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Chai Q, Sheng M, Tong H. Alternative-splicing regulator hnRNOs (heterogeneous nuclear ribonucleoproteins) family as a prognostic model associated with immune infiltration in endometrial cancer. Asian J Surg 2024; 47:1665-1666. [PMID: 38135538 DOI: 10.1016/j.asjsur.2023.12.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Affiliation(s)
- Qiqi Chai
- Department of Nursing, Beilun District People's Hospital, Ningbo, 315800, China
| | - Mingyan Sheng
- Department of Gynecology, Beilun District People's Hospital, Ningbo, 315800, China
| | - Haofei Tong
- Department of Nursing, Beilun District People's Hospital, Ningbo, 315800, China.
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Zhang Y, Wang J, Fan Y, Lang F, Fu F, Liu Q. MMP11 and MMP17 are potential biomarkers for uterine corpus endometrial carcinoma prognosis. Clin Transl Oncol 2024; 26:653-663. [PMID: 37523078 DOI: 10.1007/s12094-023-03284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Matrix metalloproteinases (MMP) are important proteases that degrade the extracellular matrix (ECM) and thus essentially mediate tumor vascularization, metastasis, and invasion. However, their potential roles in uterine corpus endometrial carcinoma (UCEC) are not fully understood. PATIENTS AND METHODS The expression, prognostic value, and correlation of UCEC patients with MMP were investigated using data from The Cancer Genome Atlas (TCGA) and other databases. Furthermore, differentially expressed genes (DEGs) were identified and their biological functions and correlations with infiltrating immune cells were analyzed. RESULTS A total of 22 MMPs were found to be abnormally expressed in UCEC tumor tissues, and high expression of MMP11 and MMP17 were associated with a better UCEC prognosis. MMP11 and MMP17 were observed to be significantly enriched in tumor tissue ECM and were associated with pathways involving degradation, glycolytic metabolism, and PI3K-Akt signaling. Infiltration of natural killer (NK), mast, and NK CD56bright cells was enhanced in tumor tissues with high MMP11 and MMP17 expression. CONCLUSION MMP11 and MMP17 may affect UCEC prognosis by influencing immune cell infiltration and may be potential UCEC biomarkers.
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Affiliation(s)
- Yanhui Zhang
- Shandong Province Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238, Jingshi East Road, Jinan City, Shandong Province, China
| | - Jing Wang
- Shandong Province Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238, Jingshi East Road, Jinan City, Shandong Province, China
| | - Yuqin Fan
- Shandong Province Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238, Jingshi East Road, Jinan City, Shandong Province, China
| | - Fangfang Lang
- Shandong Province Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238, Jingshi East Road, Jinan City, Shandong Province, China
| | - Fengping Fu
- Shandong Province Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238, Jingshi East Road, Jinan City, Shandong Province, China
| | - Qunying Liu
- Shandong Province Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238, Jingshi East Road, Jinan City, Shandong Province, China.
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Xie H, Li M, Zheng Y. Associations of metformin therapy treatment with endometrial cancer risk and prognosis: A systematic review and meta-analysis. Gynecol Oncol 2024; 182:15-23. [PMID: 38246042 DOI: 10.1016/j.ygyno.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/29/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Several abstract studies have demonstrated that metformin may be beneficial for preventing and treating endometrial cancer (EC), while the results have been inconsistent and inconclusive. This systematic review and meta-analysis aimed to investigate the association between metformin use and the incidence and mortality of endometrial cancer in diabetic patients. METHODS A systematic literature search was performed in Pubmed, EMBASE, Web of Science, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP from inception to November 2022. The outcome measures were hazard ratios (HRs) comparing the EC incidence and mortality in patients with type 2 diabetes mellitus (T2DM) on metformin and non-metformin. A random or fixed-effects model was applied for data analysis, and subgroup analysis was performed to look for factors of heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessed the evidence's certainty. RESULTS Eleven studies reported data on EC incidence. The pooled results suggested that the use of metformin was associated with a significantly higher incidence of EC (HR = 1.17, 95% CI 1.09-1.26, P < 0.0001). Further, seventeen studies were included for survival analysis. The pooled data showed that metformin could significantly decrease all-cause mortality (HR = 0.62, 95% CI 0.52-0.74, P < 0.00001) and endometrial cancer-specific mortality (HR = 0.95, 95% CI 0.90, 1.00, P = 0.03). Finally, we noted that metformin was associated with significantly improving the progression-free survival (PFS) of EC patients with T2DM (HR = 0.55, 95% CI 0.44, 0.68, P < 0.00001). CONCLUSIONS This meta-analysis did not prove that metformin was beneficial for preventing EC. However, metformin could reduce their mortality risk and prolong the progression-free survival time of EC patients with T2DM.
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Affiliation(s)
- Hui Xie
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou 450000, China
| | - Muhan Li
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Yuling Zheng
- The First Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou 450000, China.
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Ayodele A, Obeng-Gyasi E. Exploring the Potential Link between PFAS Exposure and Endometrial Cancer: A Review of Environmental and Sociodemographic Factors. Cancers (Basel) 2024; 16:983. [PMID: 38473344 DOI: 10.3390/cancers16050983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
This exploratory narrative review paper delves into the intricate interplay between per- and polyfluoroalkyl substances (PFAS) exposure, sociodemographic factors, and the influence of stressors in the context of endometrial cancer. PFAS, ubiquitous environmental contaminants notorious for their persistence in the ecosystem, have garnered attention for their potential to disrupt endocrine systems and provoke immune responses. We comprehensively examine the various sources of PFAS exposure, encompassing household items, water, air, and soil, thus shedding light on the multifaceted routes through which individuals encounter these compounds. Furthermore, we explore the influence of sociodemographic factors, such as income, education, occupation, ethnicity/race, and geographical location and their relationship to endometrial cancer risk. We also investigated the role of stress on PFAS exposure and endometrial cancer risk. The results revealed a significant impact of sociodemographic factors on both PFAS levels and endometrial cancer risk. Stress emerged as a notable contributing factor influencing PFAS exposure and the development of endometrial cancer, further emphasizing the importance of stress management practices for overall well-being. By synthesizing evidence from diverse fields, this review underscores the need for interdisciplinary research and targeted interventions to comprehensively address the complex relationship between PFAS, sociodemographic factors, stressors, and endometrial cancer.
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Affiliation(s)
- Aderonke Ayodele
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
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55
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Yang Q, Lv Z, Wang M, Kong M, Zhong C, Gao K, Wan X. LATS1/2 loss promote tumor immune evasion in endometrial cancer through downregulating MHC-I expression. J Exp Clin Cancer Res 2024; 43:54. [PMID: 38383447 PMCID: PMC10880206 DOI: 10.1186/s13046-024-02979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/11/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND LATS1/2 are frequently mutated and down-regulated in endometrial cancer (EC), but the contributions of LATS1/2 in EC progression remains unclear. Impaired antigen presentation due to mutations or downregulation of the major histocompatibility complex class I (MHC-I) has been implicated in tumor immune evasion. Herein, we elucidate the oncogenic role that dysregulation of LATS1/2 in EC leads to immune evasion through the down-regulation of MHC-I. METHODS The mutation and expression as well as the clinical significance of LATS1/2 in EC was assessed in the TCGA cohort and our sample cohort. CRISPR-Cas9 was used to construct knockout cell lines of LATS1/2 in EC. Differentially expressed genes were analyzed by RNA-seq. The interaction between LATS1/2 and STAT1 was verified using co-immunoprecipitation and GST pull-down assays. Mass spectrometry, in vitro kinase assays, ChIP-qPCR, flow cytometry, immunohistochemistry, immunofluorescence and confocal microscopy were performed to investigate the regulation of LATS1/2 on MHC-I through interaction with and phosphorylate STAT1. The killing effect of activated PBMCs on EC cells were used to monitor anti-tumor activity. RESULTS Here, we demonstrate that LATS1/2 are frequently mutated and down-regulated in EC. Moreover, LATS1/2 loss was found to be associated with a significant down-regulation of MHC-I, independently of the Hippo-YAP pathway. Instead, LATS1/2 were found to directly interact with and phosphorylate STAT1 at Ser727, a crucial transcription factor for MHC-I upregulation in response to interferon-gamma (IFN-γ) signaling, to promote STAT1 accumulating and moving into the nucleus to enhance the transcriptional activation of IRF1/NLRC5 on MHC-I. Additionally, the loss of LATS1/2 was observed to confer increased resistance of EC cells to immune cell-mediated killing and this resistance could be reversed by over-expression of MHC-I. CONCLUSION Our findings indicate that dysregulation of LATS1/2 in EC leads to immune evasion through the down-regulation of MHC-I, leading to the suppression of infiltrating activated CD8 + T cells and highlight the importance of LATS1/2 in IFN-γ signaling-mediated tumor immune response, suggesting that LATS1/2 is a promising target for immune checkpoint blockade therapy in EC.
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Affiliation(s)
- Qianlan Yang
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China
| | - Zehen Lv
- Department of Clinical Laboratory, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China
| | - Mengfei Wang
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China
| | - Mengwen Kong
- Department of Clinical Laboratory, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China
| | - Cheng Zhong
- Department of Clinical Laboratory, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China
| | - Kun Gao
- Department of Clinical Laboratory, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China.
| | - Xiaoping Wan
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
- Shanghai Key Laboratory of Maternal and Fetal Medicine, Shanghai First Maternity and Infant Hospital, Shanghai, 200092, China.
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Xiao Y, Yu X, Wang Y, Song G, Liu M, Wang D, Wang H. A novel immune-related gene signature for diagnosis and potential immunotherapy of microsatellite stable endometrial carcinoma. Sci Rep 2024; 14:3738. [PMID: 38355782 PMCID: PMC10867009 DOI: 10.1038/s41598-024-53338-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
An immune-related gene signature (IRGS) was established to better understand the molecular and immunologic characteristics of microsatellite instable (MSI) and microsatellite stable (MSS) endometrial carcinoma (EC), and provide potential immunotherapy directions for MSS patients. Top 20 immune-related hub genes were screened by weight gene coexpression network analysis (WGCNA), and an IRGS was further established through Cox regression analysis. The molecular and immune characteristics were clarified in IRGS high and low risk groups. Expression and MS status validation of the IRGS were conducted through quantitative real-time Polymerase Chain Reaction (rt-qPCR) and immunohistochemistry (IHC) analysis. The IRGS includes 2 oncogenes (AGTR1 and HTR3C) and 2 tumor suppressor genes (CD3E and SERPIND1). Patients in IRGS high-risk group were more with MSS status, higher tumor grade, later FIGO stage, serous histology and elder ages compared with IRGS low-risk group (P < 0.05). Besides, patients in MSS group were more FIGO stages II-IV (42.7% vs. 26%), serous histology (35.7% vs. 5.3%) and with higher IRGS risk score (1.51 ± 3.11 vs. 1.02 ± 0.67) (P < 0.05) than patients in MSI group. Furthermore, patients in IRGS high-risk group had higher tumor purity, more Macrophages M1 and Macrophages M2 infiltrating, higher proportion of Macrophages M2 and Dendritic cells activated, lower proportion of T cells regulatory (Tregs), lower tumor mutation burden (TMB). Correspondingly, subjects in IRGS low-risk group had higher immunphenoscores than IRGS high-risk group. The relative mRNA level of AGTR1 and HTR3C were gradually increase, while CD3E and SERPIND1 were reversed in rt-qPCR. Through IHC experiments, AGTR1(69.2% vs 30%, P = 0.074) and HTR3C (76.9% vs 30%, P = 0.024) had higher positive staining rates in ECs than non-ECs. While SERPIND1 (84.6% vs 20%, P = 0.003) and CD3E (61.5% vs 40%, P = 0.000) had higher positive staining rates in non-ECs. IRGS is a potential diagnostic and prognostic biomarker for EC. IRGS low risk group might benefit from immune checkpoint inhibitors, while IRGS high risk group deserve other potential immunotherapy.
