Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands.
Br J Cancer. 2023 Mar;128(7):1360-1368. doi: 10.1038/s41416-023-02141-0. Epub 2023 Jan 23.
BACKGROUND: Risk-assessment of endometrial cancer (EC) is based on clinicopathological factors and molecular subgroup. It is unclear whether adding hormone receptor expression, L1CAM expression or CTNNB1 status yields prognostic refinement. METHODS: Paraffin-embedded tumour samples of women with high-risk EC (HR-EC) from the PORTEC-3 trial (n = 424), and a Dutch prospective clinical cohort called MST (n = 256), were used. All cases were molecularly classified. Expression of L1CAM, ER and PR were analysed by whole-slide immunohistochemistry and CTNNB1 mutations were assessed with a next-generation sequencing. Kaplan-Meier method, log-rank tests and Cox's proportional hazard models were used for survival analysis. RESULTS: In total, 648 HR-EC were included. No independent prognostic value of ER, PR, L1CAM, and CTNNB1 was found, while age, stage, and adjuvant chemotherapy had an independent impact on risk of recurrence. Subgroup-analysis showed that only in NSMP HR-EC, ER-positivity was independently associated with a reduced risk of recurrence (HR 0.33, 95%CI 0.15-0.75). CONCLUSIONS: We confirmed the prognostic impact of the molecular classification, age, stage, and adjuvant CTRT in a large cohort of high-risk EC. ER-positivity is a strong favourable prognostic factor in NSMP HR-EC and identifies a homogeneous subgroup of NSMP tumours. Assessment of ER status in high-risk NSMP EC is feasible in clinical practice and could improve risk stratification and treatment.
背景:子宫内膜癌(EC)的风险评估基于临床病理因素和分子亚组。目前尚不清楚是否增加激素受体表达、L1CAM 表达或 CTNNB1 状态可以改善预后。
方法:使用 PORTEC-3 试验(n=424)中高危 EC(HR-EC)的石蜡包埋肿瘤样本和荷兰前瞻性临床队列 MST(n=256)。所有病例均进行分子分类。通过全切片免疫组织化学分析 L1CAM、ER 和 PR 的表达,并用下一代测序评估 CTNNB1 突变。采用 Kaplan-Meier 法、log-rank 检验和 Cox 比例风险模型进行生存分析。
结果:共纳入 648 例 HR-EC。未发现 ER、PR、L1CAM 和 CTNNB1 的独立预后价值,而年龄、分期和辅助化疗对复发风险有独立影响。亚组分析显示,仅在 NSMP HR-EC 中,ER 阳性与复发风险降低独立相关(HR 0.33,95%CI 0.15-0.75)。
结论:我们在一个大型高危 EC 队列中证实了分子分类、年龄、分期和辅助 CTRT 的预后影响。ER 阳性是 NSMP HR-EC 的一个强烈有利的预后因素,并确定了一个同质的 NSMP 肿瘤亚组。在高危 NSMP EC 中评估 ER 状态在临床实践中是可行的,并且可以改善风险分层和治疗。
J Microbiol Biotechnol. 2025-8-26
Diagnostics (Basel). 2025-8-21
Cancers (Basel). 2025-8-1
Cancers (Basel). 2025-7-22
Diagnostics (Basel). 2025-7-30
J Clin Oncol. 2025-7-20
Geburtshilfe Frauenheilkd. 2025-1-16
CA Cancer J Clin. 2022-1
Int J Gynecol Pathol. 2022-5-1
Int J Gynecol Cancer. 2021-1