Hveem Tarjei S, Njølstad Tormund S, Nielsen Birgitte, Syvertsen Rolf Anders, Nesheim John Arne, Kjæreng Marna L, Kildal Wanja, Pradhan Manohar, Marcickiewicz Janusz, Tingulstad Solveig, Staff Anne C, Haugland Hans K, Eraker Runar, Oddenes Klaus, Rokne Jan A, Tjugum Jostein, Lode Margaret S, Amant Frederic, Werner Henrica M J, Bjørge Line, Albregtsen Fritz, Liestøl Knut, Salvesen Helga B, Trovik Jone, Danielsen Håvard E
Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.
Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
Cancer Epidemiol Biomarkers Prev. 2017 Jan;26(1):61-67. doi: 10.1158/1055-9965.EPI-16-0215. Epub 2016 Sep 1.
Most endometrial carcinoma patients are diagnosed at an early stage with a good prognosis. However, a relatively low fraction with lethal disease constitutes a substantial number of patients due to the high incidence rate. Preoperative identification of patients with high risk and low risk for poor outcome is necessary to tailor treatment. Nucleotyping refers to characterization of cell nuclei by image cytometry, including the assessment of chromatin structure by nuclear texture analysis. This method is a strong prognostic marker in many cancers but has not been evaluated in preoperative curettage specimens from endometrial carcinoma.
The prognostic impact of changes in chromatin structure quantified with Nucleotyping was evaluated in preoperative curettage specimens from 791 endometrial carcinoma patients prospectively included in the MoMaTEC multicenter trial.
Nucleotyping was an independent prognostic marker of disease-specific survival in preoperative curettage specimens among patients with Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage I-II disease (HR=2.9; 95% CI, 1.2-6.5; P = 0.013) and significantly associated with age, FIGO stage, histologic type, histologic grade, myometrial infiltration, lymph node status, curettage histology type, and DNA ploidy.
Nucleotyping in preoperative curettage specimens is an independent prognostic marker for disease-specific survival, with potential to supplement existing parameters for risk stratification to tailor treatment.
This is the first study to evaluate the prognostic impact of Nucleotyping in curettage specimens from endometrial carcinoma and shows that this may be a clinically useful prognostic marker in endometrial cancer. External validation is warranted. Cancer Epidemiol Biomarkers Prev; 26(1); 61-67. ©2016 AACR.
大多数子宫内膜癌患者在早期被诊断，预后良好。然而，由于发病率高，患有致命性疾病的患者比例相对较低，但数量仍然可观。术前识别预后不良的高危和低危患者对于制定个体化治疗方案很有必要。核型分析是指通过图像细胞术对细胞核进行表征，包括通过核纹理分析评估染色质结构。该方法在许多癌症中是一个强有力的预后标志物，但尚未在子宫内膜癌的术前刮宫标本中进行评估。
在MoMaTEC多中心试验前瞻性纳入的791例子宫内膜癌患者的术前刮宫标本中，评估用核型分析量化的染色质结构变化的预后影响。
在国际妇产科联盟（FIGO）I-II期疾病患者的术前刮宫标本中，核型分析是疾病特异性生存的独立预后标志物（HR=2.9；95%CI，1.2-6.5；P=0.013），并且与年龄、FIGO分期、组织学类型、组织学分级、肌层浸润、淋巴结状态、刮宫组织学类型和DNA倍体显著相关。
术前刮宫标本中的核型分析是疾病特异性生存的独立预后标志物，有可能补充现有的风险分层参数以指导治疗。
这是第一项评估核型分析在子宫内膜癌刮宫标本中的预后影响的研究，表明这可能是子宫内膜癌中一种临床有用的预后标志物。需要进行外部验证。《癌症流行病学、生物标志物与预防》；26(1)；61-67。©2016美国癌症研究协会。
