Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Saitama, 359-8513, Japan.
Department of Surgery, National Defense Medical College Hospital, Tokorozawa, Saitama, 359-8513, Japan.
Diagn Pathol. 2021 Apr 8;16(1):28. doi: 10.1186/s13000-021-01093-4.
This study aimed to investigate the association between clinicopathologic factors, mesothelin, and cancer antigen (CA) 125 in endometrial carcinoma.
Between 1989 and 2017, patients with endometrial carcinoma who underwent total hysterectomy and bilateral salpingo-oophorectomy at our hospital were identified. The association between either or both immunochemical expression of mesothelin and CA125 and clinicopathological features were retrospectively examined.
Among 485 patients, 171 were positive for mesothelin, 368 were positive for CA125, and 167 were positive for mesothelin and CA125. The expression of mesothelin and CA125 was positively correlated (p < 0.01). More patients with mesothelin expression showed myometrial invasion of more than 50% (p = 0.028) and positive lymphovascular invasion (p = 0.027). Similarly, more patients with co-expression of mesothelin and CA125 had myometrial invasion of more than 50% (p = 0.016) and positive lymphovascular invasion (p = 0.02). Patients with mesothelin expression and co-expression of mesothelin and CA125 demonstrated worse progression-free survival (PFS) and overall survival (OS). In the multivariate analysis, mesothelin expression and co-expression were poor prognostic factors for PFS (mesothelin expression: hazard ratio [HR] = 2.14, p < 0.01; co-expression: HR = 2.19, p < 0.01) and OS (mesothelin expression: HR = 2.18, p < 0.01; co-expression: HR = 2.22, p < 0.01).
Mesothelin expression and co-expression might be associated with tumor aggressiveness and poor prognosis in patients with endometrial carcinoma. Persons with mesothelin-expressing endometrial cancers present a particularly high medical unmet need.
本研究旨在探讨子宫内膜癌中临床病理因素、间皮素和癌抗原（CA）125 之间的关联。
在 1989 年至 2017 年间，在我院行全子宫切除术和双侧附件切除术的子宫内膜癌患者被确定。回顾性检查间皮素和 CA125 的免疫化学表达与临床病理特征之间的关系。
在 485 例患者中，171 例间皮素阳性，368 例 CA125 阳性，167 例间皮素和 CA125 均阳性。间皮素和 CA125 的表达呈正相关（p<0.01）。更多表达间皮素的患者肌层浸润超过 50%（p=0.028）和阳性脉管浸润（p=0.027）。同样，更多间皮素和 CA125 共表达的患者肌层浸润超过 50%（p=0.016）和阳性脉管浸润（p=0.02）。表达间皮素和间皮素和 CA125 共表达的患者无进展生存期（PFS）和总生存期（OS）更差。多变量分析显示，间皮素表达和间皮素和 CA125 共表达是 PFS（间皮素表达：风险比 [HR] = 2.14，p<0.01；共表达：HR = 2.19，p<0.01）和 OS（间皮素表达：HR = 2.18，p<0.01；共表达：HR = 2.22，p<0.01）的不良预后因素。
间皮素表达和共表达可能与子宫内膜癌患者的肿瘤侵袭性和不良预后相关。表达间皮素的子宫内膜癌患者存在特别高的医疗未满足需求。
