Correlation between nm23-H_1 expression and transvaginal color Doppler ultrasound performance after radiotherapy for cervical cancer

Transl Cancer Res. 2022 May;11(5):1354-1361. doi: 10.21037/tcr-22-1114.

Abstract

Background: This study aimed to explore the correlation between nm23-H_1 gene expression and transvaginal color Doppler ultrasound performance following radiotherapy (RT) for cervical cancer.

Methods: Eighty patients with cervical cancer treated surgically after RT were retrospectively included in this study. Another 60 normal cervical tissue specimens from the pathology department and 30 cervical cancer tissues that did not undergo preoperative RT were included as control samples. Nm23-H_1 protein expression in cervical tissue was detected using immunohistochemistry. Color Doppler flow imaging (CDFI) was used to detect the imaging signs and resistance index (RI) of cervical cancer.

Results: (I) Immunohistochemical detection showed that the positive rates of the nm23-H_1 protein in cervical cancer and normal cervical tissues were 37.5% (30/80) and 70.0% (42/60), respectively, and the difference was statistically significant (χ2=14.498, P=0.000). In cervical cancer cells, nm23-H_1 was mainly localized in the cytoplasm but was also expressed in small amounts in the cell membrane. (II) We observed that the expression status of nm23-H_1 was closely correlated with the tumor diameter, lymph node metastasis status, and differentiation degree of patients (P<0.05). The positive rate of nm23-H_1 was higher in patients with cervical cancer with larger tumor diameters, presence of lymph node metastasis, and lower differentiation degree. (III) Ultrasound findings in the 80 cervical cancer patients exhibited no echogenicity in two cases, moderate echogenicity in six cases, hypoechogenicity in 36 cases, and hyperechogenicity in 36 cases. The maximum RI of the patients' cervical tumors was 0.612, the minimum RI was 0.273, and the mean RI was 0.45. Nm23-H_1 protein expression was significantly correlated with CDFI grade and RI (P<0.05). Patients with positive nm23-H_1 expression had a significantly higher CDFI grade and RI compared to patients in the nm23-H_1 negative expression group.

Conclusions: Nm23-H_1 protein expression following RT for cervical cancer was significantly correlated with the clinicopathological parameters, CDFI grading, and RI index of cervical cancer patients.

Keywords: Cervical cancer; nm23-H_1; radiotherapy (RT); transvaginal color Doppler.