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Xing M, Wu B, Wang S. Heat Shock Protein B7 Inhibits the Progression of Endometrial Carcinoma by Inhibiting PI3K/AKT/mTOR Pathway. Reprod Sci 2023; 30:590-600. [PMID: 35859224 DOI: 10.1007/s43032-022-01041-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the role and mechanism of action of Heat shock protein B7 (HSPB7) in endometrial carcinoma (EC). METHODS GEPIA (Gene Expression Profiling Interactive Analysis) was used to analyze the expression and prognostic value of HSPB7 in TCGA data. HSPB7 mRNA and protein expression levels were detected by qRT-PCR and Western blot, respectively. EC cell proliferation, apoptosis, migration, and invasion were determined by colony formation, EdU, flow cytometry, and transwell assays. Mitochondrial membrane potential was determined using JC-1 probe. In addition, apoptosis-related and metastasis-related proteins were quantitatively evaluated. A gene set enrichment analysis of the signaling pathways by which HSPB7 influences EC was performed and the levels of enriched pathway-related proteins were evaluated. RESULTS We first proved that HSPB7 was downregulated in EC tissues and HSPB7 levels were positively related to survival rates. In functional assays, HSPB7 overexpression suppressed the proliferation, migration, and invasion of EC cells and conversely promoted apoptosis. Moreover, HSPB7 overexpression decreased the mitochondrial membrane potential of EC cells significantly. Bioinformatics analyses revealed that the PI3K/AKT/mTOR pathway was significantly enriched in EC. HSPB7 inhibited the phosphorylation of the PI3K/AKT/mTOR pathway to reduce proliferation, migration and invasion, and increased apoptosis in EC cells. CONCLUSION HSPB7 was downregulated in EC and influenced EC cell proliferation, invasion, migration, and apoptosis via the PI3K/AKT/mTOR signaling pathway. These findings provide a novel perspective for the development of EC treatment strategies.
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Abdol Manap N, Ng BK, Phon SE, Abdul Karim AK, Lim PS, Fadhil M. Endometrial Cancer in Pre-Menopausal Women and Younger: Risk Factors and Outcome. Int J Environ Res Public Health 2022; 19:9059. [PMID: 35897440 DOI: 10.3390/ijerph19159059] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/04/2022]
Abstract
Endometrial cancer is the sixth most common malignancy in women, and it is known to be a disease among postmenopausal women, but there is rising in the number of endometrial cancers among premenopausal women. This study aims to determine the clinical characteristic, risk factors, outcomes, and survival in pre and postmenopausal women with endometrial cancer in Malaysia. A retrospective study was conducted in Hospital Melaka that involved all women who were diagnosed with endometrial cancer in Hospital Melaka from January 2002 until July 2020. All subjects’ histopathological examination result was confirmed, and their clinical data were extracted and transferred into a standardized data checklist and analysed. A total number of 392 cases was obtained from the Annual Cancer Registry Hospital Melaka. However, only 281 cases were studied, including 44.8% premenopausal and 55.2% postmenopausal women. In the premenopausal group, there were higher incidence of obesity (30.8 + 8.6 vs. 28.9 + 7.1), younger age at menarche (12.7 + 1.5 vs. 13.3 + 1.6), lesser parity (1.47 vs. 3.26), and a higher number of nulliparous women (46.8% vs. 19.4%) as compared to postmenopausal group. The premenopausal group tends to be presented with a well-differentiated grading of tumour (52.4%) and a higher incidence of having concomitant endometrial hyperplasia (41.3%). The mean survival among the premenopausal group (200.3 + 7.9 months) is higher compared to postmenopausal group (153.9 + 6.5 months). These findings correlate with good survival and prognosis among the premenopausal group compared to the postmenopausal group.