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Affiliation(s)
- Yunyun Xiao
- Department of Gynecology and Obstetrics, Dalian Maternal and Children's Medical Group, No. 1 Dunhuang Street, Shahekou District, Dalian, 116033, Liaoning, China
| | - XiaoChuan Yu
- Department of Gynecology and Obstetrics, Dalian Maternal and Children's Medical Group, No. 1 Dunhuang Street, Shahekou District, Dalian, 116033, Liaoning, China
| | - Yaping Wang
- Department of Pathology, Dalian Maternal and Children's Medical Group, Dalian, 116033, Liaoning, China
| | - Guangyao Song
- Department of Pathology, Dalian Maternal and Children's Medical Group, Dalian, 116033, Liaoning, China
| | - Ming Liu
- Department of Pathology, Dalian Maternal and Children's Medical Group, Dalian, 116033, Liaoning, China
| | - Daqing Wang
- Department of Oncology, Dalian Maternal and Children's Medical Group, No. 1 Dunhuang Street, Shahekou District, Dalian, 116033, Liaoning, China.
| | - Huali Wang
- Department of Gynecology and Obstetrics, Dalian Maternal and Children's Medical Group, No. 1 Dunhuang Street, Shahekou District, Dalian, 116033, Liaoning, China.
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Weissinger M, Bala L, Brucker SY, Kommoss S, Hoffmann S, Seith F, Nikolaou K, la Fougère C, Walter CB, Dittmann H. Additional Value of FDG-PET/MRI Complementary to Sentinel Lymphonodectomy for Minimal Invasive Lymph Node Staging in Patients with Endometrial Cancer: A Prospective Study. Diagnostics (Basel) 2024; 14:376. [PMID: 38396415 PMCID: PMC10887690 DOI: 10.3390/diagnostics14040376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Lymph node metastases (LNM) are rare in early-stage endometrial cancer, but a diagnostic systematic lymphadenectomy (LNE) is often performed to achieve reliable N-staging. Therefore, this prospective study aimed to evaluate the benefit of [18F]-Fluorodeoxyglucose (FDG) PET/MRI complementary to SPECT/CT guided sentinel lymphonodectomy (SLNE) for a less invasive N-staging Methods: 79 patients underwent a whole-body FDG-PET/MRI, SLN mapping with 99mTc-Nanocolloid SPECT/CT and indocyanine green (ICG) fluoroscopy followed by LNE which served as ground truth. RESULTS FDG-PET/MRI was highly specific in N-staging (97.2%) but revealed limited sensitivity (66.7%) due to missed micrometastases. In contrast, bilateral SLN mapping failed more often in patients with macrometastases. The combination of SLN mapping and FDG-PET/MRI increased the sensitivity from 66.7% to 77.8%. Additional SLN labeling with dye (ICG) revealed a complete SLN mapping in 80% (8/10) of patients with failed or incomplete SLN detection in SPECT/CT, reducing the need for diagnostic systematic LNE up to 87%. FDG-PET/MRI detected para-aortic LNM in three out of four cases and a liver metastasis. CONCLUSIONS The combination of FDG-PET/MRI and SLNE can reduce the need for diagnostic systematic LNE by up to 87%. PET/MRI complements the SLN technique particularly in the detection of para-aortic LNM and occasional distant metastases.
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Affiliation(s)
- Matthias Weissinger
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany (C.l.F.); (H.D.)
| | - Lidia Bala
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany (C.l.F.); (H.D.)
| | - Sara Yvonne Brucker
- Department of Women’s Health, University Hospital Tuebingen, 72076 Tuebingen, Germany; (S.Y.B.)
| | - Stefan Kommoss
- Department of Women’s Health, University Hospital Tuebingen, 72076 Tuebingen, Germany; (S.Y.B.)
- Gynecologic Oncology, Diakonie-Hospital Schwäbisch Hall, 74523 Schwäbisch Hall, Germany
| | - Sascha Hoffmann
- Department of Women’s Health, University Hospital Tuebingen, 72076 Tuebingen, Germany; (S.Y.B.)
| | - Ferdinand Seith
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany
- Image-Guided and Functionally Instructed Tumor Therapies (iFIT)-Cluster of Excellence, Eberhard Karls University, 72076 Tuebingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tuebingen, 72076 Tuebingen, Germany
| | - Christian la Fougère
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany (C.l.F.); (H.D.)
- Image-Guided and Functionally Instructed Tumor Therapies (iFIT)-Cluster of Excellence, Eberhard Karls University, 72076 Tuebingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tuebingen, 72076 Tuebingen, Germany
| | | | - Helmut Dittmann
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany (C.l.F.); (H.D.)
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Chen SJ, Zhang J, Zhou T, Rao SS, Li Q, Xiao LY, Wei ST, Zhang HF. Epigenetically upregulated NSUN2 confers ferroptosis resistance in endometrial cancer via m 5C modification of SLC7A11 mRNA. Redox Biol 2024; 69:102975. [PMID: 38042059 PMCID: PMC10711489 DOI: 10.1016/j.redox.2023.102975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023] Open
Abstract
Endometrial cancer (EC) is a prevalent gynecological malignancy worldwide, and 5-methylcytosine (m5C) modification of mRNA is a crucial epigenetic modification associated with the development and occurrence of several cancers. However, the precise function of m5C modification in EC remains elusive. This study aimed to investigate the expression and clinical significance of the primary m5C modification writer, NSUN2, in EC. Our findings indicated that NSUN2 exhibited a substantial up-regulation in EC as a result of an epigenetic augmentation in H3K4me3 levels within the promoter region, which was triggered by the down-regulation of KDM5A. Moreover, gain- and loss-of-function experiments revealed the role of NSUN2 in enhancing m5C modification of mRNA, thereby promoting EC cell proliferation. RNA bisulfite sequencing and transcriptomic sequencing were employed to elucidate the involvement of NSUN2 in the regulation of ferroptosis. Subsequent in vitro experiments confirmed that the knockdown of NSUN2 significantly up-regulated the levels of lipid peroxides and lipid ROS in EC cells, thereby augmenting the susceptibility of EC to ferroptosis. Mechanistically, NSUN2 stimulated the m5C modification of SLC7A11 mRNA, and the m5C reader YBX1 exhibited direct recognition and binding to the m5C sites on SLC7A11 mRNA via its internal cold shock domain (CSD), leading to an increase in SLC7A11 mRNA stability and elevated levels of SLC7A11. Additionally, rescue experiments showed that NSUN2 functioned as a suppressor of ferroptosis, which was dependent on SLC7A11. Overall, targeting the NSUN2/SLC7A11 axis inhibited tumor growth by increasing lipid peroxidation and ferroptosis of EC cells both in vitro and in vivo. Therefore, our study provides new insight into the role of NSUN2, suggesting that NSUN2 may serve as a prognostic biomarker and therapeutic target in patients with EC.
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Affiliation(s)
- Shuai-Jun Chen
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Jun Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ting Zhou
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shan-Shan Rao
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Qian Li
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ling-Yan Xiao
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Si-Tian Wei
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Hong-Feng Zhang
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
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Mayer CM, O'Connor RM, Do AT, Cerda VR, Wang SM, Scott ME, Li AJ, Rimel BJ, Manuel MR, Taylor KN, Kim KH. Association between adherence to posttreatment National Comprehensive Cancer Network (NCCN) surveillance guidelines and detection of recurrent uterine cancer. Gynecol Oncol 2024; 181:8-11. [PMID: 38096674 DOI: 10.1016/j.ygyno.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To identify correlations between disease recurrence and adherence to NCCN posttreatment surveillance guidelines in patients who develop recurrent uterine cancer. METHODS Retrospective analysis identified patients (n = 60) with recurrent uterine cancer and at least one surveillance visit with a gynecologic oncologist between 2011 and 2020. Adherence to NCCN guidelines and details of recurrence were recorded. RESULTS Recurrent uterine cancer was identified in 60 patients with an average time to recurrence (TTR) of 25 months. Of those, 39 (65%) were adherent to NCCN surveillance guidelines and 36 (60%) were symptomatic at the time of recurrence diagnosis. Asymptomatic recurrence was diagnosed by imaging in 11 (46%), physical exam in 7 (29%), and blood work in 6 (25%) patients. Patients who were adherent to NCCN guidelines were diagnosed with recurrence on average 11 months earlier (p = 0.0336). Adherence was an independent predictor of TTR for all patients regardless of symptoms. There was no significant effect of age, race, primary language, or stage of disease on adherence. CONCLUSION Adherence to NCCN posttreatment surveillance guidelines for uterine cancer is independently associated with an earlier diagnosis of recurrence.
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Affiliation(s)
- Christopher M Mayer
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA.
| | - Reed M O'Connor
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Anthony T Do
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Victoria R Cerda
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Stephanie M Wang
- George Washington University, Department of Obstetrics & Gynecology, Washington, DC 20052, USA
| | - Marla E Scott
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Andrew J Li
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - B J Rimel
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Michael R Manuel
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Kristin N Taylor
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
| | - Kenneth H Kim
- Cedars-Sinai Medical Center, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Los Angeles, CA 90048, USA
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60
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Costas L, Frias-Gomez J, Peinado FM, Molina-Molina JM, Peremiquel-Trillas P, Paytubi S, Crous-Bou M, de Francisco J, Caño V, Benavente Y, Pelegrina B, Martínez JM, Pineda M, Brunet J, Matias-Guiu X, de Sanjosé S, Ponce J, Olea N, Alemany L, Fernández MF. Total Effective Xenoestrogen Burden in Serum Samples and Risk of Endometrial Cancer in the Spanish Screenwide Case-Control Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:27012. [PMID: 38415615 PMCID: PMC10901108 DOI: 10.1289/ehp13202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Endometrial cancer is a hormone-dependent cancer, and estrogens play a relevant role in its etiology. However, little is known about the effects of environmental pollutants that act as xenoestrogens or that influence estrogenic activity through different pathways. OBJECTIVE We aimed to assess the relationship between the combined estrogenic activity of mixtures of xenoestrogens present in serum samples and the risk of endometrial cancer in the Screenwide case-control study. METHODS The total effective xenoestrogen burden (TEXB) attributable to organohalogenated compounds (TEXB- α ) and to endogenous hormones and more polar xenoestrogens (TEXB- β ) was assessed in serum from 156 patients with endometrial cancer (cases) and 150 controls by combining chemical extraction and separation by high-performance liquid chromatography with the E-SCREEN bioassay for estrogenicity. RESULTS Median TEXB- α and TEXB- β levels for cases (0.30 and 1.25 Eeq pM / mL , respectively) and controls (0.42 and 1.28 Eeq pM / mL , respectively) did not significantly differ (p = 0.653 and 0.933, respectively). An inverted-U risk trend across serum TEXB- α and TEXB- β levels was observed in multivariate adjusted models: Positive associations were observed for the second category of exposure in comparison to the lowest category of exposure [odds ratio ( OR ) = 2.11 (95% CI: 1.13, 3.94) for TEXB- α , and OR = 3.32 (95% CI: 1.62, 6.81) for TEXB- β ], whereas no significant associations were observed between the third category of exposure and the first [OR = 1.22 (95% CI: 0.64, 2.31) for TEXB- α , and OR = 1.58 (95% CI: 0.75, 3.33) for TEXB- β ]. In mutually adjusted models for TEXB- α and TEXB- β levels, the association of TEXB- α with endometrial cancer risk was attenuated [OR = 1.45 (95% CI: 0.61, 3.47) for the second category of exposure], as well as estimates for TEXB- β (OR = 2.68 ; 95% CI: 1.03, 6.99). Most of the individual halogenated contaminants showed no associations with both TEXB and endometrial cancer. CONCLUSIONS We evaluated serum total xenoestrogen burden in relation to endometrial cancer risk and found an inverted-U risk trend across increasing categories of exposure. The use of in vitro bioassays with human samples may lead to a paradigm shift in the way we understand the negative impact of chemical mixtures on human health effects. These results are relevant from a public health perspective and for decision-makers in charge of controlling the production and distribution of chemicals with xenoestrogenic activity. https://doi.org/10.1289/EHP13202.
