Investigation of the antiproliferative and antitumoral effects of the human amniotic membrane on endometrial cancer cells in an animal model

Aim : The aim of this study was to evaluate the antiproliferative, antiangiogenic, and proapoptotic effects of the human amniotic membrane on endometrial cancer cells in a BALB/c nude mouse model, and to investigate whether these effects vary according to the frequency of application. Additionally, the contribution of the combination of the amniotic membrane with cisplatin to antitumoral efficacy was assessed. Materials and Methods: In this experimental study, a subcutaneous tumor model was established in BALB/c nude mice using the HCI-EC-23 human endometrial cancer cell line. A total of 32 mice were divided into four groups: control group, daily amniotic membrane application group, weekly amniotic membrane application group, and cisplatin plus amniotic membrane combination group. After a 21-day follow-up and treatment period, tumor tissues were excised and evaluated using immunohistochemical markers Ki-67, caspase- 3, and CD31. Results: Comparison of median Ki-67 percentage values, median caspase-3 values, and median CD31 values among the groups revealed no statistically significant differences. However, a statistically significant difference was observed among the groups in terms of median tumor volume. Macroscopic evaluation demonstrated tumor development in all four groups, with differences in tumor size distribution. The highest tumor volumes were observed in Group 1. Tumor volumes in Groups 2 and 3 were lower compared to Group 1, although this difference did not reach statistical significance. In contrast, a marked reduction in tumor size was observed in Group 4, which was statistically significant. Conclusion: The findings of this study suggest that the human amniotic membrane alone does not induce significant tumor regression; however, when combined with cisplatin, it may enhance antitumoral efficacy. Although the amniotic membrane did not demonstrate a strong antitumoral effect as monotherapy in the subcutaneous endometrial cancer mouse model, its combination with cisplatin resulted in a tumor growth-suppressive effect. These results indicate that the amniotic membrane may have the potential to modulate the tumor microenvironment and increase chemosensitivity. Further preclinical and clinical studies are warranted to support these findings.