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Yu F, Li B, Sun J, Qi J, De Wilde RL, Torres-de la Roche LA, Li C, Ahmad S, Shi W, Li X, Chen Z. PSRR: A Web Server for Predicting the Regulation of miRNAs Expression by Small Molecules. Front Mol Biosci 2022; 9:817294. [PMID: 35386297 PMCID: PMC8979021 DOI: 10.3389/fmolb.2022.817294] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/10/2022] [Indexed: 12/13/2022] Open
Abstract
Background: MicroRNAs (miRNAs) play key roles in a variety of pathological processes by interacting with their specific target mRNAs for translation repression and may function as oncogenes (oncomiRs) or tumor suppressors (TSmiRs). Therefore, a web server that could predict the regulation relations between miRNAs and small molecules is expected to achieve implications for identifying potential therapeutic targets for anti-tumor drug development. Methods: Upon obtaining positive/known small molecule-miRNA regulation pairs from SM2miR, we generated a multitude of high-quality negative/unknown pairs by leveraging similarities between the small molecule structures. Using the pool of the positive and negative pairs, we created the Dataset1 and Dataset2 datasets specific to up-regulation and down-regulation pairs, respectively. Manifold machine learning algorithms were then employed to construct models of predicting up-regulation and down-regulation pairs on the training portion of pairs in Dataset1 and Dataset2, respectively. Prediction abilities of the resulting models were further examined by discovering potential small molecules to regulate oncogenic miRNAs identified from miRNA sequencing data of endometrial carcinoma samples. Results: The random forest algorithm outperformed four machine-learning algorithms by achieving the highest AUC values of 0.911 for the up-regulation model and 0.896 for the down-regulation model on the testing datasets. Moreover, the down-regulation and up-regulation models yielded the accuracy values of 0.91 and 0.90 on independent validation pairs, respectively. In a case study, our model showed highly-reliable results by confirming all top 10 predicted regulation pairs as experimentally validated pairs. Finally, our predicted binding affinities of oncogenic miRNAs and small molecules bore a close resemblance to the lowest binding energy profiles using molecular docking. Predictions of the final model are freely accessible through the PSRR web server at https://rnadrug.shinyapps.io/PSRR/. Conclusion: Our study provides a novel web server that could effectively predict the regulation of miRNAs expression by small molecules.
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Affiliation(s)
- Fanrong Yu
- Department of Obstetrics and Gynecology, Fengxian District Central Hospital, Shanghai Jiao Tong University Affiliated to Sixth People’s Hospital South Campus, Shanghai, China
| | - Bihui Li
- Department of Oncology, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Jianfeng Sun
- Department of Bioinformatics, Wissenschaftzentrum Weihenstephan, Technical University of Munich, Freising, Germany
| | - Jing Qi
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstraße, Düsseldorf, Germany
| | - Rudy Leon De Wilde
- University Hospital for Gynecology, Pius-Hospital, University Medicine Oldenburg, Oldenburg, Germany
| | | | - Cheng Li
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
| | - Wenjie Shi
- University Hospital for Gynecology, Pius-Hospital, University Medicine Oldenburg, Oldenburg, Germany
| | - Xiqing Li
- Oncology Department, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, China
- *Correspondence: Zihao Chen, ; Xiqing Li,
| | - Zihao Chen
- University Hospital for Gynecology, Pius-Hospital, University Medicine Oldenburg, Oldenburg, Germany
- *Correspondence: Zihao Chen, ; Xiqing Li,
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Cai Y, Hao M, Chang Y, Liu Y. LINC00665 enhances tumorigenicity of endometrial carcinoma by interacting with high mobility group AT-hook 1. Cancer Cell Int 2021; 21:8. [PMID: 33407473 PMCID: PMC7789558 DOI: 10.1186/s12935-020-01657-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022] Open
Abstract
Background Endometrial carcinoma is a frequently diagnosed cancer among females. LncRNAs are reported to be associated with various cancers. Their biological roles in endometrial carcinoma progression is an emerging scientific area. LINC00665 can exert a significant role in many cancers. However, its potential function in endometrial carcinoma is still poorly known. Method qRT-PCR was carried out to test expression of LINC00665 and HMGA1. Western blot analysis was carried out to detect protein expression of HMGA1. Cell proliferation was evaluated using Cell Counting Kit-8 (CCK-8) and EdU assay. Flow cytometry assay was used to determine cell apoptosis and cell cycle. Wound healing and transwell invasion assay was carried out to test cell migration and invasion. Immunohistochemical staining and HE staining were conducted to assess Ki-67 and tumor growth respectively. Results Expression of LINC00665 in clinical endometrial carcinoma tissues and cells was obviously up-regulated. Loss of LINC00665 could repress endometrial carcinoma cell viability, induce cell apoptosis and block cell cycle in G1 phase. KLE and HHUA cell migration and invasion ability were depressed by LINC00665 shRNA. Decrease of LINC00665 suppressed endometrial carcinoma tumorigenicity in vivo. RIP assay proved that LINC00665 directly bound with HMGA1 protein. shRNA of HMGA1 obviously restrained endometrial carcinoma cell growth and cell invasion. Conclusions LINC00665 might promote endometrial carcinoma progression by positively modulating HMGA1.