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Affiliation(s)
- Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jon Frias-Gomez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Barcelona, Barcelona, Spain
| | - Francisco M. Peinado
- Centre of Biomedical Research, University of Granada, Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), Hospital Universitario San Cecilio, Granada, Spain
| | | | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Barcelona, Barcelona, Spain
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Crous-Bou
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Javier de Francisco
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Department of Anesthesiology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Victor Caño
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Department of Anesthesiology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Pelegrina
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
| | - José Manuel Martínez
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Department of Gynecology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Marta Pineda
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Hereditary Cancer group, Molecular Mechanisms and Experimental Therapy in Oncology Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Cancer (CIBERONC), Carlos III Institute of Health, Madrid, Spain
| | - Joan Brunet
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Hereditary Cancer group, Molecular Mechanisms and Experimental Therapy in Oncology Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Cancer (CIBERONC), Carlos III Institute of Health, Madrid, Spain
| | - Xavier Matias-Guiu
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Cancer (CIBERONC), Carlos III Institute of Health, Madrid, Spain
- Department of Pathology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Silvia de Sanjosé
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Jordi Ponce
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Department of Gynecology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Nicolás Olea
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centre of Biomedical Research, University of Granada, Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), Hospital Universitario San Cecilio, Granada, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mariana F. Fernández
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centre of Biomedical Research, University of Granada, Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), Hospital Universitario San Cecilio, Granada, Spain
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Li F, Zheng Y, Yang F, Liu J. Assessing the learning curve for transumbilical single-site laparoscopy for endometrial cancer. Front Oncol 2024; 14:1337719. [PMID: 38361776 PMCID: PMC10867325 DOI: 10.3389/fonc.2024.1337719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Applying transumbilical laparoendoscopic single-site surgery to endometrial cancers is worldwide, and the depiction of the learning curve is rarely described, which leads to the vagueness of young clinical practitioners. We accumulated the data to identify the completion of the learning curve by analyzing the operative and postoperative outcomes of the patients with endometrial cancer for transumbilical laparoendoscopic single-site surgery (TU-LESS). Methods This was a retrospective, consecutive single-center study of patients with endometrial cancer undergoing standard endometrial cancer comprehensive staging surgery (extrafascial hysterectomy, bilateral salpingectomy, and pelvic lymphadenectomy) through TU-LESS by an experienced surgeon from December, 2017 to June, 2021 in the Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, China. Results After applying the inclusion and exclusion criteria, 42 patients were included in the study. The learning curve for this study was evaluated using both cumulative sum (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) methods. Applying CUSUM and RA-CUSUM has grouped 42 cases into three phases. The prior five cases represented the learning period. The following six cases were needed to lay a technical foundation (cases 6-11). The third phase was regarded as achieving proficiency (cases 12-42). The operative time decreased drastically with the learning curve. There were no significant differences in terms of postoperative complications and lymph node retrieval among the three phases. More difficult patients were confronted in the third phase. Discussion In our study, the learning curve was composed of three phases. According to the results of our study, 11 cases were required for experienced surgeons to achieve a technical foundation.
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Affiliation(s)
| | - Ying Zheng
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
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Alhadeethi A, Ibrahim AA, Atia A, Alabdallat YJ, Alkhawaldeh IM, El Din Moawad MH. Clinical Characteristics and Prognostic Factors of Endometrial Cancer Patients With Liver Metastasis: A Surveillance, Epidemiology, and End Results Database (SEER)-Based Study of 1,034 Women. Cureus 2024; 16:e54606. [PMID: 38524022 PMCID: PMC10958981 DOI: 10.7759/cureus.54606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Background There are several patterns of metastatic spread from endometrial cancer (EC). Although studies have been conducted to study the EC population with distant metastasis in the bone and lungs, there is still a lack of studies on liver metastasis. This study aims to evaluate and assess the clinical features and prognostic factors of EC patients with liver metastasis. Methodology We conducted a retrospective cohort study adhering to the guidelines for reporting observational research. We utilized the Surveillance, Epidemiology, and End Results database to gather data on female patients diagnosed with EC and reported liver metastasis. We estimated survival curves using the Kaplan-Meier method and evaluated differences in survival using the log-rank test. We also conducted univariable and multivariable Cox proportional hazards regression analyses to determine the hazard ratios with 95% confidence intervals for overall survival (OS) and identify factors that impact survival. Results We analyzed data from 1,034 EC patients with liver metastasis. Median OS after liver metastasis was six months, and cancer-specific survival was seven months. Univariate Cox regression analysis revealed several factors associated with decreased OS in EC patients. These included age (≥60 years), non-endometrioid and sarcoma histological subtypes, absence of surgery, no chemotherapy, and the presence of distant metastasis to the lung, brain, and bone. Conversely, married marital status and white race were linked to a better prognosis. Subsequent multivariate Cox regression analysis identified age (≥60 years), non-endometrioid histological subtype, absence of surgery, no chemotherapy, and the presence of distant metastasis to lung, brain, and bone remaining as independent risk factors for decreased OS. In contrast, the white race still emerged as an independent prognostic factor for better OS. Conclusions Various risk factors, such as age, race, lung, bone, or brain metastasis, as well as chemotherapy and surgery, may influence the prognosis of individuals with primary EC liver metastases.
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Affiliation(s)
| | - Ahmed A Ibrahim
- Cardiology, Faculty of Medicine, Menofia University, Menofia, EGY
| | - Ahmed Atia
- Cardiovascular Disease, Kasr Alainy School of Medicine, Cairo University, Cairo, EGY
| | | | | | - Mostafa H El Din Moawad
- Clinical Epidemiology and Clinical Trials Management, Public Health and Community Department, Suez Canal University, Ismailia, EGY
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Zakerinasab F, Behfar Q, Parsaee R, Zadeh RH, Foroughi E, Amirbeik A, Ahmadi G. BRCA 1/2 mutations and risk of uterine cancer: a systematic review and meta-analysis. BMC Genom Data 2024; 25:13. [PMID: 38297203 PMCID: PMC10829221 DOI: 10.1186/s12863-024-01189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/01/2024] [Indexed: 02/02/2024] Open
Abstract
PURPOSE In this study, we aim to investigate the association between BRCA1/2 mutation and uterine cancer incidence. MATERIAL AND METHOD We systematically searched three databases including PubMed, Scopus, and Google Scholar up to August 2023; and reviewed 23 cohorts and cross-sectional studies to explore the association between BRCA1/2 mutations and uterine cancer incidence. RESULTS This systematic review comprised a total of 21 cohort studies and 2 cross-sectional studies after the screening process. According to meta-analysis the prevalence of the BRCA1/2 gene in patients with uterine cancer was 0.02 (95%CI = [0.01,0.03], P < 0.01, I2 = 94.82%) CONCLUSIONS: Our meta-analysis investigates a 2% prevalence of BRCA1/2 mutation in patients with uterine cancer. Patients with BRCA1/2 mutations might be more conscious of uterine malignancies.
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Affiliation(s)
| | - Qumars Behfar
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Reza Parsaee
- Master Student in Molecular Genetics, Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Hossein Zadeh
- Student's Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elaheh Foroughi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhesam Amirbeik
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Tang M, Yin S, Zeng H, Huang A, Huang Y, Hu Z, Shah AR, Zhang S, Li H, Chen G. The P286R mutation of DNA polymerase ε activates cancer-cell-intrinsic immunity and suppresses endometrial tumorigenesis via the cGAS-STING pathway. Cell Death Dis 2024; 15:69. [PMID: 38238314 PMCID: PMC10796917 DOI: 10.1038/s41419-023-06418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/22/2024]
Abstract
Endometrial carcinoma (EC) is a prevalent gynecological tumor in women, and its treatment and prevention are significant global health concerns. The mutations in DNA polymerase ε (POLE) are recognized as key features of EC and may confer survival benefits in endometrial cancer patients undergoing anti-PD-1/PD-L1 therapy. However, the anti-tumor mechanism of POLE mutations remains largely elusive. This study demonstrates that the hot POLE P286R mutation impedes endometrial tumorigenesis by inducing DNA breakage and activating the cGAS-STING signaling pathway. The POLE mutations were found to inhibit the proliferation and stemness of primary human EC cells. Mechanistically, the POLE mutants enhance DNA damage and suppress its repair through the interaction with DNA repair proteins, leading to genomic instability and the upregulation of cytoplasmic DNA. Additionally, the POLE P286R mutant also increases cGAS level, promotes TBK1 phosphorylation, and stimulates inflammatory gene expression and anti-tumor immune response. Furthermore, the POLE P286R mutation inhibits tumor growth and facilitates the infiltration of cytotoxic T cells in human endometrial cancers. These findings uncover a novel mechanism of POLE mutations in antagonizing tumorigenesis and provide a promising direction for effective cancer therapy.
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Affiliation(s)
- Ming Tang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Shasha Yin
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Department of Biochemistry and Molecular Biology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Hongliang Zeng
- Center of Medical Laboratory Animal, Hunan Academy of Chinese Medicine, Changsha, 410013, China
| | - Ao Huang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
- Center of Medical Laboratory Animal, Hunan Academy of Chinese Medicine, Changsha, 410013, China
| | - Yujia Huang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Zhiyi Hu
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Ab Rauf Shah
- Department of Pathology and Microbiology, UNMC, Omaha, USA
| | - Shuyong Zhang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Gannan Medical University, Ministry of Education, Ganzhou, 341000, China.
- School of Basic Medicine, Gannan Medical University, Ganzhou, 341000, China.
| | - Haisen Li
- School of Life Sciences, Fudan University, Shanghai, 200438, China.
