Segawa T, Sasagawa T, Saijoh K, Inoue M
Department of Obstetrics and Gynecology, School of Medicine, Kanazawa University, Japan.
Clin Cancer Res. 2000 Jun;6(6):2341-8.
Abnormalities in structure and expression of the fragile histidine triad transcription (FHIT) gene have been reported in a variety of cancers, including endometrial cancers. A good correlation between FHIT gene alteration and loss of Fhit expression was observed in endometrial cancers, although those are the selected cases. Therefore, we investigated the association of Fhit expression with clinicopathological features in 111 cases of endometrial cancer. Loss of Fhit expression was associated with high malignant potential, including extensive muscular invasion, advanced surgical stage, high histological grade, nonendometrioid types of adenocarcinoma, negative estrogen receptor status, and p53 overexpression. The presence of personal cancer history was also related to the loss of Fhit with a marginal significance. Survival curves determined by the Kaplan-Meier method and univariate analysis demonstrated that decreased expression of Fhit was associated with a poor outcome. However, multivariate analysis using the stepwise Cox proportional hazard model showed that whereas lymph node metastasis, advanced stage, and high tumor grade were related to poor survival rates, loss of Fhit expression was not. Consequently, loss of Fhit expression is associated with advanced surgical stage and does not appear to be an independent prognostic factor in endometrial cancers, although a still larger sample of patients will be required to asses this issue definitively.
脆性组氨酸三联体转录(FHIT)基因的结构和表达异常已在包括子宫内膜癌在内的多种癌症中被报道。在子宫内膜癌中观察到FHIT基因改变与Fhit表达缺失之间存在良好的相关性,尽管这些是选定的病例。因此,我们研究了111例子宫内膜癌中Fhit表达与临床病理特征的相关性。Fhit表达缺失与高恶性潜能相关,包括广泛的肌层浸润、手术分期晚、组织学分级高、非子宫内膜样腺癌类型、雌激素受体阴性状态和p53过表达。个人癌症病史的存在也与Fhit缺失相关,具有边缘显著性。通过Kaplan-Meier方法和单因素分析确定的生存曲线表明,Fhit表达降低与不良预后相关。然而,使用逐步Cox比例风险模型的多因素分析表明,虽然淋巴结转移、晚期和高肿瘤分级与低生存率相关,但Fhit表达缺失并非如此。因此,Fhit表达缺失与手术分期晚相关,并且似乎不是子宫内膜癌的独立预后因素,尽管需要更大规模的患者样本才能最终评估这个问题。