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Affiliation(s)
- Yixuan Cai
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Min Hao
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yue Chang
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yun Liu
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
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Sun R, Sun X, Liu H, Li P. Knockdown of lncRNA TDRG1 Inhibits Tumorigenesis in Endometrial Carcinoma Through the PI3K/AKT/mTOR Pathway. Onco Targets Ther 2019; 12:10863-10872. [PMID: 31849490 PMCID: PMC6912007 DOI: 10.2147/ott.s228168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/21/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Endometrial carcinoma (EC) is one of the most frequently diagnosed malignancies in females. Dysregulation of lncRNA TDRG1 has been widely documented in several cancers, including EC. However, the mechanism of this lncRNA involving in EC progression remains to be further elucidated. MATERIALS AND METHODS The enrichment levels of TDRG1 in EC tissues and cell lines were examined by RT-qPCR. Flow cytometry, cell counting kit-8 (CCK-8), transwell, and Western blot assays were conducted to assess whether TDRG1 knockdown could affect cell cycle arrest, proliferation, migration, invasion, and apoptosis of EC cells. The phosphorylation levels of mTOR, AKT and PI3K that associated with PI3K/Akt/mTOR pathway were determined by Western blot assay. RESULTS TDRG1 expression was markedly upregulated in EC tissues and cell lines. Knockdown of TDRG1 significantly induced cell cycle arrest and apoptosis, inhibited cell proliferation, restrained the invasion and migration abilities in EC cells. Moreover, TDRG1 silencing decreased the protein levels of p-AKT, p-PI3K, and p-mTOR of EC cells. CONCLUSION Our data underlined the implication of TDRG1 in EC progression, proposing that targeting TDRG1 might be a potential therapeutic avenue in EC.
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Affiliation(s)
- Ruimei Sun
- Department of Radiotherapy, The Affiliated Hospital of Weifang Medical University, Weifang261041, People’s Republic of China
| | - Xiujiang Sun
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Weifang Medical University, Weifang261041, People’s Republic of China
| | - Hua Liu
- Department of Gynaecology, The Affiliated Hospital of Weifang Medical University, Weifang261041, People’s Republic of China
| | - Peirui Li
- Department of Thyroid and Breast Surgery, The Affiliated Hospital of Weifang Medical University, Weifang261041, People’s Republic of China
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Candido EC, Rangel Neto OF, Toledo MCS, Torres JCC, Cairo AAA, Braganca JF, Teixeira JC. Systematic lymphadenectomy for intermediate risk endometrial carcinoma treatment does not improve the oncological outcome. Eur J Obstet Gynecol Reprod Biol X 2019; 3:100020. [PMID: 31403112 PMCID: PMC6687380 DOI: 10.1016/j.eurox.2019.100020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/20/2019] [Accepted: 04/09/2019] [Indexed: 12/31/2022] Open
Abstract
Objective To evaluate the indication and performance of systematic lymphadenectomy (SL) in Stage I endometrioid endometrial carcinoma (EEC), at intermediate risk (FIGO IAG2/G3, IBG1/G2) on recurrence, disease-free survival (DFS) and survival. Study design 194 women underwent hysterectomies by laparotomy, with SL (n = 95) or without SL (n = 99) between 1990 and 2014 was evaluated. Diagnosis period, age, BMI, comorbidities, stage, and adjuvant radiotherapy were analyzed. DFS and cancer-specific survival were analyzed by Kaplan-Meier and log-rank test, and recurrences by Cox regression. Results SL was performed in 93% (41/44) of women managed before 1998 and decreasing after that (p < 0.001). SL was also more frequent if BMI under 35.0 kg/m2 (p < 0.001) and in women without