Gabriel Boris, Hasenburg Annette, Waizenegger Miriam, Orlowska-Volk Marzenna, Stickeler Elmar, zur Hausen Axel
Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg, Germany.
Int J Gynecol Cancer. 2009 Oct;19(7):1221-5. doi: 10.1111/IGC.0b013e3181b33c61.
The pp125 focal adhesion kinase (FAK) plays a pivotal role in tumor cell signaling. Focal adhesion kinase expression has been linked to tumor cell proliferation, invasion, and metastasis, but data on endometrial cancer are inconclusive.
We assess FAK expression by immunohistochemistry in endometrial cancer for its value to predict patient prognosis.
Of 134 endometrial cancer cases, 120 (89%) revealed moderate and strong expressions of FAK, whereas weak expression was found in 14 (11%) tumors. Kaplan-Meier analysis indicated a clear trend toward improved survival rates for patients with endometrial carcinomas weakly expressing FAK, and notably, there was neither lymph node metastasis nor tumor-related death in this patient subgroup. Increased expression of FAK correlated with higher histological tumor grade (P = 0.002), lymphatic vascular space invasion (P = 0.003), and vascular space invasion (P = 0.02). Significant prognostic survival variables were tumor stage (P < 0.01), histological type (P < 0.01), tumor grade (P = 0.028), and pelvic lymph node status (P = 0.035). Multivariate Cox regression analysis identified histological tumor grade as a significant independent predictor of patient survival (hazards ratio, 2.71; P = 0.03).
Further studies are warranted to elucidate whether FAK expression analysis is a suitable tool in stratifying patients at different risks of disease progress, and wether FAK might become a new molecular target for endometrial anticancer therapy.
pp125粘着斑激酶(FAK)在肿瘤细胞信号传导中起关键作用。粘着斑激酶的表达与肿瘤细胞的增殖、侵袭和转移有关,但关于子宫内膜癌的数据尚无定论。
我们通过免疫组织化学评估子宫内膜癌中FAK的表达,以预测患者预后。
在134例子宫内膜癌病例中,120例(89%)显示FAK中度和强表达,而14例(11%)肿瘤显示弱表达。Kaplan-Meier分析表明,FAK弱表达的子宫内膜癌患者生存率有明显提高的趋势,值得注意的是,该患者亚组既无淋巴结转移也无肿瘤相关死亡。FAK表达增加与更高的组织学肿瘤分级(P = 0.002)、淋巴管间隙浸润(P = 0.003)和血管间隙浸润(P = 0.02)相关。重要的预后生存变量是肿瘤分期(P < 0.01)、组织学类型(P < 0.01)、肿瘤分级(P = 0.028)和盆腔淋巴结状态(P = 0.035)。多变量Cox回归分析确定组织学肿瘤分级是患者生存的重要独立预测因素(风险比,2.71;P = 0.03)。
有必要进一步研究以阐明FAK表达分析是否是对不同疾病进展风险患者进行分层的合适工具,以及FAK是否可能成为子宫内膜癌抗癌治疗的新分子靶点。