- AoBio Medical Co., Shanghai, 200438, China.
| | - Guofang Chen
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
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Fu B, Zhou M, Geng X, Jiang Y, Zeng H, Zhou X, Yu Z, Pan J, Zhu Y, Zheng H, Huang S, Gong Y, Huang D, Zhong Y. LAMP3 is a potent uterine corpus endometrial carcinoma prognostic biomarker associated with immune behavior. Aging (Albany NY) 2024; 16:714-745. [PMID: 38217544 PMCID: PMC10817406 DOI: 10.18632/aging.205414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/21/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Uterine corpus endometrial carcinoma (UCEC) is one of the most common gynecological malignancies and its incidence and mortality continue apace. Lysosome-associated membrane protein 3 (LAMP3) is the third member of the LAMP family and its overexpression has been described to be involved in the progression of breast, ovarian and cervical cancers, but there has been an absence of research focusing on its role in UCEC. METHODS WGCNA, TIMER, LinkedOmics, GSEA, Cytoscape, Kaplan-Meier plotter, GDC, GeneMANIA, cBioPortal, PDB, RNAinter, miRNet were applied in this research. RESULTS Our study uncovers that LAMP3 possesses higher expression levels in UCEC compared to normal tissues, and this differential expression profile is tightly aligned with clinical and pathological features, and patients demonstrating high LAMP3 expression tend to have a shorter survival expectancy. The high expression of LAMP3 is modulated by the designated ceRNA network. LAMP3 is engaged in UCEC progression by functioning in a variety of biological roles of relevance to immunity. Furthermore, we predicted several prospering drugs based on drug sensitivity. Finally, we also constructed possible docking patterns of LAMP3 with ABCA3, RAB9A, and SGTB. CONCLUSIONS LAMP3 is a formidable biomarker for UCEC and could be a prospective candidate for the diagnosis, treatment and prognostic assessment of UCEC.
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Affiliation(s)
- Bidong Fu
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Nanchang University, Nanchang, China
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Minqin Zhou
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Xitong Geng
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Yike Jiang
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Hong Zeng
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Xuanrui Zhou
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Zichuan Yu
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Jingying Pan
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Yanting Zhu
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Hao Zheng
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Shuhan Huang
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Yiyang Gong
- Second College of Clinical Medicine, Nanchang University, Nanchang, China
| | - Da Huang
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yanying Zhong
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Nanchang University, Nanchang, China
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Vanbraband J, Van Damme N, Silversmit G, De Geyndt A, Bouche G, Jacomen G, de Jonge E, Goffin F, Denys H, Amant F. Practice patterns, time trends and quality of care of uterine cancer in Belgium: An analysis of the EFFECT database. Gynecol Oncol 2024; 180:70-78. [PMID: 38086166 DOI: 10.1016/j.ygyno.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To investigate the practice patterns and quality of care for uterine cancer on a national level in Belgium, including trends in practice over the period 2012-2016. METHODS Quality indicators were measured using the EFFectiveness of Endometrial Cancer Treatment (EFFECT) database. Multivariable logistic mixed regression was used to test for associations between the quality indicators and year of diagnosis, adjusted for potential confounders and intra-cluster correlations. RESULTS The EFFECT database includes 4178 patients diagnosed with uterine cancer in the period 2012-2016. Minimally invasive surgery (laparoscopic or robotic-assisted) was applied in 61.6% of patients who had surgery for clinical stage I endometrial carcinoma (EC), increasing from 52.9% in 2012 to 66.4% in 2016. At least pelvic lymph node staging was performed in 69.0% of patients with clinical stage I, high-grade EC; and in 63.9% of patients with clinical stage I-II serous carcinoma, clear cell carcinoma or carcinosarcoma. The latter increased from 48.8% in 2012 to 77.2% in 2016. Adjuvant radiotherapy (external beam and/or brachytherapy) was offered to 33.5% of patients who had surgery without lymph node staging for pathological stage I EC at high-intermediate or high risk of recurrence. Adjuvant chemotherapy was administered to 64.4% of patients with pathological stage III-IVA EC. CONCLUSIONS Study results indicate an overall good quality of care for patients with uterine cancer in Belgium. Treatment areas with potential room for improvement include the use of minimally invasive surgery, comprehensive surgical staging and adjuvant therapy, which confirms the remaining controversies in uterine cancer treatment and the need for further research.
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Affiliation(s)
- Joren Vanbraband
- Unit of Gynecologic Oncology, Department of Oncology, KU Leuven, Campus Gasthuisberg, ON4 Herestraat 49, Box 1045, 3000 Leuven, Belgium.
| | - Nancy Van Damme
- Belgian Cancer Registry, Koningsstraat 215, Box 7, 1210 Brussels, Belgium.
| | - Geert Silversmit
- Belgian Cancer Registry, Koningsstraat 215, Box 7, 1210 Brussels, Belgium.
| | - Anke De Geyndt
- Belgian Cancer Registry, Koningsstraat 215, Box 7, 1210 Brussels, Belgium.
| | - Gauthier Bouche
- The Anticancer Fund, Brusselsesteenweg 11, 1860 Meise, Belgium.
| | - Gerd Jacomen
- Laboratory of Pathological Anatomy, AZ Sint-Maarten, Liersesteenweg 435, 2800 Mechelen, Belgium.
| | - Eric de Jonge
- Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Campus Sint-Jan, Synaps Park 1, 3600 Genk, Belgium.
| | - Frédéric Goffin
- Department of Obstetrics and Gynecology, CHU de Liège et Hôpital de La Citadelle, Boulevard du 12e de Ligne 1, 4000 Liège, Belgium.
| | - Hannelore Denys
- Department of Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Frédéric Amant
- Unit of Gynecologic Oncology, Department of Oncology, KU Leuven, Campus Gasthuisberg, ON4 Herestraat 49, Box 1045, 3000 Leuven, Belgium; Department of Surgery, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands; Department of Gynecologic Oncology, UZ Leuven, Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
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Meng X, Yang D, Deng Y, Xu H, Jin H, Yang Z. Diagnostic accuracy of MRI for assessing lymphovascular space invasion in endometrial carcinoma: a meta-analysis. Acta Radiol 2024; 65:133-144. [PMID: 37101417 DOI: 10.1177/02841851231165671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND The lymphovascular space invasion (LVSI) status of endometrial cancer (EC) has guiding significance in lymph node dissection. However, LVSI can only be obtained after surgery. Researchers have tried to extract the information of LVSI using magnetic resonance imaging (MRI). PURPOSE To evaluate the ability of preoperative MRI to predict the LVSI status of EC. MATERIAL AND METHODS A search was conducted by using the PubMed/MEDLINE, EMBASE, Web of Science, and the Cochrane Library databases. Articles were included according to the criteria. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2. A bivariate random effects model was used to obtain pooled summary estimates, heterogeneity, and the area under the summary receiver operating characteristic curve (AUC). A subgroup analysis was performed to identify sources of heterogeneity. RESULTS A total of nine articles (814 patients) were included. The risk of bias was low or unclear for most studies, and the applicability concerns were low or unclear for all studies. The summary AUC values as well as pooled sensitivity and specificity of LVSI status in EC were 0.82, 73%, and 77%, respectively. According to the subgroup analysis, radiomics/non-radiomics features, country/region, sample size, age, MR manufacturer, magnetic field, scores of risk bias, and scores of applicability concern may have caused heterogeneity. CONCLUSION Our meta-analysis showed that MRI has moderate diagnostic efficacy for LVSI status in EC. Large-sample, uniformly designed studies are needed to verify the true value of MRI in assessing LVSI.
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Affiliation(s)
- Xuxu Meng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Dawei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Yuhui Deng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Medical Imaging Division, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, PR China
| | - Hui Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - He Jin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
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Lu TF, Lu CH, Sun L, Liu CK, Shih YH, Hwang SF, Hsu ST. Long-term outcome of minimally invasive staging surgery for clinical stage I endometrial cancer: A single institute experience in Taiwan. J Chin Med Assoc 2024; 87:79-87. [PMID: 37792993 DOI: 10.1097/jcma.0000000000001006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Endometrial cancer is the most common gynecological cancer in developed countries. With recent advances in equipment and knowledge, minimally invasive surgery (MIS) is widely accepted for the treatment of endometrial cancer. This study had the largest number of cases to date in Taiwan, comparing outcomes between MIS and laparotomy staging surgery using real-world data with long-term follow-up. METHODS We retrospectively reviewed patients with clinical stage 1 endometrial cancer from 2009 to 2020 in our institute. All patients underwent comprehensive surgical staging procedures by MIS or laparotomy. The safety, morbidity, progression-free survival (PFS), and overall survival (OS) rates of the two groups were compared. Clinical and pathologic factors were compared with Chi-square and Fisher Exact test. PFS and OS were estimated by the Kaplan-Meier method. Differences between survival curves were analyzed using the log-rank test. A p value of <0.05 was considered statistically significant. Using Cox proportional hazards models, all factors found to be significantly associated with risk of recurrence on univariate analyses were then assessed together through multivariable models, resulting in a final oncologic outcome between MIS and laparotomy. RESULTS A total of 665 cases (412 cases in MIS group and 253 cases in laparotomy group) were enrolled for data analysis. Median operation time was shorter in MIS group (244 and 265 minutes, p < 0.001). Median blood loss was also less (75 and 430 mL, p < 0.001). Median postoperative hospitalization duration was longer in the laparotomy group (2 and 7 days, p = 0.001). After adjusting presurgery risk factors, the PFS and OS were no significant difference in MIS and laparotomy groups. CONCLUSION Using real-world data with long-term follow-up, we could confirm excellent PFS and OS in selective patients with clinical stage 1 endometrial carcinoma who received MIS, and the surgical time, hospital day, and blood loss were also less.
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Affiliation(s)
- Ting-Fang Lu
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Chien-Hsing Lu
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Biomedical Sciences, Ph.D. Program in Translational Medicine, and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Lou Sun
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Chi-Ku Liu
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Yu-Hsiang Shih
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Sheau-Feng Hwang
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Shih-Tien Hsu
- Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Center for General Education, Ling Tung University, Taichung, Taiwan, ROC
- School of Medicine, China Medical University, Taichung, Taiwan, ROC
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69
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Gan W, Bian C. The research progress on synchronous endometrial and ovarian carcinoma. Front Oncol 2023; 13:1291602. [PMID: 38144530 PMCID: PMC10748788 DOI: 10.3389/fonc.2023.1291602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Synchronous endometrial and ovarian carcinoma (SEOC) is the most common combination of primary double cancer in the female reproductive system. The etiology and pathogenesis of SEOC remain unclear, and clinically, it is often misdiagnosed as metastatic cancer, affecting the formulation of treatment plans and prognosis for patients. This article provides a review of its epidemiology, pathological and clinical characteristics, risk factors, pathogenesis, diagnosis, treatment, and prognosis.