comorbidities (p = 0.017). Distribution of age, stage and postoperative radiotherapy were not different between groups. There were 14 recurrences (7.4%), concentrated in the SL group (12 cases) and associated with Stage IAG3 (35.7%, p = 0.009). Longitudinal evaluation exhibited 95% of 5-year cancer-specific survival rate for non-SL group vs. 88% for the SL group (p = 0.039), and DFS rate was 97% for the non-SL group vs. 85% for the SL group (p = 0.004). Cox regression analyses exhibited Stage IAG3 (HR 6.48, IC95% 1.88–22.39; p = 0.003) associated with less DFS. Conclusion SL in surgical staging of EEC at intermediate risk presented no benefits regarding recurrences, DFS, and cancer-specific survival rate when compared to patients not submitted to complete surgical staging. Stage IAG3 had poor prognosis regardless treatment modality. Our results provide further evidence to support the current trend to avoid SL in the surgical approach to selected women.
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Affiliation(s)
- Elaine C Candido
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Osmar F Rangel Neto
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Maria Carolina S Toledo
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - José Carlos C Torres
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Aurea A A Cairo
- Department of Obstetrics and Gynecology, Pontifical Catholic University of Campinas, Av. John Boyd Dunlop, s/n - Jd. Ipaussurama, Campinas, SP, 13060-904 Brazil
| | - Joana F Braganca
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
| | - Julio C Teixeira
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitaria, Campinas, SP, 13083-881, Brazil
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Piedimonte S, Richer L, Souhami L, Arseneau J, Fu L, Gilbert L, Alfieri J, Jardon K, Zeng XZ. Clinical significance of isolated tumor cells and micrometastasis in low-grade, stage I endometrial cancer. J Surg Oncol 2018; 118:1194-1198. [DOI: 10.1002/jso.25259] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/09/2018] [Indexed: 01/24/2023]
Affiliation(s)
- Sabrina Piedimonte
- Department of Obstetrics and Gynecology; McGill University Health Center; Montreal Canada
| | - Lara Richer
- Department of Pathology; McGill University Health Center; Montreal Canada
| | - Luis Souhami
- Department of Radiation Oncology; McGill University Health Center; Montreal Canada
| | - Jocelyne Arseneau
- Department of Pathology; McGill University Health Center; Montreal Canada
| | - Lili Fu
- Department of Pathology; McGill University Health Center; Montreal Canada
| | - Lucy Gilbert
- Department of Obstetrics and Gynecology; McGill University Health Center; Montreal Canada
- Department of Gynecologic Oncology; McGill University Health Center; Montreal Canada
| | - Joanne Alfieri
- Department of Radiation Oncology; McGill University Health Center; Montreal Canada
| | - Kris Jardon
- Department of Gynecologic Oncology; McGill University Health Center; Montreal Canada
| | - Xing Ziggy Zeng
- Department of Obstetrics and Gynecology; McGill University Health Center; Montreal Canada
- Department of Gynecologic Oncology; McGill University Health Center; Montreal Canada
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Sun Y, Zou X, He J, Mao Y. Identification of long non-coding RNAs biomarkers associated with progression of endometrial carcinoma and patient outcomes. Oncotarget 2017; 8:52604-52613. [PMID: 28881755 PMCID: PMC5581054 DOI: 10.18632/oncotarget.17537] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/07/2017] [Indexed: 12/16/2022] Open
Abstract
