Yalcin Necim, Yildirim Hulya Tosun, Alci Aysun, Gokkaya Mustafa, Goksu Mehmet, Ureyen Isin, Toptas Tayfun
Department of Gynecological Oncology, Saglik Bilimleri University Antalya Training and Research Hospital, 07100 Antalya, Turkey.
Department of Pathology, Saglik Bilimleri University Antalya Training and Research Hospital, 07100 Antalya, Turkey.
Oncol Lett. 2025 Mar 20;29(5):239. doi: 10.3892/ol.2025.14985. eCollection 2025 May.
Sirtuin-1 (SIRT1) expression levels are upregulated in various types of cancer and are associated with adverse outcomes. However, there is limited research on SIRT1 expression in types of gynecological cancer. The present study primarily sought to investigate the expression characteristics of SIRT1 in non-endometrioid endometrial cancer (EC) using immunohistochemistry. The secondary endpoint was to evaluate the impact of SIRT1 expression levels on progression-free survival (PFS). The present study was a single-center, retrospective cohort study that included patients who underwent hysterectomy between June 2017 and December 2021 and had a postoperative histopathological diagnosis of non-endometrioid EC. The tissue slides were stained with a monoclonal antibody targeting the SIRT1 protein. The nuclear staining reaction of SIRT1 was considered to be positive in the presence of any percentage of nuclear staining. The cytoplasmic staining reaction of SIRT1 was assessed using the immune reactivity scoring (IRS) system, which was determined by multiplying the scores for the staining percentage and staining intensity. IRS values of 0 to 2 were considered as negative expression; 3 to 4 as low expression; 6 to 8 as moderate expression; and 9 to 12 as high expression. Cox proportional hazards regression models were used to identify factors influencing PFS. Data from a total of 43 patients who met the eligibility criteria were presented. Cytoplasmic staining with SIRT1 was detected in all samples (100%), whereas no nuclear staining was evident in any of the tissue samples. According to the IRS results, 20.9% of samples exhibited negative cytoplasmic expression, 14.0% exhibited low expression, 37.2% exhibited moderate expression and 27.9% exhibited high expression. The estimated 3-year PFS rate was 43.6%. Cox regression models demonstrated no independent factor influencing PFS. In conclusion, SIRT1 expression was found to be cytoplasmic in non-endometrioid EC. According to the IRS, ~80% of cases exhibited varying degrees of SIRT1 expression. However, SIRT1 expression levels had no significant impact on PFS.
沉默调节蛋白1（SIRT1）的表达水平在各类癌症中上调，并与不良预后相关。然而，关于SIRT1在妇科癌症类型中的表达研究有限。本研究主要旨在通过免疫组织化学研究SIRT1在非子宫内膜样子宫内膜癌（EC）中的表达特征。次要终点是评估SIRT1表达水平对无进展生存期（PFS）的影响。本研究是一项单中心回顾性队列研究，纳入了2017年6月至2021年12月期间接受子宫切除术且术后组织病理学诊断为非子宫内膜样EC的患者。组织切片用靶向SIRT1蛋白的单克隆抗体染色。在存在任何百分比的核染色时，SIRT1的核染色反应被认为是阳性。SIRT1的细胞质染色反应使用免疫反应评分（IRS）系统进行评估，该评分通过将染色百分比得分和染色强度得分相乘来确定。IRS值为0至2被视为阴性表达；3至4为低表达；6至8为中度表达；9至12为高表达。使用Cox比例风险回归模型来确定影响PFS的因素。呈现了总共43例符合纳入标准患者的数据。所有样本（100%）均检测到SIRT1的细胞质染色，而在任何组织样本中均未发现明显的核染色。根据IRS结果，20.9%的样本表现为阴性细胞质表达，14.0%表现为低表达，37.2%表现为中度表达，27.9%表现为高表达。估计的3年PFS率为43.6%。Cox回归模型显示没有影响PFS的独立因素。总之，发现在非子宫内膜样EC中SIRT1表达为细胞质表达。根据IRS，约80%的病例表现出不同程度的SIRT1表达。然而，SIRT1表达水平对PFS没有显著影响。