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Affiliation(s)
- Wenli Gan
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Gynecology and Obstetrics, Affiliated Hospital of Sichuan Nursing Vocational College (The Third People's Hospital of Sichuan Province), Chengdu, Sichuan, China
| | - Ce Bian
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China
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70
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Ray-Coquard I, Monk BJ, Lorusso D, Mahdi H, Upadhyay V, Graul R, Husain A, Mirza MR, Slomovitz B. The promise of combining CDK4/6 inhibition with hormonal therapy in the first-line treatment setting for metastatic or recurrent endometrial adenocarcinoma. Int J Gynecol Cancer 2023; 33:1943-1949. [PMID: 37907262 PMCID: PMC10804003 DOI: 10.1136/ijgc-2023-004739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/29/2023] [Indexed: 11/02/2023] Open
Abstract
Metastatic or recurrent endometrioid adenocarcinoma of the uterine corpus is often incurable with limited treatment options. First-line treatment often includes cytotoxic chemotherapy, which incurs significant toxicities for many patients. Endometrial cancer, specifically endometrioid cancer, is a hormone-sensitive disease and, while single-agent hormonal therapies have demonstrated clinical benefit, resistance to these agents often leads to the use of chemotherapy. There is a lack of approved endocrine treatment options in the metastatic setting for most recurrent endometrial cancers, representing an unmet clinical need. Emerging evidence suggests that hormonal therapy in combination with other targeted treatments, such as cyclin dependent kinase (CDK)4/6 inhibitors, is well tolerated and effective in select patient populations. We discuss the clinical evidence suggesting that the combination of CDK4/6 inhibitors and hormonal therapy has the potential to represent an important addition to the first-line treatment options for patients with low-grade advanced or recurrent endometrial cancer.
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Affiliation(s)
- Isabelle Ray-Coquard
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers de l'Ovaire (GINECO), Centre Leon Bèrard, Lyon, France
| | - Bradley J Monk
- Honor Health Research Institute, University of Arizona, Creighton University, Phoenix, Arizona, USA
| | - Domenica Lorusso
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Haider Mahdi
- Department of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | | | | | | | - Mansoor Raza Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Brian Slomovitz
- Gynecologic Oncology, Mount Sinai Medical Center, Miami, Florida, USA
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71
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Cai L, Cai L, Zhou L, Zhao Y, Qian J. Identification and validation of a seven cuproptosis-associated lncRNA signature to predict the prognosis of endometrial cancer. J Int Med Res 2023; 51:3000605231213435. [PMID: 38102991 PMCID: PMC10725657 DOI: 10.1177/03000605231213435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 10/23/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE Endometrial cancer (EC) is one of the most prevalent cancers in women. Long non-coding RNAs (lncRNAs) are potential diagnostic biomarkers in patients with EC. METHODS We obtained clinical information and transcriptome data for 552 patients with EC from The Cancer Genome Atlas database. Cuproptosis-associated lncRNAs were obtained through Pearson's correlation analysis. Univariate and multivariate Cox regression analyses were applied and a signature predicting overall survival (OS) among patients with EC was constructed. We also analyzed the tumor immune microenvironment and drug sensitivity. The results were validated by quantitative real time-polymerase chain reaction, and 5-ethynyl-2'-deoxyuridine and wound-healing assays. RESULTS Seven cuproptosis-associated lncRNAs related to prognosis were screened out and a signature was constructed. OS was significantly superior in the low-risk group. In addition, patients in the low-risk group had more CD8+ T cell infiltration, a stronger type II interferon response, and greater cisplatin sensitivity. Expression levels of some of the lncRNAs were significantly increased by cuproptosis. Furthermore, silencing of lncRNA AC084117.1 significantly inhibited the proliferation and migration of EC cells. CONCLUSION We constructed a seven cuproptosis-associated lncRNA signature to predict the prognosis of patients with EC with good predictive power.
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Affiliation(s)
| | | | - Lin Zhou
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, People’s Republic of China
| | - Yating Zhao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, People’s Republic of China
| | - Jianhua Qian
- Department of Gynecology and Obstetrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, People’s Republic of China
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Ying J, Huang W, Fu L, Yang H, Cheng J. Weakly supervised segmentation of uterus by scribble labeling on endometrial cancer MR images. Comput Biol Med 2023; 167:107582. [PMID: 37922606 DOI: 10.1016/j.compbiomed.2023.107582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/28/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023]
Abstract
Uterine segmentation of endometrial cancer MR images can be a valuable diagnostic tool for gynecologists. However, uterine segmentation based on deep learning relies on artificial pixel-level annotation, which is time-consuming, laborious and subjective. To reduce the dependence on pixel-level annotation, a method of weakly supervised uterine segmentation on endometrial cancer MRI slices is proposed, which only requires scribble label and is enhanced by pseudo-label technology, exponential geodesic distance loss and input disturbance strategy. Specifically, the limitations caused by the shortage of supervision are addressed by dynamically mixing the two outputs of the dual branch network to generate pseudo-labels, expanding supervision information and promoting mutual supervision training. On the other hand, considering the large difference of grayscale intensity between the uterus and surrounding tissues, the exponential geodesic distance loss is introduced to enhance the ability of the network to capture the edge of the uterus. Input disturbance strategies are incorporated to adapt to the flexible and variable characteristics of the uterus and further improve the segmentation performance of the network. The proposed method is evaluated on MRI images from 135 cases of endometrial cancer. Compared with other four weakly supervised segmentation methods, the performance of the proposed method is the best, whose mean DI, HD95, Recall, Precision, ADP are 92.8%, 11.632, 92.7%, 93.6%, 6.5% and increasing by 2.1%, 9.144, 0.6%, 2.4%, 2.9% respectively. The experimental results demonstrate that the proposed method is more effective than other weakly supervised methods and achieves similar performance as those fully supervised.
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Affiliation(s)
- Jie Ying
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China.
| | - Wei Huang
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Le Fu
- Department of Radiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Haima Yang
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Jiangzihao Cheng
- School of Optical-Electrical and Computer Engineering, University of Shanghai for Science and Technology, Shanghai, China
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73
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Mukherjee A, Gu Z, Chen LH, Potosky AL, Haque R. Association of metabolic syndrome conditions with risk of second primary uterine cancer in breast cancer survivors. J Cancer Res Clin Oncol 2023; 149:17749-17755. [PMID: 37925391 DOI: 10.1007/s00432-023-05489-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE Uterine cancer risk is high in breast cancer survivors. Although breast cancer and uterine cancer share some common epidemiological risk factors, association of metabolic syndrome with incident uterine cancer in breast cancer survivors is under-studied. We evaluated the association of metabolic syndrome conditions with second primary uterine cancer in breast cancer survivors. METHODS In this retrospective cohort study, 37,303 breast cancer patients diagnosed between 2008 and 2020 at Kaiser Permanente Southern California, an integrated healthcare system, were included. Data on cancer-related variables, sociodemographic, and clinical variables were extracted from KPSC's Surveillance, Epidemiology, and End Results (SEER)-affiliated cancer registry and electronic health records, as appropriate. Patients were followed from breast cancer diagnosis until 12/31/2021 for incident uterine cancer. Proportional hazards regression was used to report association [HR (95% CI)] between metabolic conditions and uterine cancer. RESULTS More than half (53.1%) of the breast cancer survivors had 1-2 metabolic conditions; 19.4% had 3 + , while 27. 5% had no metabolic conditions. Median time to follow-up was 5.33 years and 185 (0.5%) patients developed second primary uterine cancer. Obesity was associated with an elevated uterine cancer risk in the adjusted model [HR (95% CI) 1.64 (1.20-2.25)]. Having 1-2 metabolic conditions (versus none) was not associated with increased uterine cancer risk [adjusted HR (95% CI) 1.24 (0.85-1.82)]; however, there was an increased uterine cancer risk with 3 + metabolic conditions [adjusted HR (95% CI) 1.82 (1.16-2.87)]. CONCLUSION Although not statistically significant, we found a trend demonstrating greater uterine cancer risk by increasing numbers of metabolic syndrome conditions in breast cancer survivors.
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Affiliation(s)
- Amrita Mukherjee
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA.
| | - Zheng Gu
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA
| | - Lie Hong Chen
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA
| | - Arnold L Potosky
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Reina Haque
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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Seon KE, Lee YJ, Lee JY, Nam EJ, Kim S, Kim YT, Kim SW. Initial experience with the da Vinci SP robot-assisted surgical staging of endometrial cancer: a retrospective comparison with conventional laparotomy. J Robot Surg 2023; 17:2889-2898. [PMID: 37816993 DOI: 10.1007/s11701-023-01730-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023]
Abstract
To compare the perioperative outcomes of surgical staging performed using conventional laparotomy (LT) or the da Vinci SP robotic system (SP) in patients with endometrial cancer. We retrospectively analyzed 180 patients with stage I-III endometrial cancer who underwent surgical staging using LT (n = 126) or SP (n = 54) at the Yonsei Cancer Center between November 2018 and December 2022. Propensity score matching (PSM) was performed to mitigate potential confounding biases. Fifty-one pairs of patients were matched by PSM. SP required longer total operation time than LT (221 vs. 142 min in SP vs. LT, respectively, p < 0.001). However, estimated blood loss and postoperative hemoglobin change were lower in SP than in LT (30 vs. 100 mL, p < 0.001; 0.6 vs. 1.6 g/dL, p < 0.001 for SP vs. LT respectively). Furthermore, postoperative minor complications (13.7% in SP vs. 33.3% in LT, p = 0.02), perioperative transfusion rate (0% in SP vs. 11.8% in LT, p = 0.03), and postoperative hospital stay (2 days for SP vs. 8 days for LT, p < 0.001) were lower in SP than in LT. Although the patient-controlled analgesia administration rate was lower in SP (13.8% in SP vs. 100% in LT, p < 0.001), the median postoperative pain score at 6, 12, and 24 h after surgery was lower in SP than in LT (2 vs. 3, p = 0.002; 2 vs. 3, p = 0.005; 2 vs. 3, p = 0.001 for SP vs. LT, respectively). Although SP required longer total operation time, it demonstrated several advantages over LT in endometrial cancer staging.
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Affiliation(s)
- Ki Eun Seon
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Yong Jae Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Jung-Yun Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Eun Ji Nam
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Sunghoon Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Young Tae Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Sang Wun Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea.
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Li H, Liao H, Jing B, Wang Y. Effects of coagulation function indicators and tumor markers on diagnosis and clinicopathological characteristics of endometrial cancer. Int J Biol Markers 2023; 38:214-222. [PMID: 37635376 DOI: 10.1177/03936155231196253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Endometrial cancer is currently the prevalent malignant cancer worldwide. Diagnostic efficiency of tumor markers is limited, and coagulation function indicators in endometrial cancer are less concerned. METHODS This study attempted to evaluate the effects of coagulation function indicators and tumor markers on the clinical diagnosis and clinicopathological characteristics of patients with endometrial cancer. The retrospective analysis compared the differences in coagulation function indicators and tumor markers among 175 patients with endometrial cancer and 170 healthy women from January 2020 to October 2022. RESULTS Compared to the healthy control, the levels of D-dimer, fibrinogen, human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), CA153, and CA199 in patients with endometrial cancer were significantly higher (P < 0.05). Univariate and multivariate regression analyses revealed that abnormal levels of D-dimer, fibrinogen, HE4, CA125, CA153, and CA199 were related risk factors affecting the incidence of endometrial cancer. Receiver operating characteristic curve analysis exhibited that the area under the curve (0.931) and accuracy (85.2%) of combined diagnosis of coagulation function indicators (D-dimer, fibrinogen) and tumor markers (HE4, CA125, CA153, CA199) were the highest, and its sensitivity (82.3%) and specificity (88.2%) were higher than any single or combined indicators of four tumor markers. Moreover, relative expression levels of the combined indicators were significantly different among clinicopathological characteristics that had the highest predictive value in the FIGO stage (P < 0.001). CONCLUSIONS D-dimer and fibrinogen represent potential diagnostic factors for endometrial cancer. The combination of coagulation function indicators and tumor markers exhibited high diagnostic value in endometrial cancer, as well as predictive value for clinicopathological characteristics.