Endometrial carcinoma is a complex disease characterized by both genetic, epigenetic and environmental factors. Increasing evidence has suggested that long non-coding RNAs (lncRNAs) play important roles in the development and progression of cancers. In this study, we performed a comparison analysis for lncRNA expression between patients with early-stage (stage I/II) and those with advanced-stage (stage III/IV) derived from The Cancer Genome Atlas (TCGA) project and identified 17 differentially expressed lncRNAs using student t-test. Five of the 17 differentially expressed lncRNAs were selected as optimal biomarkers that are significantly associated with progression of UCEC using random forest feature selection procedure. A risk classifier of five lncRNAs was developed to as a molecular signature that identifies patients at high risk for progression using support vector machine. Results of five-lncRNA risk classifier achieved high discriminatory performance in distinguishing advanced stage from early stage with 78% prediction accuracy, 96.6% sensitivity and 76.6% specificity. Functional analysis suggested that these five lncRNA biomarkers may play critical roles in the progression of UCEC by participating in important cancer-related biological processes. Our study will help to improve our understanding of underlying mechanisms in the progression of UCEC and provide novel lncRNAs as candidate predictive biomarkers for the identification of patients with high risk for progression.
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Affiliation(s)
- Yanan Sun
- Department of Gynecology and Obstetrics, Daqing Oilfield General Hospital, Daqing 163000, China
| | - Xiaoyan Zou
- Department of Gynecology and Obstetrics, Daqing Oilfield General Hospital, Daqing 163000, China
| | - Jun He
- Department of Gynecology and Obstetrics, Daqing Oilfield General Hospital, Daqing 163000, China
| | - Yuqin Mao
- Department of Gynecology and Obstetrics, Daqing Oilfield General Hospital, Daqing 163000, China
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Bourgioti C, Chatoupis K, Tzavara C, Antoniou A, Rodolakis A, Moulopoulos LA. Predictive ability of maximal tumor diameter on MRI for high-risk endometrial cancer. Abdom Radiol (NY) 2016; 41:2484-95. [PMID: 27714421 DOI: 10.1007/s00261-016-0927-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIM To investigate the predictive ability of tumor size for deep myometrial invasion (≥50%) and metastatic lymphadenopathy, on maximal tumor diameter (MRI) of endometrial cancer. MATERIALS AND METHODS Our study population consisted of 105 patients (mean age: 59.8 years) with histologically confirmed endometrial cancer. All patients underwent preoperative pelvic MRI. Tumor maximal diameter (size) was calculated on multiple sequences, and the largest value was recorded. Logistic regression analysis was performed to investigate the association of maximal tumor diameter (MRI) with the depth of myometrial invasion and the presence of pelvic nodal metastases (histology); optimal tumor size cut-off for the prediction of deep myometrial involvement and nodal metastases was calculated using ROC analysis. Surgicopathological specimen examination was the standard of reference. RESULTS Tumor size on MRI, independently predicted deep myometrial invasion. Optimal maximal tumor diameter cut-off for the prediction of deep myometrial invasion was 2 cm (SE 90%, SP 50.9%). When tumor size was used as a categorical variable in the multiple logistic regression model, tumor size >2 cm had 10.04 times greater odds of deep myometrial invasion (95% CI 3.34-30.17, p < 0.001). Optimal tumor size cut-off for prediction of nodal metastases was 4 cm (SE 60%, SP 76.9%). Multiple logistic regression analysis with nodal metastases as a dependent variable showed that tumor size >4 cm had 4.79 times greater odds for malignant dissemination to the lymph nodes (95% CI 1.00-23.09, p = 0.047). CONCLUSION Maximal tumor diameter on preoperative MRI may be yet another prognosticator for deep myometrial invasion and metastatic lymphadenopathy in patients with endometrial carcinoma.
