[PMID]: | 28599900 |
[Au] Autor: | Halle MK; Ojesina AI; Engerud H; Woie K; Tangen IL; Holst F; Høivik E; Kusonmano K; Haldorsen IS; Vintermyr OK; Trovik J; Bertelsen BI; Salvesen HB; Krakstad C |
[Ad] Endereço: | Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway; Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Norway. |
[Ti] Título: | Clinicopathologic and molecular markers in cervical carcinoma: a prospective cohort study. |
[So] Source: | Am J Obstet Gynecol;217(4):432.e1-432.e17, 2017 Oct. |
[Is] ISSN: | 1097-6868 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | BACKGROUND: Cervical cancer is a major health problem worldwide. Identification of effective clinicopathologic and molecular markers is vital to improve treatment stratification. OBJECTIVES: The purpose of this study was to validate a set of well-defined clinicopathologic features in a large population-based, prospectively collected cervical cancer cohort to support their use in the clinic. Further, we explored p53 and human epidermal growth factor receptor 2 as potential prognostic markers in cervical cancer. STUDY DESIGN: Tissue was collected from 401 patients with cervical cancer. Clinical data that included follow-up evaluations were collected from patient journals. Histopathologic data were evaluated and revised by an expert pathologist. The prognostic impact of selected clinicopathologic variables was analyzed in the whole cohort. Tissue microarrays were prepared from 292 carcinomas, and p53 and human epidermal growth factor receptor 2 protein levels were evaluated by immunohistochemistry. Fresh frozen samples from overlapping cervical carcinomas previously were subjected to human papilloma virus typing (n=94), whole exome (n=100) and RNA (n=79) sequencing; the results were available for our analyses. RESULTS: Among the clinicopathologic variables, vascular space invasion, histologic type, and tumor size were verified as strong independent prognostic markers. High p53 protein levels were associated significantly with markers for aggressive phenotype and survival, also in multivariate survival analysis, but did not reflect TP53 mutational status. High human epidermal growth factor receptor 2 protein levels were identified in 21% of all tumors. ERBB2 amplification was associated with poor outcome (P=.003); human epidermal growth factor receptor 2 protein level was not. CONCLUSIONS: Our findings support that the Féderation Internationale de Gynécologie et d'Obstétrique s guidelines should include vascular space invasion and tumor size 2-4 cm and that careful selection of histologic type is essential for stratification of patient risk groups. High p53 levels independently predict poor survival yet do not reflect mutational status in cervical cancer. Amplified ERBB2 significantly links to poor survival, while HercepTest does not. With optimal stratification, human epidermal growth factor receptor 2-based therapy may improve cervical cancer treatment. |
[Mh] Termos MeSH primário: |
Neoplasias do Colo do Útero/genética Neoplasias do Colo do Útero/metabolismo
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[Mh] Termos MeSH secundário: |
Adulto Biomarcadores Tumorais/genética Biomarcadores Tumorais/metabolismo Carcinoma/genética Carcinoma/metabolismo Carcinoma/mortalidade Carcinoma/patologia Estudos de Coortes Feminino Deleção de Genes Genes erbB-2 Genes p53 Papillomavirus Humano 16/isolamento & purificação Papillomavirus Humano 18/isolamento & purificação Seres Humanos Imuno-Histoquímica Meia-Idade Mutação Invasividade Neoplásica Tumores Neuroendócrinos/genética Tumores Neuroendócrinos/metabolismo Tumores Neuroendócrinos/mortalidade Tumores Neuroendócrinos/patologia Prognóstico Receptor ErbB-2/metabolismo Análise de Sequência Análise Serial de Tecidos Proteína Supressora de Tumor p53/metabolismo Neoplasias do Colo do Útero/mortalidade Neoplasias do Colo do Útero/patologia
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; VALIDATION STUDIES |
[Nm] Nome de substância:
| 0 (Biomarkers, Tumor); 0 (Tumor Suppressor Protein p53); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2) |
[Em] Mês de entrada: | 1710 |
[Cu] Atualização por classe: | 171002 |
[Lr] Data última revisão:
| 171002 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 170611 |
[St] Status: | MEDLINE |
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