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Affiliation(s)
- Huayan Li
- Department of Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Huifeng Liao
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Bilin Jing
- Department of Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yifeng Wang
- Department of Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Wang Y, Sun Y, Sun F, Han P, Fan R, Ren F. Comparison of clinical characteristics and prognosis between type I and type II endometrial cancer: a single-center retrospective study. Discov Oncol 2023; 14:211. [PMID: 37994955 PMCID: PMC10667178 DOI: 10.1007/s12672-023-00820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES To explore the differences in clinical characteristics, prognosis, and risk factors between type I and type II endometrial cancer (EC). MATERIALS AND METHODS We retrospectively collected EC patients diagnosed with type I or type II EC from 2009 to 2021 in the First Affiliated Hospital of Zhengzhou University. RESULTS In total, 606 eligible EC patients (396 type I, and 210 type II) were included. Baseline analyses revealed that type II patients were older, had more advanced clinical stage, were more likely to receive chemoradiotherapy, and had higher incidence of myometrial infiltration, cervix involvement, lymph node metastasis and positive ascites cytology. Type II significantly favored poorer overall survival (OS) (HR = 9.10, 95%CI 4.79-17.28, P < 0.001) and progression-free survival (PFS) (HR = 6.07, 95%CI 2.75-13.37, P < 0.001) compared to type I. For all included EC, univariate and multivariate COX analyses revealed age, myometrial infiltration and pathological type were independent risk factors for OS and PFS. Subgroup analyses identified age, menopause, clinical stage, and lymph node metastasis as independent risk factors for type I regarding OS. While age, myometrial infiltration and chemoradiotherapy were identified as risk and protective factors for type II regrading OS. Age and cervix involvement were identified as independent risk factors for type I regarding PFS. Myometrial infiltration was identified as independent risk factor for type II regarding PFS. CONCLUSION Type II patients shared different clinical characteristics and worse prognosis compared to type I, and their independent risk and protective factors also varied.
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Affiliation(s)
- Yuanpei Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Sun
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fangfang Sun
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Pin Han
- Department of Obstetrics and Gynecology, Luoyang Maternal and Child Health Care Hospital, Luoyang, Henan, China
| | - Rujia Fan
- Department of Obstetrics and Gynecology, Henan Province People's Hospital, Zhengzhou University, Zhengzhou, Henan, China.
| | - Fang Ren
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Chen Z, Liu C, Wu J, Kong F. Association of coffee and caffeine consumption with risk and prognosis of endometrial cancer and its subgroups: a Mendelian randomization. Front Nutr 2023; 10:1291355. [PMID: 38035346 PMCID: PMC10682782 DOI: 10.3389/fnut.2023.1291355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Background Previous studies have not established potential causal associations between coffee and caffeine consumption in endometrial cancer (EC) and its subgroups. Therefore, we used a two-sample MR method to assess the causal association between coffee and caffeine consumption and EC risk. We also evaluated the association between these genetically predicted exposures and EC prognosis. Materials and methods This study used 12 and two independent single-nucleotide polymorphisms (SNPs) associated with coffee and caffeine consumption as instrumental variables at a genome-wide significance level of p < 5 × 10-8. The EC Association Consortium (ECAC) performed a genome-wide association study (GWAS) analysis of 12,906 cases and 108,979 controls. FinnGen Consortium performed a GWAS analysis of 1,967 EC cases and 167,189 controls. The primary technique we employed was inverse-variance weighted, followed by the weighted median, MR-Egger regression, and MR robust adjusted profile score methods. We used the MR pleiotropy residual sum, Outlier test, and MR-Egger regression to assess Outlier and pleiotropic variants. We also conducted a sensitivity analysis through the leave-one-out method. Results Genetically predicted coffee consumption was not associated with EC and its subgroups in the ECAC, and the association was consistent in the FinnGen consortium. After excluding eight SNPs with confounding factors, the study performed sensitivity analyses, delivering consistent results. We also observed that caffeine consumption was not correlated with EC risk. As confirmed by MR analysis, selected SNPs determined that most do not significantly impact the likelihood of developing EC. Conclusion Our study indicated no convincing evidence supports coffee and caffeine consumption causing EC or impacting its prognosis. More studies are needed to validate the results.
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Affiliation(s)
- Ziyu Chen
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Chaosheng Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jing Wu
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Fandou Kong
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Mahdi H, Ray-Coquard I, Lorusso D, Mirza MR, Monk BJ, Slomovitz B. Evolving treatment paradigms in metastatic or recurrent low-grade endometrial cancer: When is hormonal-based therapy the preferred option? Int J Gynecol Cancer 2023; 33:1675-1681. [PMID: 37640446 PMCID: PMC10646884 DOI: 10.1136/ijgc-2023-004454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 08/31/2023] Open
Abstract
Endometrial cancer is the most common gynecologic malignancy in developed countries, with increasing incidence and mortality rates worldwide. While most cases are successfully treated with surgery, first-line treatment options for metastatic or recurrent endometrial cancer involve significant toxicities. Imprecise classification of heterogeneous subgroups further complicates treatment decisions and interpretation of clinical trial results. Recent advances in molecular classification are guiding treatment decisions for metastatic or recurrent endometrial cancers. Integrating molecular characteristics with traditional clinicopathology can both reduce overtreatment or undertreatment and help guide the appropriate choice of therapies and effective design of future studies. Here we discuss the treatment of metastatic or recurrent low-grade endometrioid adenocarcinoma of the uterine corpus, which is distinct from high-grade tumors histologically, molecularly, and in treatment response.
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Affiliation(s)
- Haider Mahdi
- Department of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Isabelle Ray-Coquard
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers de l'Ovaire (GINECO), Centre Leon Berard, Lyon, Rhône-Alpes, France
| | - Domenica Lorusso
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | | | - Bradley J Monk
- HonorHealth Research Institute, University of Arizona, Creighton University, Phoenix, Arizona, USA
| | - Brian Slomovitz
- Division of Gynecologic Oncology, Mount Sinai Medical Center, Miami Beach, Florida, USA
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Mauro J, Filipello F, Tripodi E, Di Guardia G, Buda A. Serous endometrial cancer confined to a polyp with malignant pleural effusion. Int J Gynecol Cancer 2023; 33:1812-1818. [PMID: 37931974 DOI: 10.1136/ijgc-2023-004942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Affiliation(s)
- Jessica Mauro
- Gynecologic Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
- University of Udine, Udine, Italy
| | - Federica Filipello
- Division of Pathology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
| | - Elisa Tripodi
- Gynecologic Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
| | - Giuseppe Di Guardia
- Division of Radiology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
| | - Alessandro Buda
- Gynecologic Oncology, Ospedale Michele e Pietro Ferrero, Verduno, Cuneo, Italy
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Peñalver-Piñol A, Benavente Y, Frias-Gomez J, Alguacil J, Santibañez M, Contreras-Llanes M, Peremiquel-Trillas P, López-Querol M, Paytubi S, Pelegrina B, Onieva I, Martínez JM, Fernandez-Gonzalez S, Francisco JD, Caño V, Brunet J, Pineda M, Ponce J, Matias-Guiu X, Bosch FX, Sanjosé SD, Alemany L, Costas L. Occupational exposure to pesticides and endometrial cancer in the Screenwide case-control study. Environ Health 2023; 22:77. [PMID: 37919733 PMCID: PMC10621144 DOI: 10.1186/s12940-023-01028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Endometrial cancer is the most common gynaecological tumour in developed countries and disease burden is expected to increase over the years. Identifying modifiable risk factors may help developing strategies to reduce the expected increasing incidence of these neoplasms. OBJECTIVE This study evaluates the association between occupational exposure to pesticides and endometrial cancer using data from a recent case-control study in Spain. METHODS The analyses included data from 174 consecutive incident endometrial cancer cases and 216 hospital controls frequency-matched by age. Data were collected through structured epidemiological questionnaires and exposure to pesticides was assessed using a Spanish job-exposure matrix (MatEmESp). RESULTS Overall, 12% of controls and 18% of cases were occupationally exposed to pesticides. We observed a positive association between occupational exposure to pesticides and endometrial cancer (OR = 2.08; 95% CI = 1.13-3.88 compared to non-exposed). In general, exposures that occurred farther in the past were significantly associated with endometrial cancer. Exposure to insecticides, fungicides and herbicides were positively associated with endometrial cancer (OR = 2.08; 95% CI = 1.13-3.88, OR = 4.40; 95% CI = 1.65-13.33, and OR = 5.25; 95% CI = 1.84-17.67, respectively). The agricultural, poultry and livestock activities scenario was associated with endometrial cancer (OR = 4.16; 95% CI = 1.59-12.32), while the cleaning exposure scenario was not (OR = 1.22; 95% CI = 0.55-2.67). CONCLUSIONS Assessment of occupational exposure to pesticides assessed using a Spanish job-exposure matrix revealed a positive association with endometrial cancer. The elucidation of the role of pesticide compounds on endometrial cancer should shed a light on the aetiology of this tumour.
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Affiliation(s)
- Arnau Peñalver-Piñol
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Servei de Medicina Preventiva i Epidemiologia, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, Barcelona, 08035, Spain
| | - Yolanda Benavente
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
| | - Jon Frias-Gomez
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Dept. of Sociology, Social Work and Public Health, Research Group "Preventive Medicine and Public Health", Center for Research in Health and Environment (CYSMA), Huelva, Spain
| | | | - Manuel Contreras-Llanes
- Dept. of Sociology, Social Work and Public Health, Research Group "Preventive Medicine and Public Health", Center for Research in Health and Environment (CYSMA), Huelva, Spain
- Dept. of Integrated Sciences, Center for Research in Natural Resources, Health and Environment (RENSMA), Faculty of Experimental Sciences, Research Group "Radiation Physics and Environment" (FRYMA), Campus El Carmen s/n, Huelva, 21007, Spain
| | - Paula Peremiquel-Trillas
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Marta López-Querol
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
| | - Sonia Paytubi
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
| | - Beatriz Pelegrina
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
| | - Irene Onieva
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
| | - José Manuel Martínez
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Sergi Fernandez-Gonzalez
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Javier de Francisco
- Department of Anesthesiology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Caño
- Department of Anesthesiology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Brunet
- Consortium for Biomedical Research in Cancer - CIBERONC. Carlos III Institute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Hereditary Cancer Program, IDIBELL, ONCOBELL Program, Catalan Institute of Oncology, L'Hospitalet, Barcelona, Spain
- Medical Oncology Department, Catalan Institute of Oncology, Doctor Josep Trueta Girona University Hospital, Girona, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBGI, Girona, Spain
| | - Marta Pineda
- Consortium for Biomedical Research in Cancer - CIBERONC. Carlos III Institute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Hereditary Cancer Program, IDIBELL, ONCOBELL Program, Catalan Institute of Oncology, L'Hospitalet, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Matias-Guiu
- Consortium for Biomedical Research in Cancer - CIBERONC. Carlos III Institute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL. Hospitalet de Llobregat, Bar-celona, Spain
| | - Francesc Xavier Bosch
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
- Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Laia Alemany
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain
| | - Laura Costas
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology. IDIBELL, Av Gran Vía 199-203, L'Hospitalet de Llobregat, Barcelona, 08908, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP. Carlos III In-stitute of Health, Av. De Monforte de Lemos 5, Madrid, 28029, Spain.