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Body N, Lavoué V, De Kerdaniel O, Foucher F, Henno S, Cauchois A, Laviolle B, Leblanc M, Levêque J. Are preoperative histology and MRI useful for classification of endometrial cancer risk? BMC Cancer 2016; 16:498. [PMID: 27430321 PMCID: PMC4950781 DOI: 10.1186/s12885-016-2554-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background The 2010 guidelines of the French National Cancer Institute (INCa) classify patients with endometrial cancer into three risk groups for lymph node invasion and recurrence on the basis of MRI and histological analysis of an endometrial specimen obtained preoperatively. The classification guides therapeutic choices, which may include pelvic and/or para-aortic lymphadenectomy. The purpose of this study was to evaluate the diagnostic performance of preoperative assessment to help identify intermediate- or high-risk patients requiring lymphadenectomy. Methods The study included all patients who underwent surgery for endometrial cancer between January 2010 and December 2013 at either Rennes University Hospital or Vannes Regional Hospital. The criteria for eligibility included a preoperative assessment with MRI and histological examination of an endometrial sample. A histological comparison was made between the preoperative and surgical specimens. Results Among the 91 patients who underwent a full preoperative assessment, the diagnosis of intermediate- or high-risk endometrial cancer was established by MRI and histology with a sensitivity of 70 %, specificity of 82 %, positive predictive value (PPV) of 87 %, negative predictive value (NPV) of 61 %, positive likelihood ratio (LR+) of 3.8 and negative likelihood ratio (LR-) of 0.3. The risk group was underestimated in 32 % of patients and overestimated in 7 % of patients. MRI underestimated endometrial cancer stage in 20 % of cases, while endometrial sampling underestimated the histological type in 4 % of cases and the grade in 9 % of cases. Conclusion The preoperative assessment overestimated or underestimated the risk of recurrence in nearly 40 % of cases, with errors in lesion type, grade or stage. Erroneous preoperative risk assessment leads to suboptimal initial surgical management of patients with endometrial cancer.
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Affiliation(s)
- Noemie Body
- Gynaecology Department, Rennes University Hospital, Hôpital Sud, Rennes, France
| | - Vincent Lavoué
- Gynaecology Department, Rennes University Hospital, Hôpital Sud, Rennes, France. .,Oncogenesis, Stress and Signaling, ER 4440, CRCL CRLCC Eugène Marquis, Rennes, France. .,University of Rennes 1, Faculty of Medicine, Rennes, France.
| | | | - Fabrice Foucher
- Gynaecology Department, Rennes University Hospital, Hôpital Sud, Rennes, France.,Oncogenesis, Stress and Signaling, ER 4440, CRCL CRLCC Eugène Marquis, Rennes, France
| | - Sébastien Henno
- Pathology Department, CHU Pontchaillou, Rennes University Hospital, Rennes, France
| | - Aurélie Cauchois
- Pathology Department, CHU Pontchaillou, Rennes University Hospital, Rennes, France
| | - Bruno Laviolle
- Clinical Pharmacology Department, Rennes University Hospital, CIC Inserm 0203, Hôpital Pontchaillou, Rennes, France
| | - Marc Leblanc
- Gynaecology Department, Bretagne Atlantique Hospital, Vannes, France
| | - Jean Levêque
- Gynaecology Department, Rennes University Hospital, Hôpital Sud, Rennes, France.,Oncogenesis, Stress and Signaling, ER 4440, CRCL CRLCC Eugène Marquis, Rennes, France.,University of Rennes 1, Faculty of Medicine, Rennes, France
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Walker CJ, Miranda MA, O'Hern MJ, McElroy JP, Coombes KR, Bundschuh R, Cohn DE, Mutch DG, Goodfellow PJ. Patterns of CTCF and ZFHX3 Mutation and Associated Outcomes in Endometrial Cancer. J Natl Cancer Inst 2015; 107:djv249. [PMID: 26330387 DOI: 10.1093/jnci/djv249] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 08/05/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The genetic events responsible for tumor aggressiveness in endometrioid endometrial cancer (EEC) remain poorly understood. The chromosome 16q22 tumor suppressor genes CTCF and ZFHX3 are both frequently mutated in EEC, but their respective roles in outcome have not been