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KMID : 1137020190300010013
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Journal of Gynecologic Oncology
2019 Volume.30 No. 1 p.13 ~ p.13
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The prognostic significance of estrogen and progesterone receptors in grade I and II endometrioid endometrial adenocarcinoma: hormone receptors in risk stratification
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Guan Jun
Xie Liying
Luo Xuezhen
Yang Bingyi
Zhang Hongwei
Zhu Qin
Chen Xiaojun
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Abstract
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Objectives: Although patients with grade I and II endometrioid endometrial adenocarcinoma (EEA) are considered with good prognosis, among them 15%?25% died in 5 years. It is still unknown whether integrating estrogen receptor (ER) and progesterone receptor (PR) into clinical risk stratification can help select high-risk patients with grade I?II EEA. This study was to investigate the prognostic value of ER and PR double negativity (ER/PR loss) in grade I?II EEA, and the association between ER/PR loss and The Cancer Genome Atlas (TCGA) classification.
Methods: ER and PR were assessed by immunohistochemistry on hysterectomy specimens of 903 patients with grade I?II EEA. ER and PR negativity were determined when <1% tumor nuclei were stained. Gene expression data were obtained from the TCGA research network.
Results: Compared with ER or PR positive patients (n=868), patients with ER/PR loss (n=35) had deeper myometrial infiltration (p=0.012), severer FIGO stage (p=0.004), and higher rate of pelvic lymph node metastasis (p=0.020). In univariate analysis, ER/PR loss correlated with a shorter progression-free survival (PFS; hazard ratio [HR]=5.25; 95% confidence interval [CI]=2.21?12.52) and overall survival (OS; HR=7.59; 95% CI=2.55?22.60). In multivariate analysis, ER/PR loss independently predicted poor PFS (HR=3.77; 95% CI=1.60?10.14) and OS (HR=5.56; 95% CI=1.37?22.55) for all patients, and poor PFS for patients in stage IA (n=695; HR=5.54; 95% CI=1.28?23.89) and stage II?IV (n=129; HR=5.77; 95% CI=1.57?21.27). No association was found between ER/PR loss and TCGA classification.
Conclusion: Integrating ER/PR evaluation into clinical risk stratification may improve prognosis for grade I?II EEA patients.
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KEYWORD
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Endometrial Cancer, Endometrioid Carcinoma, Low-Grade, Estrogen Receptor, Progesterone Receptor, Biomarker
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