Smogeli Elisabeth, Davidson Ben, Cvancarova Milada, Holth Arild, Katz Betina, Risberg Bjørn, Kristensen Gunnar, Lindemann Kristina
Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, PB 4953 Nydalen 0424, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway.
BMC Cancer. 2016 Aug 4;16:596. doi: 10.1186/s12885-016-2631-4.
L1 cell adhesion molecule (L1CAM) overexpression has been reported to be strongly associated with poor prognosis in early stage endometrial cancer (EC). We aimed at the validation of L1CAM as a marker of poor prognosis in an independent study population.
Patients with endometrioid EC FIGO stage I, were treated at Oslo University Hospital between 2005 and 2012. L1CAM expression was detected by immunohistochemistry with >10 % L1CAM staining defined as positive. Risks of relapse and death were estimated as hazard ratios (HRs) with 95 % confidence intervals (95 % CI).
Of 450 patients, 388 (86 %) were evaluable for L1CAM expression and 35 (9 %) were L1CAM positive. After follow-up for a median time of 4.8 years (0.1-8.8), 33 (8 %) patients had recurred. 6/35 (17 %) L1CAM positive patients relapsed compared to 27/353 (8 %) L1CAM-negative patients. There were 7 (20 %) deaths in the L1CAM positive group, and 34 (10 %) in the negative group. In multivariate analysis, controlled for age and FIGO stage, L1CAM positivity was not significantly associated with the risk of relapse (HR 2.08, 95 % CI: 0.85-5.10, p = 0.11) or death of all-cause (HR 1.81, 95 % CI: 0.79-4.11, p = 0.16). In patients who were not treated with chemotherapy, L1CAM was significantly associated with risk of relapse (HR 2.9; 95 % CI: 1.08-7.56; p = 0.04).
Our report confirms that L1CAM is associated with a more aggressive tumortype and more distant relapses. The overall recurrence rate in this population was low as were the absolute differences between L1CAM positive and negative patients. In this independent study sample, L1CAM failed to be a clinically relevant marker of poor prognosis in stage I endometrioid endometrial carcinoma.
据报道，L1细胞粘附分子（L1CAM）过表达与早期子宫内膜癌（EC）的不良预后密切相关。我们旨在在一个独立的研究人群中验证L1CAM作为不良预后标志物的作用。
2005年至2012年期间，在奥斯陆大学医院接受治疗的子宫内膜样EC FIGO I期患者。通过免疫组织化学检测L1CAM表达，L1CAM染色>10%定义为阳性。复发和死亡风险以风险比（HRs）及95%置信区间（95%CI）进行评估。
450例患者中，388例（86%）可评估L1CAM表达，35例（9%）L1CAM阳性。中位随访4.8年（0.1 - 8.8年）后，33例（8%）患者复发。L1CAM阳性患者中有6/35例（17%）复发，而L1CAM阴性患者中有27/353例（8%）复发。L1CAM阳性组有7例（20%）死亡，阴性组有34例（10%）死亡。在多因素分析中，校正年龄和FIGO分期后，L1CAM阳性与复发风险（HR 2.08，95%CI：0.85 - 5.10，p = 0.11）或全因死亡风险（HR 1.81，95%CI：0.79 - 4.11，p = 0.16）无显著相关性。在未接受化疗的患者中，L1CAM与复发风险显著相关（HR 2.9；95%CI：1.08 - 7.56；p = 0.04）。
我们的报告证实L1CAM与更具侵袭性的肿瘤类型及更远距离的复发相关。该人群的总体复发率较低，L1CAM阳性和阴性患者之间的绝对差异也较低。在这个独立的研究样本中，L1CAM未能成为I期子宫内膜样子宫内膜癌不良预后的临床相关标志物。