determined. METHODS Targeted deep sequencing of CTCF and ZFHX3 was performed for 542 EEC samples. Copy number loss (CNL) was determined using microsatellite typing of paired tumor and normal DNA and a novel Bayesian method based on variant allele frequencies of germline polymorphisms. All statistical tests were two-sided. RESULTS Mutation rates for CTCF and ZFHX3 were 25.3% and 20.4%, respectively, and there was a statistically significant excess of tumors with mutation in both genes (P = .003). CNL rates were 17.4% for CTCF and 17.2% for ZFHX3, and the majority of CNLs included both CTCF and ZFHX3. Mutations were more frequent in tumors with microsatellite instability, and CNLs were more common in microsatellite-stable tumors (P < .001). Patients with ZFHX3 mutation and/or CNL had higher-grade tumors (P = .001), were older (P < .001), and tended to have more frequent lymphovascular space invasion (P = .07). These patients had reduced recurrence-free and overall survival (RFS: hazard ratio [HR] = 2.35, 95% confidence interval [CI] = 1.38 to 3.99, P = .007; OS: HR = 1.51, 95% CI = 1.11 to 2.07, P = .04). CONCLUSIONS Our data demonstrate there is strong selection for inactivation of both CTCF and ZFHX3 in EEC. Mutation occurs at high frequency in microsatellite-unstable tumors, whereas CNLs are common in microsatellite-stable cancers. Loss of these two tumor suppressors is a frequent event in endometrial tumorigenesis, and ZFHX3 defects are associated with poor outcome.
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Affiliation(s)
- Christopher J Walker
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - Mario A Miranda
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - Matthew J O'Hern
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - Joseph P McElroy
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - Kevin R Coombes
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - Ralf Bundschuh
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - David E Cohn
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - David G Mutch
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM)
| | - Paul J Goodfellow
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology (CJW, MAM, MJO, DEC, PJG), Department of Biomedical Informatics, Center for Biostatistics, College of Medicine (JPM, KRC), The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (CJW, MAM, MJO, JPM, KRC, DEC, PJG), Department of Physics, Department of Chemistry & Biochemistry, Department of Internal Medicine, Division of Hematology, Center for RNA Biology (RB), The Ohio State University, Columbus, OH; Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Washington University, St. Louis, MO (DGM).
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Hayashi H, Takamura H, Nakanuma S, Kinoshita J, Makino I, Nakamura K, Oyama K, Nakagawara H, Miyashita T, Tajima H, Ninomiya I, Kitagawa H, Fujimura T, Fushida S, Tani T, Ohta T. Aggressive Surgical Management for Metastatic Liver Tumors From Squamous Cell Carcinomas: Report of Three Cases. Int Surg 2015; 100:1271-5. [DOI: 10.9738/intsurg-d-14-00312.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The use of hepatectomy for the treatment of metastatic liver tumors (MLTs) arising from squamous cell carcinomas (SCCs) has not been well investigated. The use of hepatectomy for MLTs from SCCs, especially in advanced cases, needs further investigation. Three patients with SCC-derived MLTs underwent hepatectomy. On clinicopathologic examination, the primary lesions were found to be oral cancer, lung cancer, and oropharyngeal cancer, with synchronous metastasis in 2 patients and metachronous metastasis in 1 patient. One case also involved adrenal metastasis, and another involved direct invasion of the diaphragm and lung. In all cases, surgery was performed to eliminate any residual tumor tissue. After the hepatectomy, 1 patient died (22 months postoperatively) of an unrelated disease, 1 remains alive (30 months postoperatively) with a recurrent tumor, and 1 remains alive (60 months postoperatively) without recurrence. For the patients with solitary MLT derived from SCC, hepatectomy gives a chance for a cure. Thus, aggressive hepatectomy is an important modality in the multidisciplinary approach for controlling SCC-derived MLTs.
