DNA Mismatch Repair Protein Expression Status Is Associated with Social Demographic Factors in Endometrial Carcinoma

Objective: The relationship between social demographic factors and biomarker expression is less studied. Methods: We have reviewed 645 endometrial carcinomas with demographic information including race/ethnicity, marital status, religious belief, body mass index (BMI), and pathology staging as well as DNA mismatch repair enzyme expression (MMR) status. Statistical analysis was performed by using various programs in R-package. Results: A total of 645 hysterectomy specimens of endometrial carcinoma, including 463 low grade carcinomas (72%) and 182 high grade carcinomas (28%) were reviewed. Race/ethnicity and marital status were found significantly associated with patient’s age (p<0.01), BMI/obesity (p<0.01) and religious belief (p<0.01). Patients’ marital status was also significantly associated with tumor grade (p=0.01). MMR deficiency was statistically associated with patients’ age (p<0.01) and marital status (p=0.02) in overall endometrial carcinoma. MMR deficiency was also significantly associated with tumor grade (p<0.01), nodal metastasis (p<0.01), and FIGO stages (p<0.01) in low grade endometrial carcinoma but not in high grade endometrial carcinoma. Conclusion: Social demographic factors appear not only as risk factors for pathogenesis but also affect the tumor pathology grade, MMR expression status, clinical stages, nodal metastasis and ultimately treatment and prognosis. These correlative data also provide preliminary and incremental basis for more rigorous prospective study for MMR expression in endometrial carcinoma.