在子宫内膜癌的分子亚群中，激素生物标志物仍然与预后相关。

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2024-11-07 DOI:10.1016/j.ygyno.2024.10.028

Stephanie W. Vrede , Willem Jan Van Weelden , Johan Bulten , C. Blake Gilks , Steven Teerenstra , Jutta Huvila , Xavier Matias-Guiu , Antonio Gil-Moreno , Jasmin Asberger , Sanne Sweegers , Louis J.M. van der Putten , Heidi V.N. Küsters-Vandevelde , Casper Reijnen , Eva Colas , Jitka Hausnerová , Vit Weinberger , Marc P.L.M. Snijders , Petra Vinklerova , Antonella Ravaggi , Franco Odicino , Johanna M.A. Pijnenborg

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引用次数: 0

摘要

目的：子宫内膜癌（EC）中激素生物标志物的预后相关性已得到证实。雌激素受体（ER）/孕激素受体（PR）表达的三层风险模型已被证明可改善预后。但尚未对分子亚组进行评估。本研究旨在评估EC分子亚组中ER/PR的表达情况：方法：采用欧洲个体化治疗中心网络和加拿大温哥华的数据，进行了一项回顾性多中心队列研究。ER/PR免疫组化表达分为以下几组：ER/PR 0-10%、20-80% 或 90-100%。分子亚组通过全新一代测序或结合免疫组化来确定：POLEmut、错配修复缺陷（MMRd）、p53mut和无特异性分子特征（NSMP）：共纳入 739 例患者（中位随访 5.0 年）。9.1%的肿瘤被归类为POLEmut（67例），27.6%的肿瘤被归类为MMRd（204例），20.8%的肿瘤被归类为p53mut（154例），42.5%的肿瘤被归类为NSMP（314例）。在所有分子亚组中，ER/PR 90%-100% 表达的患者疾病特异性生存率（DSS）最高。在 p53mut 中，PR 90-100% 表达的患者 5 年 DSS 为 100.0%。ER表达与MMRd和NSMP肿瘤的预后更相关，而PR表达与p53突变和NSMP肿瘤的预后更相关。在所有分子亚组中，PR 0-10%、p53mut、淋巴管间隙侵犯和FIGO III-IV期仍是降低DSS的独立预后因素，而PR 90-100%和POLEmut仍是改善DSS的独立预后因素：我们的研究表明，ER/PR 表达在分子亚组中仍与预后相关，三层截断值可改善预后。这些数据支持在临床实践中对ER/PR表达进行常规评估。

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Hormonal biomarkers remain prognostically relevant within the molecular subgroups in endometrial cancer

Objective

The prognostic relevance of hormonal biomarkers in endometrial cancer (EC) has been well-established. A refined three-tiered risk model for estrogen receptor (ER)/progesterone receptor (PR) expression was shown to improve prognostication. This has not been evaluated in relation to the molecular subgroups. This study aimed to evaluate the ER/PR expression within the molecular subgroups in EC.

Methods

A retrospective multicenter cohort study was performed and data from the European Network for Individualized Treatment centers and Vancouver, Canada were used. ER/PR immunohistochemical expression was grouped as: ER/PR 0–10 %, 20–80 % or 90–100 %. Molecular subgroups were determined with full next-generation sequencing or combined with immunohistochemistry: POLEmut, mismatch repair deficient (MMRd), p53mut and no-specific molecular profile (NSMP).

Results

A total of 739 patients were included (median follow-up 5.0 years). Tumors were classified as POLEmut in 9.1 %(N = 67), MMRd in 27.6 %(N = 204), p53mut in 20.8 %(N = 154) and NSMP in 42.5 %(N = 314). Among all molecular subgroups, patients with ER/PR 90–100 % expression revealed the best disease-specific survival (DSS). Within p53mut, PR 90–100 % expression showed a 5-year DSS of 100.0 %. ER expression is prognostic more relevant in MMRd and NSMP tumors while PR expression in p53mut and NSMP tumors. Across all molecular subgroups, PR 0–10 %, p53mut, lympho-vascular space invasion and FIGO stage III-IV remained independently prognostic for reduced DSS Whereas PR 90–100 % and POLEmut remained independently prognostic for improved DSS.

Conclusion

We demonstrated that ER/PR expression remain prognostically relevant within the molecular subgroups, and that a three-tiered cutoff refines prognostication. These data support incorporating routine evaluation of ER/PR expression in clinical practice.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy