Xiang Libing, Jiang Wei, Li Jiajia, Shen Xuxia, Yang Wentao, Yang Gong, Wu Xiaohua, Yang Huijuan
Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Sci Rep. 2015 Sep 11;5:14035. doi: 10.1038/srep14035.
The aim of this study was to evaluate the clinicopathological and prognostic relevance of PIK3CA mutations in Chinese patients with surgically resected cervical cancer. PIK3CA mutations were screened in 771 cervical cancer specimens using reverse transcription polymerase chain reaction and Sanger sequencing. In total, 13.6% (105 of 771) of patients harbored non-synonymous PIK3CA mutations. Patients harboring PIK3CA mutations were older than patients with wild-type PIK3CA (mean age: 50.7 years vs. 47.0 years, P < 0.01). PIK3CA mutations were more commonly observed in postmenopausal patients than in premenopausal patients (19.6% vs. 10.2%, P < 0.01). PIK3CA mutations were more common in squamous cell carcinomas than in non-squamous cell tumors (15.3% vs 7.3%, of P < 0.01). The 3-year relapse-free survival was 90.2% for PIK3CA mutant patients and 80.9% for PIK3CA wild-type patients (P = 0.03). PIK3CA mutation was confirmed as an independent predictor for better treatment outcome in the multivariate analyses (HR = 0.54, 95% CI: 0.29-0.99, P = 0.048). PIK3CA mutations were significantly associated with less distant metastases (mutant-type: 8/105, wild-type: 98/666, p = 0.048). Thus, patients with mutant PIK3CA had distinct characteristics in age, menopausal status, and histological subtype and have better treatment outcome and less distant metastasis after surgery-based multimodal therapy.
本研究旨在评估PIK3CA突变在中国接受手术切除的宫颈癌患者中的临床病理特征及预后相关性。采用逆转录聚合酶链反应和桑格测序法对771例宫颈癌标本进行PIK3CA突变筛查。共有13.6%(771例中的105例)患者存在PIK3CA非同义突变。携带PIK3CA突变的患者比野生型PIK3CA患者年龄更大(平均年龄:50.7岁对47.0岁,P<0.01)。PIK3CA突变在绝经后患者中比绝经前患者更常见(19.6%对10.2%,P<0.01)。PIK3CA突变在鳞状细胞癌中比非鳞状细胞肿瘤更常见(15.3%对7.3%,P<0.01)。PIK3CA突变患者的3年无复发生存率为90.2%,PIK3CA野生型患者为80.9%(P=0.03)。在多变量分析中,PIK3CA突变被确认为更好治疗结果的独立预测因素(HR=0.54,95%CI:0.29-0.99,P=0.048)。PIK3CA突变与远处转移较少显著相关(突变型:8/105,野生型:98/666,p=0.048)。因此,PIK3CA突变患者在年龄、绝经状态和组织学亚型方面具有独特特征,并且在基于手术的多模式治疗后具有更好的治疗结果和更少的远处转移。