Background:Ezrin is a cell membrane-cytoskeleton linker that is essential to maintain the normal cell shape and the integrity of cell-cell adhesion. Overexpression of ezrin is correlated with poor prognosis in several malignancies.
Aim: To evaluate the expression of ezrin in hyperplastic and neoplastic endometrial tissues and to correlate its expression with the clinical and pathological parameters of endometrial carcinoma.
Methods: Tissue sections of 66 specimens including 37 endometrial carcinoma, 16 atypical endometrial hyperplasia and 13 benign endometrial hyperplasia were evaluated for ezrin expression by immunohistochemistry.
Results: Ezrin expression was detected in all endometrial carcinoma specimens and in 90% of hyperplasia. There was redistribution of ezrin from membranous expression in endometrial hyperplasia to diffuse cytoplasmic expression in endometrial carcinoma (p < 0.0001). Expression of ezrin was significantly higher in atypical compared to benign hyperplasia (p < 0.001) and it was relatively higher in endometrial carcinoma compared to atypical endometrial hyperplasia (p=0.086). Among the carcinoma specimens, expression of ezrin was significantly associated with invasion of myometrium (p=0.001), higher FIGO stage (p=0.008) and the presence of vascular tumor emboli (p=0.001). Muscle-invasive tumor cells expressed significantly higher levels of ezrin compared to non-invasive cells of the same tumor tissue (p < 0.0001). Tumor size, tumor grade and villoglandular morphology did not correlate significantly with ezrin expression.
Conclusion: Ezrin was overexpressed in endometrial carcinoma and its expression was associated with the invasive potential of tumor cells.