Expression of the serine protease hepsin and clinical outcome of human endometrial cancer

Background: Hepsin is a type II transmembrane serine protease originally identified in the human liver as a cDNA clone. Hepsin was found to be significantly overexpressed in cancer samples compared to matched various tissues (e.g. prostate, renal, ovarian carcinoma). The purpose of the present study was to examine hepsin expression and to evaluate its clinicopathological significance in endometrial cancer. Patients and Methods: Hepsin expression was examined by immunohistochemisty in 34 cases with normal endometrium as a control, 11 cases with endometrial hyperplasia, and 128 cases with endometrioid adenocarcinoma. Results: Hepsin expression was found to be significantly higher in endometrial cancer compared to normal endometrium and endometrial hyperplasia. High levels of hepsin expression were associated with advanced stage (p<0.001), high grade (p=0.002), depth of myometrial invasion (p<0.001), cervical involvement (p=0.007), lymph node metastasis (p=0.001), lymph vascular space (LVS) involvement (p=0.006), ovarian metastasis (p=0.002), and peritoneal cytology (p=0.03) of endometrial cancer. Conclusion: These findings indicate that hepsin protein expression could be an important indication for high risk of endometrial cancer.