Wen Shan-Yun, Li Chang-Hua, Zhang Yan-Li, Bian Yu-Hai, Ma Li, Ge Qiu-Lin, Teng Yin-Cheng, Zhang Zhi-Gang
Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China ; Department of Obstetrics and Gynecology, Shanghai Songjiang District Central Hospital Shanghai, China.
Department of Obstetrics & Gynecology, Huai'an First People's Hospital, Nanjing Medical University Huai'an, Jiangsu, PR China.
Int J Clin Exp Pathol. 2014 Apr 15;7(5):2068-78. eCollection 2014.
Early-stage endometrial carcinoma (EC) patients have a high cure rate; however, those with high-risk factors may have poor prognosis. Thus, there is an urgent need for searching for new prognostic molecules to more accurately predict survival of patients. We detected the Rictor mRNA expression level in 30 fresh EC tissue and 17 normal endometrial tissue samples with real-time quantitative RT-PCR and Rictor protein expression level in 134 (test cohort) and 115 (validation cohort) paraffin tissue samples by immunohistochemistry, analyzed the correlation between variables and overall survival (OS) using Cox proportional hazards regression, compared the prognostic accuracy of Rictor with other clinicopathological risk factors by logistic regression. The results showed that Rictor mRNA expression of EC is higher than that of normal endometrium; Rictor protein expression level was closely correlated with FIGO stage, grade and vascular invasion in both cohorts; a univariate analysis showed that the pathological type, stage, grade, vascular invasion, lymphatic metastasis and Rictor were predictors of OS in both cohorts; furthermore, multivariate Cox proportional hazards regression analysis indicated that vascular invasion and Rictor were independent prognostic factors for EC in both cohorts; an ROX curve comparison showed that the area under the curve (AUC) for Rictor combined with other clinicopathological prognostic factors was higher than any individual factor or other clinicopathological prognostic factors' combination. Based on the above data, we concluded that Rictor is an independent prognostic factor for EC. It combined with other clinicopathological risk factors was a stronger prognostic model than individual risk factor or their combination.
早期子宫内膜癌(EC)患者的治愈率较高;然而,具有高危因素的患者预后可能较差。因此,迫切需要寻找新的预后分子,以更准确地预测患者的生存率。我们采用实时定量逆转录聚合酶链反应检测了30例新鲜EC组织和17例正常子宫内膜组织样本中Rictor mRNA的表达水平,并通过免疫组织化学检测了134例(测试队列)和115例(验证队列)石蜡组织样本中Rictor蛋白的表达水平,使用Cox比例风险回归分析变量与总生存期(OS)之间的相关性,通过逻辑回归比较Rictor与其他临床病理危险因素的预后准确性。结果显示,EC的Rictor mRNA表达高于正常子宫内膜;两个队列中Rictor蛋白表达水平均与国际妇产科联盟(FIGO)分期、分级和血管侵犯密切相关;单因素分析表明,病理类型、分期、分级、血管侵犯、淋巴转移和Rictor是两个队列中OS的预测因素;此外,多因素Cox比例风险回归分析表明,血管侵犯和Rictor是两个队列中EC的独立预后因素;受试者工作特征(ROC)曲线比较显示,Rictor与其他临床病理预后因素联合的曲线下面积(AUC)高于任何单个因素或其他临床病理预后因素的组合。基于上述数据,我们得出结论,Rictor是EC的独立预后因素。它与其他临床病理危险因素联合是比单个危险因素或其组合更强的预后模型。