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Chase DM, McCann LD, Treuth A, Cui H, Laniewski P, Jimenez NR, Mahnert ND, Roe DJ, Herbst-Kralovetz MM. Preoperative quality of life at time of gynecologic surgery: considerations for postoperative management. AJOG GLOBAL REPORTS 2023; 3:100275. [PMID: 38077226 PMCID: PMC10701442 DOI: 10.1016/j.xagr.2023.100275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Patients presenting for gynecologic surgery are a heterogeneous group. Preoperative quality of life may be a useful tool to guide postoperative management. OBJECTIVE This study aimed to examine the key drivers of preoperative quality of life to improve counseling and postoperative management. STUDY DESIGN This study analyzed preoperative survey results from 154 participants using the following surveys: National Institutes of Health Toolbox Global Health v1.2, Gastrointestinal: Gas and Bloating v1.1 13a, Gastrointestinal: Diarrhea v1.0 6a, and Sexual Function and Satisfaction Brief Profile (Female) v2.0, Perceived Stress Scale, the Vaginal Assessment Scale, and the Vulvar Assessment Scale. Survey results in the form of T-scores were compared in patients with endometrial cancer and patients with benign gynecologic conditions using the Kruskal-Wallis test. The multivariate analysis was performed using linear regression to adjust the comparisons for age, body mass index, and comorbidity. RESULTS Of the 154 patients, preoperative diagnosis was benign in 66% (n=102) and endometrial cancer in 34% (n=52). Patients with endometrial cancer were more likely to be older, non-White, in lower income brackets, have higher body mass index, and be postmenopausal (P<.05). Although preoperative global health scores were similar between benign and malignant cases (P>.05), when adjusted for age, the differences in global health quality of life between patients with benign gynecologic conditions and those with endometrial cancer became significant, because the endometrial cancer group was older than the benign group (P<.05). However, when adjusting for age, body mass index, and comorbidities (hypertension and diabetes), the differences were no longer significant (P>.05). Sexual interest was decreased in the patients with endometrial cancer both in the unadjusted and adjusted model; and vulvar complaints became significantly different between the groups when controlling for body mass index, age, and comorbidities (P<.05). CONCLUSION Despite substantial differences in preoperative diagnosis, preoperative quality of life is highly influenced by age, body mass index, and comorbidities. Therefore, these factors should be explored in surgical outcomes and postoperative management trials.
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Affiliation(s)
- Dana M. Chase
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA (Dr Chase)
| | - Lelan D. McCann
- Department of Obstetrics and Gynecology, College of Medicine-Phoenix, The University of Arizona, Banner University Medical Center Phoenix, Phoenix, AZ (Drs McCann, Mahnert, and Herbst-Kralovetz)
| | - Alice Treuth
- Department of Basic Medical Sciences, College of Medicine-Phoenix, The University of Arizona, Phoenix, AZ (Ms Treuth and Drs Laniewski, Jimenez, and Herbst-Kralovetz)
| | - Haiyan Cui
- University of Arizona Cancer Center, Tucson, AZ (Drs Cui and Roe)
| | - Pawel Laniewski
- Department of Basic Medical Sciences, College of Medicine-Phoenix, The University of Arizona, Phoenix, AZ (Ms Treuth and Drs Laniewski, Jimenez, and Herbst-Kralovetz)
| | - Nicole R. Jimenez
- Department of Basic Medical Sciences, College of Medicine-Phoenix, The University of Arizona, Phoenix, AZ (Ms Treuth and Drs Laniewski, Jimenez, and Herbst-Kralovetz)
| | - Nicole D. Mahnert
- Department of Obstetrics and Gynecology, College of Medicine-Phoenix, The University of Arizona, Banner University Medical Center Phoenix, Phoenix, AZ (Drs McCann, Mahnert, and Herbst-Kralovetz)
| | - Denise J. Roe
- University of Arizona Cancer Center, Tucson, AZ (Drs Cui and Roe)
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ (Dr Roe)
| | - Melissa M. Herbst-Kralovetz
- Department of Obstetrics and Gynecology, College of Medicine-Phoenix, The University of Arizona, Banner University Medical Center Phoenix, Phoenix, AZ (Drs McCann, Mahnert, and Herbst-Kralovetz)
- Department of Basic Medical Sciences, College of Medicine-Phoenix, The University of Arizona, Phoenix, AZ (Ms Treuth and Drs Laniewski, Jimenez, and Herbst-Kralovetz)
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Yan B, Zhao T, Li Z, Ren J, Zhang Y. An MR-based radiomics nomogram including information from the peritumoral region to predict deep myometrial invasion in stage I endometrioid adenocarcinoma: a preliminary study. Br J Radiol 2023; 96:20230026. [PMID: 37751166 PMCID: PMC10607389 DOI: 10.1259/bjr.20230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE To develop and validate an MR-based radiomics nomogram combining different imaging sequences (ADC mapping and T2 weighted imaging (T2WI)), different tumor regions (combined intra- and peritumoral regions), and different parameters (clinical features, tumor morphological features, and radiomics features) while considering different MR field strengths in predicting deep myometrial invasion (MI) in Stage I endometrioid adenocarcinoma (EEA). METHODS A total of 202 patients were retrospectively analyzed and divided into two cohorts (training cohort, 1.5 T MR, n = 131; validation cohort, 3.0 T MR, n = 71). Axial ADC mapping and T2WI were conducted. Radiomics features were extracted from intra- and peritumoral regions. Least absolute shrinkage and selection operator regression, univariate analysis, and multivariate logistic regression were used to select radiomics features and tumor morphological and clinical parameters. The area under the receiver operator characteristic curve (AUC) was calculated to evaluate the performance of the prediction model and radiomics nomogram. RESULTS Ten radiomics features, 4 morphological parameters and 1 clinical characteristic were selected. The radiomics nomogram achieved good discrimination between the superficial and deep MI cohorts. The AUC was 0.927 (95% confidence interval [CI]: 0.865, 0.967) in the training cohort and 0.921 (95% CI: 0.872, 0.948) in the validation cohort. The specificity and sensitivity were 92.0 and 78.9% in the training cohort and 83.0 and 77.8% in the validation cohort, respectively. CONCLUSION The radiomics nomogram showed good performance in predicting the depth of MI in Stage I EEA before surgery and might be useful for surgical patient management. ADVANCES IN KNOWLEDGE An MR-based radiomics nomogram was useful for predicting deep MI in Stage I EEA patients (AUCtrain = 0.927, AUCvalidation = 0.921). The intra- and peritumoral radiomics features complemented each other. The nomogram was developed and validated with different MR field strengths, suggesting that the model demonstrates good generalizability.
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Affiliation(s)
| | - Tingting Zhao
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | | | | | - Yuchen Zhang
- Department of Nuclear Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
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83
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Xiong L, Chen C, Lin Y, Mao W, Song Z. A computer-aided determining method for the myometrial infiltration depth of early endometrial cancer on MRI images. Biomed Eng Online 2023; 22:103. [PMID: 37907955 PMCID: PMC10617104 DOI: 10.1186/s12938-023-01169-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
To classify early endometrial cancer (EC) on sagittal T2-weighted images (T2WI) by determining the depth of myometrial infiltration (MI) using a computer-aided diagnosis (CAD) method based on a multi-stage deep learning (DL) model. This study retrospectively investigated 154 patients with pathologically proven early EC at the institution between January 1, 2018, and December 31, 2020. Of these patients, 75 were in the International Federation of Gynecology and Obstetrics (FIGO) stage IA and 79 were in FIGO stage IB. An SSD-based detection model and an Attention U-net-based segmentation model were trained to select, crop, and segment magnetic resonance imaging (MRl) images. Then, an ellipse fitting algorithm was used to generate a uterine cavity line (UCL) to obtain MI depth for classification. In the independent test datasets, the uterus and tumor detection model achieves an average precision rate of 98.70% and 87.93%, respectively. Selecting the optimal MRI slices method yields an accuracy of 97.83%. The uterus and tumor segmentation model with mean IOU of 0.738 and 0.655, mean PA of 0.867 and 0.749, and mean DSC of 0.845 and 0.779, respectively. Finally, the CAD method based on the calculated MI depth reaches an accuracy of 86.9%, a sensitivity of 81.8%, and a specificity of 91.7% for early EC classification. In this study, the CAD method implements an end-to-end early EC classification and is found to be on par with radiologists in terms of performance. It is more intuitive and interpretable than previous DL-based CAD methods.
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Affiliation(s)
- Liu Xiong
- School of Optoelectronic and Communication Engineering, Xiamen University of Technology, No. 600 Ligong Road, Jimei District, Xiamen, 361024, Fujian, China
| | - Chunxia Chen
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - Yongping Lin
- School of Optoelectronic and Communication Engineering, Xiamen University of Technology, No. 600 Ligong Road, Jimei District, Xiamen, 361024, Fujian, China.
| | - Wei Mao
- School of Optoelectronic and Communication Engineering, Xiamen University of Technology, No. 600 Ligong Road, Jimei District, Xiamen, 361024, Fujian, China
| | - Zhiyu Song
- School of Optoelectronic and Communication Engineering, Xiamen University of Technology, No. 600 Ligong Road, Jimei District, Xiamen, 361024, Fujian, China
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84
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Yao Y, Shi L, Zhu X. Serum Anti-Mullerian Hormone Levels Might Indicate Premenopausal Endometrial Lesions. Diagnostics (Basel) 2023; 13:3301. [PMID: 37958197 PMCID: PMC10650321 DOI: 10.3390/diagnostics13213301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/08/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Endometrial proliferative lesions (EPL) usually refer to endometrial hyperplasia (EH) and endometrial cancer (EC). Among patients with premenopausal EPL who wish to preserve their fertility, only those with EH and early-stage EC have the possibility to undergo fertility preservation therapy. However, there is currently a lack of specific and reliable screening criteria and models for identifying these patients. METHODS This study utilized a retrospective diagnostic study design. The training set included medical record information that met the criteria between August 2017 and October 2022, while the validation set consisted of medical record information that met the criteria from November 2022 to May 2023. The endometrial pathological test served as the gold standard. The serum anti-Mullerian hormone (AMH) level before endometrial sampling and a regression model were employed to predict EPL. RESULTS The study included a total of 1209 patients with PCOS (1119 in the control group and 90 in the endometrial proliferative lesion group) and 5366 women without PCOS (5249 in the control group and 117 in the proliferative lesion group). In the case of PCOS patients aged 20-39 years, the most effective screening threshold for AMH was found to be a serum AMH level of ≤5.39 ng/mL. The model used for this group was logit(p) = -2.562 - 0.430 × AMH + 0.127 × BMI + 1.512 × hypertension + 0.956 × diabetes -1.145 × regular menstruation. On the other hand, for non-PCOS women aged 20-39 years, the optimal screening threshold for AMH was determined to be a serum AMH value of ≤2.18 ng/mL. The model used for this group was logit(p) = -3.778 - 0.823 × AMH + 0.176 × BMI + 2.660 × diabetes -1.527 × regular menstruation -1.117 × dysmenorrhea. It is important to note that all of these findings have successfully passed internal verification. CONCLUSION For PCOS and non-PCOS women aged 20-39 years, the serum AMH test and related multiple regression models were obtained for the warning of EPL.