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Zheng L, Zheng S, Yuan X, Wang X, Zhang Z, Zhang G. Comparison of dynamic contrast-enhanced magnetic resonance imaging with T2-weighted imaging for preoperative staging of early endometrial carcinoma. Onco Targets Ther 2015; 8:1743-51. [PMID: 26229482 PMCID: PMC4514351 DOI: 10.2147/ott.s86519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose This study aimed to compare dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with T2-weighted imaging (T2WI) for the preoperative staging of early endometrial carcinoma. Methods This retrospective study included 22 subjects with early endometrial carcinoma who underwent 3.0 T MRI examination prior to hysterectomy. DCE-MRI and T2WI were evaluated for the preoperative staging of endometrial carcinoma. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DCE-MRI and T2WI were assessed and compared using the revised International Federation of Gynecology and Obstetrics surgical staging guidelines (2009) as the reference standard. Results Out of the 22 cases of endometrial carcinoma, the use of the reference standard method led to the staging of 14 as IA and eight as IB. The sensitivity, specificity, PPV, NPV, and accuracy of DCE-MRI for preoperative staging were 100% (95% confidence interval: 0.73–1.0), 62.5% (95% CI: 0.26–0.90), 82.4% (95% CI: 0.56–0.95), 100% (95% CI: 0.46–1.0), and 86.4%, respectively, and these values were 85.7% (95% CI: 0.56–0.97), 75% (95% CI: 0.36–0.96), 85.7% (95% CI: 0.56–0.97), 75% (95% CI: 0.36–0.96), and 81.8%, respectively, for T2WI. Thus, the sensitivity and accuracy of DCE-MRI were greater than those of T2WI for preoperative endometrial carcinoma staging. Conclusion DCE-MRI was more sensitive but less specific than T2WI for the preoperative staging of early endometrial carcinoma. DCE-MRI may serve as a useful and reliable tool for the preoperative assessment of endometrial carcinoma.
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Affiliation(s)
- Linfeng Zheng
- Department of Radiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China ; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sujuan Zheng
- Department of Obstetrics and Gynecology, Dengfeng People's Hospital, Zhengzhou, People's Republic of China
| | - Xiaochun Yuan
- Department of Radiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xifu Wang
- Department of Radiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Zhuoli Zhang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Guixiang Zhang
- Department of Radiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Raimond E, Canlorbe G, Bendifallah S, Hudry D, Selvi F, Ballester M, Coutant C, Graesslin O, Daraï E. [Endometrial carcinoma. Application of the guidelines of 2010: multicentre trial]. Bull Cancer 2014; 101:703-13. [PMID: 25091653 DOI: 10.1684/bdc.2014.1955] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The endometrial cancer is the most frequent gynecological cancer. To improve and homogenize the professional practices of endometrial cancer, guidelines were developed in November 2010. The aim of this study is to estimate the implementation of these recommendations. This is a retrospective multicentre study, using the databases of three French centers made between November 2010 and December 2012: the university hospital in Reims, the Tenon hospital in Paris and the Cancer Center Georges-François-Leclerc in Dijon. This study consists in the evaluation of the diagnoses and therapeutic assessment modalities for women with endometrial cancer and the concordance with the INCa guidelines. During this study, 161 patients were treated for an endometrial cancer. A histological and radiological preoperative assessment was respectively made in 92.5% and 73.3% of the cases. It revealed an agreement between anatomo-radiologic pre- and postoperative in 62.3% and 53.4% of the cases for myometrial invasion and the International Federation of Gynecology and Obstetric classification. The surgical modalities were in agreement with the guidelines in 64.6% (n = 104) and 60.3% (n = 97) of the cases. The discrepancy of the guidelines resulted from the absence or the excess realization of a lymphadenectomy. An adjuvant therapy was administered in 67.1% (n = 108) of the cases and was in agreement with the guidelines in 62.3% of the cases. s The pre- and postoperative discordance between histological and radiological results are at the origin of a default in treatment for certain patients. This discordance leads to excess or lack of nodes exploration.
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