR, the role of YAP in autophagy, and the effect of the YAP-autophagy signal on the decidualization of the eutopic ESCs. Endometriosis-related sequencing data (GSE51981) in the GEO database were used to find the genes significantly correlated with YAP. We found 155 genes with significant differences in the interaction with YAP in EMS from the dataset, and the autophagy pathway was significantly enriched. Following on from our previous studies of YAP knockdown, overexpression of YAP resulted in an increased expression of mTOR and decreased ratio of LC3-II/LC3-I and autophagy markers, in the eutopic ESCs; transmission electron microscope observation also showed fewer autophagosomes compared with the control cells. Furthermore, ESCs of the Rapamycin-treated group showed significant decidual-like changes with significantly increased decidual prolactin level at 72 h after in vitro decidualization. These results demonstrate that the increased YAP inhibited the level of autophagy by upregulating the mTOR signal in the eutopic ESCs of endometriosis. The YAP-autophagy signal plays an important role in the pathogenesis of endometriosis-associated infertility.

Comparative Proteomic Analysis Reveals Metformin Improves the Expression of Biomarkers of Endometrial Receptivity in Infertile Women with Minimal/Mild Endometriosis.

The prevalence of endometriosis is approximately 10% in women of reproductive age, and 30-50% of women with endometriosis are infertile. Metformin has been reported to inhibit the growth of ectopic lesions in endometriosis. However, its effect on the eutopic endometrium of endometriosis is unknown. This study aimed to identify whether metformin affects endometrial receptivity in infertile women with minimal/mild endometriosis. We enrolled 10 infertile women who were diagnosed with minimal/mild endometriosis through laparoscopy. Paired endometrial tissues of the secretory phase from participants were collected during surgery and after 2 months of metformin treatment (n = 5) or no medical treatment (n = 5). Protein expression profiles of the paired endometrium were detected by proteomics and compared using the self-control method (2 months later vs. in surgery). Proteomics data revealed six proteins associated with endometrial receptivity among the significantly upregulated proteins after metformin treatment (fold change > 1.5, P < 0.05). Insulin-like growth factor binding protein 7 (IGFBP-7) showed the most robust increase in these six endometrial receptivity-related proteins (fold change: 8.668, P < 0.05), while there was no significant change in the controls (fold change: 1.906, P > 0.05). The upregulation of IGFBP-7 has been validated through target proteomics, immunohistochemistry, and further demonstrated in endometriosis mouse models induced by autotransplantation. This study revealed that metformin upregulated the expression of IGFBP-7 in the endometrium of human and mouse models of endometriosis. Metformin potentially affects endometrial receptivity of minimal/mild endometriosis by improving the expression of the endometrial receptivity marker IGFBP-7.

Effectiveness of laparoscopic tubal anastomosis in tubal occlusion patients after laparoscopic salpingostomy for tubal pregnancy.

OBJECTIVE: To evaluate the effectiveness of laparoscopic tubal anastomosis for tubal occlusions associated with infertility in patients with previous laparoscopic salpingostomy for ectopic pregnancy. METHODS: This study is a retrospective analysis of the pregnancy outcomes of 173 infertile patients who underwent hysteroscopy and laparoscopic tubal anastomosis treatment between January 2013 and August 2018 in the Department of Reproductive Endocrinology in West China Second University Hospital of Sichuan University. All patients had a history of laparoscopic salpingostomy for tubal pregnancy. The primary outcomes were intrauterine pregnancy, ectopic pregnancy, and delivery rates. We further studied the associated factors that could influence the change in pregnancy status. RESULTS: The 24-month cumulative clinical pregnancy rate of all patients was 107/173 (61.8%). The distribution of outcomes for the entire group of pregnancies was as follows: intrauterine pregnancy rate, 76/173 (43.9%); ectopic pregnancy rate, 31/173 (17.9%); delivery rate, 68/173 (39.3%); and miscarriage rate, 8/173 (4.6%). Age, type of anastomosis, hydrosalpinx, and endometrial polyps were significant prognostic factors in the multivariate model. CONCLUSION: Laparoscopic tubal anastomosis is an effective treatment for tubal-associated infertility due to previous laparoscopic salpingostomy for ectopic pregnancy, especially for women under 35 years of age.

