Uzan Jennifer, Laas Enora, Alsamad Issam Abd, Skalli Dounia, Mansouri Dhouha, Haddad Bassam, Touboul Cyril
Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, 94000 Créteil, France.
Department of Pathology, Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, 94000 Créteil, France.
Int J Mol Sci. 2017 May 13;18(5):1055. doi: 10.3390/ijms18051055.
Obesity is a major risk factor for endometrial cancer (EC). Yet, its impact on prognosis is controversial. Obesity is associated with metabolic and hormonal dysregulation as well as adipokines increase. The aim of this study was to characterize the expression of biological factors related to obesity within the tumor and evaluate their impact on prognosis. One hundred and thirty-six patients, including 55 obese patients, with endometrioid type I EC operated by total hysterectomy were included in this retrospective study conducted in a Tertiary teaching hospital between 2000 and 2013. Immunohistochemistry (IHC) study was performed on type I EC tumor samples using five adipokines (SPARC, RBP4 (Retinol Binding Protein 4), adiponectin, TNF α, IL-6) and hormonal receptors (estrogen receptor and progesterone receptor). Supervised clustering of immunohistochemical markers was performed to identify clusters that could be associated with prognostic groups. The prognosis of the obese population was not different from the prognosis of the general population. Adipokine expression within tumors was not different in these two populations. In obese population, we found three clusters where co-expression was associated with a recurrence group in comparison with a non-recurrence group and four clusters where co-expression was associated with the high risk FIGO (International Federation of Gynecology and Obstetrics) stage I group in comparison of low risk FIGO stage I group. While obesity does not appear as a prognostic factor in endometrioid type I EC, the co-expression of biological factors in IHC on hysterectomy specimens allowed to distinguish two prognostic groups in obese population.
肥胖是子宫内膜癌（EC）的主要危险因素。然而，其对预后的影响存在争议。肥胖与代谢和激素失调以及脂肪因子增加有关。本研究的目的是表征肿瘤内与肥胖相关的生物学因素的表达，并评估它们对预后的影响。本回顾性研究纳入了2000年至2013年在一家三级教学医院接受全子宫切除术的136例子宫内膜样I型EC患者，其中包括55例肥胖患者。使用五种脂肪因子（富含半胱氨酸的酸性分泌蛋白（SPARC）、视黄醇结合蛋白4（RBP4）、脂联素、肿瘤坏死因子α、白细胞介素-6）和激素受体（雌激素受体和孕激素受体）对I型EC肿瘤样本进行免疫组织化学（IHC）研究。对免疫组织化学标记物进行监督聚类，以识别可能与预后组相关的聚类。肥胖人群的预后与一般人群的预后没有差异。这两个人群中肿瘤内的脂肪因子表达没有差异。在肥胖人群中，我们发现三个聚类，其共表达与复发组相关，相比之下非复发组；还有四个聚类，其共表达与国际妇产科联合会（FIGO）I期高危组相关，相比之下FIGO I期低危组。虽然肥胖在子宫内膜样I型EC中似乎不是一个预后因素，但对子宫切除标本进行的IHC中生物学因素的共表达能够在肥胖人群中区分出两个预后组。
