Köbel Martin, Atenafu Eshetu G, Rambau Peter F, Ferguson Sarah E, Nelson Gregg S, Ho T C, Panzarella Tony, McAlpine Jessica N, Gilks C Blake, Clarke Blaise A, Bernardini Marcus Q
Department of Pathology and Laboratory Medicine, University of Calgary, Canada.
Biostatistics Department, Princess Margaret Cancer Centre, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Canada.
Gynecol Oncol. 2016 Jun;141(3):559-563. doi: 10.1016/j.ygyno.2016.04.008. Epub 2016 Apr 16.
To assess the association of hormone receptor expression with outcome in high-grade endometrial carcinomas.
This study included three sites participating in the Canadian High Risk Endometrial Cancer (CHREC) consortium. Sections from tissue microarrays containing cases with a diagnosis of endometrioid grade 3 (EC3) and endometrial serous carcinoma (ESC) were assessed for estrogen (ER) and progesterone receptor (PR) expression by immunohistochemistry. Expression was considered present if >1% of tumor cell nuclei were labeled. Associations with overall survival were assessed.
ER expression was present in 168/216 (78%) of EC3 and 124/192 (65%) of ESC. PR expression was present in 148/212 (70%) of EC3 and 83/196 (42%) of ESC. PR expression was significantly associated with favorable overall survival in EC3 and ESC (log rank, p=0.018 and p=0.0024) but ER expression was not. PR expression was significantly associated with favorable overall survival in EC3 independent of age, stage, center and lymph-vascular invasion (hazard ratio=0.457, 95% CI 0.257-0.811, p=0.0075) as well as in stage I and II ESC (hazard ratio=0.266, 95% CI 0.094-0.750, p=0.0123).
Our data provide support for the assessment of the PR expression status in EC3 and ESC. Future work will be required to determine how PR expression may be incorporated into management of patients with EC3 and ESC.
评估激素受体表达与高级别子宫内膜癌预后的相关性。
本研究纳入了参与加拿大高危子宫内膜癌（CHREC）联盟的三个研究点。通过免疫组织化学评估来自组织微阵列的切片中雌激素（ER）和孕激素受体（PR）的表达，这些切片包含诊断为子宫内膜样3级（EC3）和子宫内膜浆液性癌（ESC）的病例。如果>1%的肿瘤细胞核被标记，则认为存在表达。评估其与总生存期的相关性。
ER表达存在于168/216（78%）的EC3病例和124/192（65%）的ESC病例中。PR表达存在于148/212（70%）的EC3病例和83/196（42%）的ESC病例中。PR表达与EC3和ESC的良好总生存期显著相关（对数秩检验，p=0.018和p=0.0024），但ER表达则不然。PR表达与EC3的良好总生存期显著相关，独立于年龄、分期、研究点和淋巴血管浸润（风险比=0.457，95%置信区间0.257-0.811，p=0.0075），在I期和II期ESC中也是如此（风险比=0.266，95%置信区间0.094-0.750，p=0.0123）。
我们的数据支持评估EC3和ESC中的PR表达状态。未来需要开展工作来确定如何将PR表达纳入EC3和ESC患者的管理中。
