Walter Reed National Military Medical Center, Department of Obstetrics and Gynecology, 8901 Wisconsin Avenue, Bethesda, MD 20889, United States; Women's Health Integrated Research Center at Inova Health System, Department of Defense Gynecologic Cancer Center of Excellence, 3289 Woodburn Road, Suites 370 and 375, Annandale, VA 22003, United States.
University of Southern California, Department of Pathology, 1100 N. State Street, Los Angeles, CA 90033, United States.
Gynecol Oncol. 2016 Mar;140(3):503-11. doi: 10.1016/j.ygyno.2015.12.015. Epub 2015 Dec 21.
Evidence of potential prognostic and predictive value for nestin was investigated in well-annotated uterine cancers (UCs).
Nestin expression and previously-published biomarkers were evaluated by immunohistochemistry (IHC) in UC tissue microarrays. Biomarkers were categorized as low vs. high, and nestin was cut at 10% positive staining. Relationship between nestin and clinicopathologic factors, biomarkers and outcome were evaluated using exact/log-rank testing or logistic/Cox modeling.
There were 323 eligible cases, 34% had advanced stage disease, 37% had type II disease, and 5% were carcinosarcomas. High nestin, observed in 19% of cases, was more common in advanced vs. early stage disease, type II cancers or uterine carcinosarcoma vs. type I cancers, grade 3 disease, positive lymphovascular space invasion (LVSI) and tumors >6cm (p<0.05). Nestin was inversely correlated with ER, PR and TFF3, and correlated with p53 and IMP3. Women with high vs. low nestin had worse progression-free survival (PFS) and cancer-specific survival overall, and worse PFS in the subset who received no adjuvant therapy or radiation, or had early stage, type I disease or tumors with both low and high ER, PR, TFF3, PTEN, p53 or IMP3. The relationship between nestin and PFS was independent of stage, LVSI and risk categorization but not type of UC.
High nestin was more common in UCs with aggressive features and poor outcome. Nestin may represent a predictive biomarker for treatment selection for patients previously considered to be lower risk and a candidate for no or radiation-based adjuvant therapy, and compliment ER/PR testing.
在充分注释的子宫癌（UC）中研究巢蛋白的潜在预后和预测价值。
通过免疫组织化学（IHC）在 UC 组织微阵列中评估巢蛋白表达和先前发表的生物标志物。将生物标志物分为低与高，巢蛋白阳性染色率为 10%。使用确切/对数秩检验或逻辑/Cox 模型评估巢蛋白与临床病理因素、生物标志物和结果之间的关系。
共有 323 例合格病例，34%为晚期疾病，37%为 II 型疾病，5%为癌肉瘤。在 19%的病例中观察到高巢蛋白，在晚期疾病中比早期疾病更常见，在 II 型癌症或子宫癌肉瘤中比 I 型癌症更常见，在 3 级疾病、阳性淋巴管血管间隙浸润（LVSI）和肿瘤>6cm 时更常见（p<0.05）。巢蛋白与 ER、PR 和 TFF3 呈负相关，与 p53 和 IMP3 呈正相关。与低巢蛋白相比，高巢蛋白患者的无进展生存期（PFS）和癌症特异性生存期总体较差，在未接受辅助治疗或放疗、或处于早期、I 型疾病或同时具有低和高 ER、PR、TFF3、PTEN、p53 或 IMP3 的肿瘤的患者中 PFS 更差。巢蛋白与 PFS 的关系独立于分期、LVSI 和风险分类，但与 UC 类型无关。
巢蛋白在具有侵袭性特征和不良预后的 UC 中更为常见。巢蛋白可能代表一种预测生物标志物，用于选择以前被认为风险较低的患者的治疗方法，也是 ER/PR 检测的补充。
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