Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Center for Prevention and Therapy of Gynecological Cancer, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Taiwan J Obstet Gynecol. 2024 Nov;63(6):853-860. doi: 10.1016/j.tjog.2024.07.017.
To ascertain the prognostic role of the expression levels of estrogen receptor (ER) and progesterone receptor (PR) within the stroma microenvironment of cervical cancer and explore their correlation with clinical parameters.
This retrospective cohort study involved patients with cervical cancer diagnosed and treated at Hualien Tzu Chi Hospital between 2000 and 2010. ERα, PRB, and PR (A + B) expression levels in 169 cervical carcinoma samples, including both the tumor and stromal components, were independently scored by two pathologists, and survival and clinicopathological parameters were analyzed.
ERα or PRs were predominantly expressed in the stromal compartment rather than within cervical cancer cells. Their expression was observed comprehensively within the intra- and peritumor stroma cells. A stromal PRB expression significantly correlated with a lower 5-year mortality because of cervical cancer (p = 0.011). Particularly, levels of both stromal ERα and PRB expressions correlated with lower hematogenous distant metastase rates (p = 0.013 and p = 0.011, respectively). In the multivariable logistic regression analyses, stromal PRB independently conferred a lower risk of 5-year mortality (p = 0.022), regardless of age, histology, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor differentiation, lymphovascular space invasion, and lymphatic and hematogenous metastases. Moreover, the incorporation of stromal PR (A + B) and PRB expression in the FIGO stage significantly enhanced the accuracy of survival prediction.
Stromal PRB expression emerges as an independent and favorable prognostic marker for cervical squamous cell carcinoma and correlated with a low risk of hematogenous metastases. The findings imply that incorporating this marker into the FIGO stage better predicts the survival for cervical cancer.
确定宫颈癌间质微环境中雌激素受体（ER）和孕激素受体（PR）表达水平的预后作用，并探讨其与临床参数的相关性。
本回顾性队列研究纳入了 2000 年至 2010 年在花莲慈济医院诊断和治疗的宫颈癌患者。由两位病理学家独立评估 169 例宫颈癌样本中 ERα、PRB 和 PR（A+B）的表达水平，包括肿瘤和间质成分，并分析生存和临床病理参数。
ERα 或 PRs 主要在间质区表达，而不在宫颈癌细胞内表达。它们的表达可见于肿瘤内和肿瘤周围间质细胞中。间质 PRB 表达与宫颈癌 5 年死亡率降低显著相关（p=0.011）。特别是，间质 ERα 和 PRB 表达水平均与较低的血行远处转移率相关（p=0.013 和 p=0.011）。在多变量逻辑回归分析中，无论年龄、组织学、国际妇产科联盟（FIGO）分期、肿瘤分化、脉管侵犯、淋巴和血液转移，间质 PRB 表达均独立降低宫颈癌 5 年死亡率的风险（p=0.022）。此外，FIGO 分期中加入间质 PR（A+B）和 PRB 表达可显著提高生存预测的准确性。
间质 PRB 表达是宫颈癌鳞癌的独立预后良好指标，与血行转移风险低相关。这些发现表明，将该标志物纳入 FIGO 分期可更好地预测宫颈癌的生存。