Gonadal tumor and malignancy in 118 patients with disorders of sex development with Y chromosome.

OBJECTIVE: To provide more information about tumor prevalence and malignant transformation among patients with disorders of sex development (DSD) for further guidance in prophylactic gonadectomies and surveillance. METHODS: SPSS software (version 20.0) was used for all statistical analyses. RESULTS: Phenotypically female DSD patients with a Y chromosome have a higher risk of gonadal malignancy. CONCLUSION: Bilateral gonadal resection is recommended as soon as diagnosis is made for phenotypically female patients with disorders of sex development with a Y chromosome.

Clinicopathologic features and clinical outcomes of intravenous leiomyomatosis of the uterus: A case series.

RATIONALE: Intravenous leiomyomatosis (IVL) is a rare and special type of smooth muscle tumor originating in the uterus. It is classified as a benign disease according to its histological features but shows the behavioral characteristics of a malignant tumor. It is easily misdiagnosed and recurrent. The purpose of this study was to retrospectively analyze clinicopathological data of 25 cases of IVL in order to enhance clinicians' understanding of this rare disease. PATIENT CONCERNS: We screened and identified 25 cases of IVL at our hospital from October 2013 to January 2020. Five patients had tumors. DIAGNOSES: The diagnosis in each case was pathologically confirmed after surgical treatment. INTERVENTIONS: All patients were managed surgically. Although the surgical procedures were different, the surgical approach was geared towards achieving complete excision. Three patients received hormonal therapy with gonadotropinreleasing hormone agonists after surgery. OUTCOMES: We retrospectively reviewed all medical records and analyzed the clinicopathologic features and clinical outcomes of this disease as well as the correlations between the clinical features and risk of recurrence. Neither the symptoms nor the preoperative imaging results were suggestive of IVL in any of the cases. Except for two patients who were lost to follow-up, twenty-three patients who were followed up are still alive. Three patients experienced a recurrence. LESSONS: The clinical manifestations and ultrasound images of IVL in the early stages are not typical; thus, IVL is easily misdiagnosed as uterine leiomyoma. Radiologists, pathologists, and surgeons should have a thorough understanding of IVL and a high index of vigilance for IVL in clinical practice. Surgery should always be aimed at achieving complete tumor excision. Patients with large lesions (≥7 cm) and lesions extending to the broad ligament may have an increased risk of recurrence. Early detection, diagnosis, and treatment are very important; once the diagnosis is confirmed, regular follow-ups are crucial.

MicroRNA-590 promotes cervical cancer cell growth and invasion by targeting CHL1.

MicroRNAs (miRNAs) may function as oncogenes or tumor suppressors. Here, we identified that miR-590-5p was up-regulated in human cervical cancer. Over-expression of miR-590-5p promoted cervical cancer cell growth, cell cycle and invasion via Growth curve, Colony formation, FACS and Transwell assays in HeLa and C33A cell lines. Subsequently, CHL1 was identified as a potential miR-590-5p target by bioinformatics analysis. Moreover, we showed that CHL1 was negatively regulated by miR-590-5p at the posttranscriptional level, via a specific target site within the 3'UTR by luciferase reporter assay. Furthermore, the mRNA and protein levels of CHL1 in cervical cancer cells were downregulated by miR-590-5p. And we identified the cell phenotype altered by miR-590-5p can be rescued by over-expression of CHL1. Therefore, our findings suggest that miR-590-5p acts as an oncogene by targeting the CHL1 gene and promotes cervical cancer proliferation. The findings of this study contribute to current understanding of the functions of miR-590-5p in cervical cancer.

Pregnancy complicating systemic lupus erythematosus: a series of 86 cases.

OBJECTIVE: To investigate the timing of pregnancy and pregnancy termination and its management in women with pregnancy complicating systemic lupus erythematosus (SLE). METHODS: A series of 86 cases of pregnancy complicating SLE treated in our hospital from January 2005 to June 2010 were retrospectively reviewed, including 54 cases of planned pregnancy and 32 cases of unplanned pregnancy. The pregnancy courses and clinical outcomes were analyzed. RESULTS: While 12 patients in planned pregnancy group showed active SLE during pregnancy, all 32 patients in the unplanned pregnancy group presented severe SLE complications. The incidences of pregnancy loss, preterm delivery and neonatal asphyxia in the unplanned pregnancy group were significantly higher than planned pregnancy group (P < 0.05), and the infant body weight was lower in the unplanned pregnancy group (P < 0.05). A total of 78 live infants were born and no mortality was reported, including 15 preterm infants and one neonatal SLE. CONCLUSION: Planned pregnancy during stable stage, appropriate treatment in pregnancy and close monitoring can improve the security of pregnancy complicating SLE. In situations that the drug treatment is ineffective and the mother and infant are threatened, or the fetus is mature, the pregnancy should be terminated promptly, thereby reducing the complications, and increasing the success rate of pregnancy and perinatal survival rate.

[Effect of metastasis suppressor gene KAI1 on the proliferation and invasive ability of cervical carcinoma cells].

OBJECTIVE: To explore the effect of metastasis suppressor gene KAI1 on the proliferation and invasive ability of cervical cancer cell line CaSki. METHODS: pCMV-KAI1 cDNA plasmid was transferred into cervical carcinoma cell line CaSki by liposome, which had low level of endogenous KAI1 expression. The expressions of KAI1 protein and mRNA were determined by immunohistochemistry and real-time fluorescence quantitative PCR (RT-PCR), the proliferation of KAI1-transfected CaSki cells was investigated by MTT assay and the invasive ability of these cells was evaluated by in vitro invasion assays. RESULTS: After the transfection of pCMV-KAI1 cDNA, the level of KAI1 mRNA and protein expression in CaSki cell were increased (P < 0.05), while the cell proliferation was suppresssed, and the migrative ability of passing through the membrane filte also decreased evidently (P < 0.05). CONCLUSION: The KAI1 metastasis suppressor gene suppressed the ability of proliferation and invasion of cervical cancer cell CaSki in vitro.

[Study on antimicrobial activity of human hemoglobin and its fragments both in vitro and in vivo].

OBJECTIVE: To isolate human hemoglobin and its fragrments, compare their antimicrobial activity in vitro and pilot study of their antimicrobial activity in vivo. METHODS: The alpha and beta chains of hemoglobin were separated by cation exchange chromatography and gel chromatography; The alpha and beta chains were cleaved by cyanogens bromide respectively. The cleaved fragments were purified by reverse phase high performance liquid chromatography. Antimicrobial activity of hemoglobin and its fragments was determined by agrose radial diffusion assay. After establishment of E. coli vaginal infection model, the rats were randomized into the experimental group (hemoglobin group) and the control group. The histologically pathological section was observed. RESULTS: Hemoglobin, alpha/beta chain and their fragments had similar antibacterial activities in vitro, which were mainly against Gram-negative bacteria E. coli; except alpha1-32 had a comparatively lower activity. Antimicrobial activity in vivo: a comparison of the hemoglobin group with the matrix control group (no treatment after infection), the surface layer of vaginal stratified squamous epithelium was smoother, inflammatory cells were significantly reduced in the lamina propria and congestion was obviously decreased. CONCLUSION: Human hemoglobin and its fragments had antibacterial activity in vitro, hemoglobin might relieve the inflammation of E. coil vaginal infection in rats moreover.

[Expression of metastasis suppressor gene KAI1 in cervical carcinoma and infections of HPV16 E6, E7 and HPV18 E6/E7].

OBJECTIVE: To investigate the expression of metastasis suppressor gene KAI1 in cervical carcinoma and the impact of human papillomavirus 16 E6, E7, 18 E6/E7 infection on the expression of KAI1. METHODS: The expressions of KAI1 protein in the formalin-fixed, paraffin-embedded specimens of 20 normal cervical epthelium, 15 cervical in situ carcinoma and 70 primary invasive cervical carcinoma were detected by immunohistochemistry SP. Polymerase chain reaction (PCR) tests were also undertaken to detect the HPV16 E6, E7 and HPV18 E6/E7 DNA. RESULTS: The expression of KAI1 protein was down-regulated in the invasive carcinoma and in situ carcinoma compared with the controls (P < 0.05). No significant difference was found in the expression of KAI1 protein between invasive carcinoma and in situ carcinoma. The infections of HPV16 E6, E7 and HPV18 E6/E7 were found in 67.1%, 54.3% and 12.9% of the invasive carcinoma, respectively. However, there was no correlation between the expression of KAI1 and the infections of HPV16 E6, E7 and HPV18 E6/E7. CONCLUSION: The expression of KAI1 protein is down-regulated in cervical carcinoma, which is not associated with the infection of HPV16 E6, E7 and 18 E6/E7.

[The expression of matrix metalloproteinase-2 and -9 in cervical cancer and a study of their relationship].

OBJECTIVE: To detect the expressions of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in cervical cancer and their correlation with clinicopathologic features. METHODS: With the use of specific monoclonal antibody to human MMP-2 and MMP-9, the formalin-fixed and paraffin-embedded specimens of 62 invasive carcinomas of cervix uteri, 5 carcinomas in situ, 10 normal cervical epithelia and 10 lymph node metastases were detected by immunohistochemical method. RESULTS: MMP-2 and MMP-9 protein expressions in tumor and peritumoral stromal cells were enhanced in invasive carcinoma, compared to those in carcinoma in situ and controls (P < 0.05). There was a low correlation between MMP-2 and MMP-9 (r = 0.34, P < 0.01); the expression level of MMP-9 was higher than MMP-2. The protein expressions of MMP-2 and MMP-9 did not correlate with tumor stage, histological grade or pathological subtype. MMP-9 was correlated with lymph node metastasis and lymphovascular space invasion. CONCLUSION: The over-expression of matrix metalloproteinase-2 and -9 was correlated with invasive behaviour of cervical cancer, MMP-9 was significantly correlated with the lymph node metastasis, it might become a useful prognostic indicator for early cervical cancer.

[Expression and correlation of C-met and estrogen receptor in endometrial carcinomas].

OBJECTIVE: To investigate the expression and correlation of C-met and Estrogen receptor (ER) in endometrial carcinomas. METHODS: We examined 55 samples of endometrial carcinomas using specific polyclonal endometrial carcinomas. METHODS: antibody and monoclonal antibody correspondent to the human C-met and ER respectively. The histochemical score was estimated according to the formula H = (i + 1) x pi, with a criterion of equal or more than 70 as considered to be positive in expression. RESULTS: The expression of C-met was correlated with both histological grade and clinical stage of endometrial carcinomas. The H scores of carcinomas in grade 3 was higher than in grade 1 and grade 2, while higher H scores were found in carcinomas in stage III and II compared to stage I (P < 0.05). The higher of the grade and stage were, the weaker the ER were expressed in endometrial carcinomas (P < 0.05). There was an inverse correlation between the expression of ER and C-met (r = -0.5842 P < 0.05). CONCLUSIONS: The expression of C-met and ER might be a useful predictor for the prognosis of endometrial carcinomas and an indicator to evaluate the effectiveness of the hormone intervention.