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Affiliation(s)
- Yingsha Yao
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; (Y.Y.); (L.S.)
| | - Liujing Shi
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; (Y.Y.); (L.S.)
| | - Xiaoming Zhu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; (Y.Y.); (L.S.)
- Key Laboratory of Women’s Reproductive Health of Zhejiang Province, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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85
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Zhao H, Shi C, Zhao G, Liu J, Wang X, Liang J, Li F. RNA modification regulator DDC in endometrial cancer affects the tumor microenvironment and patient prognosis. Sci Rep 2023; 13:18057. [PMID: 37872211 PMCID: PMC10593861 DOI: 10.1038/s41598-023-44269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023] Open
Abstract
Uterine corpus endometrial carcinoma (UCEC) is infiltrated by immune cells, which are involved in the growth and proliferation of malignant tumors and resistance to immunotherapy. This study suggested that RNA modification regulators played an important role in the development and prognosis of UCEC. Many studies confirmed that RNA modification played an essential role in tumor immune regulation, and abnormal RNA modification contributed to tumorigenesis and cancer progression. Based on the RNA modification regulatory factors, the UCEC samples from TCGA (The Cancer Genome Atlas) were classified into two clusters, namely Cluster A and Cluster B, using unsupervised consensus clustering. We obtained DEG (differentially expressed genes) between the two clusters, and constructed a risk model of RNA modification-related genes using DEGs. Cluster A had lower RNA modification regulatory factors, richer immune cell infiltration, and better prognosis. The differentially expressed genes between the two clusters were obtained, and these genes were used for modeling. This model divided patients with UCEC into two groups. The low-risk group had better immune infiltration, and the ROC (receiver operating characteristic) curve showed that this model had good predictive efficacy. The low-risk group had a better response to immunotherapy by immune checkpoint prediction. We obtained the key gene L-dopa decarboxylase (DDC) through the intersection of LASSO model genes and GEO dataset GSE17025. We evaluated the potential biological functions of DDC. The differences in the expression of DDC were verified by immunohistochemistry. We evaluated the relationship between DDC and immune cell infiltration and verified this difference using immunofluorescence. Cluster A with low expression of RNA modification regulators has better prognosis and richer immune cell infiltration, therefore, we believed that RNA modification regulators in UCEC were closely related to the tumor microenvironment. Also, the risk score could well predict the prognosis of patients and guide immunotherapy, which might benefit patients with UCEC.
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Affiliation(s)
- Huai Zhao
- Shengjing Hospital of China Medical University, 110001, Shenyang, Liaoning, China
| | - Chuang Shi
- Guangming Community Health Service Center, 101127, Shunyi District, Beijing, China
| | - Guoguang Zhao
- Shengjing Hospital of China Medical University, 110001, Shenyang, Liaoning, China
| | - Jiamin Liu
- Zigong First People's Hospital, 643099, Zigong, Sichuan, China
| | - Xi Wang
- The First Hospital of China Medical University, 110001, Shenyang, Liaoning, China
| | - Jie Liang
- The First Hospital of China Medical University, 110001, Shenyang, Liaoning, China.
| | - Fangmei Li
- The First Hospital of China Medical University, 110001, Shenyang, Liaoning, China.
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Liwei L, He L, Yibo D, Luyang Z, Zhihui S, Nan K, Danhua S, Junzhu W, Zhiqi W, Jianliu W. Re-stratification of patients with copy-number low endometrial cancer by clinicopathological characteristics. World J Surg Oncol 2023; 21:332. [PMID: 37865800 PMCID: PMC10589940 DOI: 10.1186/s12957-023-03229-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/14/2023] [Indexed: 10/23/2023] Open
Abstract
OBJECTIVE To stratify patients with copy-number low (CNL) endometrial cancer (EC) by clinicopathological characteristics. METHODS EC patients who underwent surgery between June 2018 and June 2022 at Peking University People's Hospital were included and further classified according to TCGA molecular subtyping: POLE ultramutated, microsatellite instability high (MSI-H), CNL, and copy-number high (CNH). Clinicopathological characteristics and prognosis of CNL patients were retrospectively reviewed. The Cox proportional hazards regression model was applied to perform univariate and multivariate analysis, and independent risk factors were identified. Differentially expressed genes (DEGs) according to overall survival (OS) were screened based on the transcriptome of CNL cases from the TCGA program. Finally, a nomogram was established, with an accuracy analysis performed. RESULTS (1) A total of 279 EC patients were included, of whom 168 (60.2%) were in the CNL group. A total of 21 patients had recurrence and 6 patients deceased, and no significant difference in recurrence-free survival (RFS) was exhibited among the four molecular subtypes (P = 0.104), but that in overall survival (OS) was statistically significant (P = 0.036). (2) CNL patients were divided into recurrence and non-recurrence groups, and significant differences (P < 0.05) were found between the two groups in terms of pathological subtype, FIGO stage, ER, PR, glycated hemoglobin (HbA1c), and high-density lipoprotein cholesterol (HDL-C). All the above factors were included in univariate and multivariate Cox regression models, among which pathological subtype, PR, and HDL-C were statistically different (P < 0.05), resulting in three independent risk factors for the prognosis of patients in the CNL group. (3) By comparing the transcriptome of tumor tissues between living and deceased CNL patients from the TCGA database, 903 (4.4%) DEGs were screened, with four lipid metabolism pathways significantly enriched. Finally, a nomogram was established, and internal cross-validation was performed, showing good discrimination accuracy with an AUC of 0.831 and a C-index of 0.748 (95% CI 0.444-1.052). (4) According to the established nomogram and the median total score (85.89), patients were divided into the high score group (n = 85) and low score group (n = 83), and the 8 patients with recurrence were all in the high score group. Survival analysis was performed between the two groups, and the difference in RFS was statistically significant (P = 0.010). CONCLUSION In the CNL group of EC patients, pathological subtype, PR, and HDL-C were independent prognostic risk factors, the nomogram established based upon which had a good predictive ability for the recurrence risk of patients with CNL EC.
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Affiliation(s)
- Li Liwei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Li He
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Dai Yibo
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Zhao Luyang
- Department of Obstetrics and Gynecology, the Seventh Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Shen Zhihui
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Kang Nan
- Department of Pathology, Peking University People's Hospital, Beijing, China
| | - Shen Danhua
- Department of Pathology, Peking University People's Hospital, Beijing, China
| | - Wang Junzhu
- The Big Data and Public Policy Laboratory, School of Government, Peking University, Beijing, China
| | - Wang Zhiqi
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
| | - Wang Jianliu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
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Joe S, Lee M, Kang J, Kim J, Hong SH, Lee SJ, Lee KH, Lee A. Enhanced Risk Stratification in Early-Stage Endometrial Cancer: Integrating POLE through Droplet Digital PCR and L1CAM. Cancers (Basel) 2023; 15:4899. [PMID: 37835593 PMCID: PMC10571976 DOI: 10.3390/cancers15194899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/24/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
AIM In order to enhance risk stratification in early-stage endometrial cancer (EC), we conducted molecular classification using surrogate markers, including the POLE droplet digital polymerase chain reaction (ddPCR) and L1CAM immunohistochemistry (IHC). METHOD We analyzed archival tumor tissue from 183 early-stage EC patients. POLE pathogenic mutations of P286R, V411L, S297F, A456P, and S459F within exons 9, 13, and 14 were detected using a ddPCR, while the mismatch repair (MMR) status was determined by MMR protein IHC and MSI tests. Additionally, we conducted IHC for p53 and L1CAM. RESULTS The 183 ECs were categorized into four subgroups: POLE-mutated (15.9%), MMR-deficient (29.0%), p53-abnormal (8.7%), and non-specific molecular profile (NSMP, 46.4%). We further subcategorized the NSMP subgroup into NSMP-L1CAMneg (41.5%) and NSMP-L1CAMpos (4.9%), which we refer to as the molecular L1CAM classification. The molecular L1CAM classification was an independent prognostic factor for recurrence-free survival (RFS) and overall survival (OS) (p < 0.001, each). CONCLUSION Integrating molecular L1CAM classification can enhance risk stratification in early-stage EC, providing valuable prognostic information to guide treatment decisions and improve patient outcomes. POLE ddPCR might be a cost-effective and easy-to-perform test as an alternative to POLE NGS.
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Affiliation(s)
- Seungyeon Joe
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.); (M.L.)
| | - Miseon Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.); (M.L.)
| | - Jun Kang
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.); (M.L.)
| | - Joori Kim
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sook-Hee Hong
- Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sung Jong Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Keun Ho Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Ahwon Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.); (M.L.)
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Ma S, Chen Q, Li X, Fu J, Zhao L. UBE2C serves as a prognosis biomarker of uterine corpus endometrial carcinoma via promoting tumor migration and invasion. Sci Rep 2023; 13:16899. [PMID: 37803076 PMCID: PMC10558470 DOI: 10.1038/s41598-023-44189-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/04/2023] [Indexed: 10/08/2023] Open
Abstract
The biological functions of ubiquitin-conjugating enzymes E2 (UBE2) family members in uterine corpus endometrial carcinoma (UCEC) remains unclear. Our study aimed to systematically analyze the expression patterns, prognostic value, biological functions and molecular regulatory mechanisms of UBE2 family in UCEC. Among nine screened UBE2 family members associated with UCEC, UBE2C was the most significantly overexpressed gene with poor prognosis. High expression levels of UBE2C in UCEC was correlated with stages, histological subtypes, patient's menopause status and TP53 mutation. Three molecules (CDC20, PTTG1 and AURKA), were identified as the key co-expression proteins of UBE2C. The generic alterations (mutation, amplification) and DNA hypomethylation might contribute to UBE2C's high expression in UCEC. Furthermore, in vitro experiments showed that the interference of UBE2C inhibited the migration and invasion of endometrial cancer cells, while partially impact cell proliferation and didn't impact the expression of epithelial-mesenchymal transition (EMT) markers. Using comprehensive bioinformatics analysis and in vitro experiments, our study provided a novel insight into the oncogenic role of UBE2 family, specifically UBE2C in UCEC. UBE2C might serve as an effective biomarker to predict poor prognosis and a potential therapeutic target in clinical practice.
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Affiliation(s)
- Sijia Ma
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Qian Chen
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xu Li
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Jing Fu
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Le Zhao
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
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Uno K, Yoshikawa N, Kitami K, Mori S, Shibata T, Iyoshi S, Fujimoto H, Mogi K, Yoshihara M, Tamauchi S, Ikeda Y, Yokoi A, Kato K, Hoshiba T, Oguchi H, Kajiyama H. The sarcopenia index measured using the lumbar paraspinal muscle is associated with prognosis in endometrial cancer. Jpn J Clin Oncol 2023; 53:942-949. [PMID: 37519058 DOI: 10.1093/jjco/hyad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE The number of type-II endometrial cancer patients has been increasing and the prognosis is not favorable. We aim to investigate whether sarcopenia index in any of several different muscles could serve as a novel biomarker of prognosis in patients with type-II endometrial cancer. METHODS We retrospectively investigated a total of 194 patients at four hospitals. Ninety patients were treated as derivation set and the other 104 patients as validation set. Using preoperative computed tomography images, we measured the horizontal cross-sectional area at the third lumbar spine level: the (i) psoas major, (ii) iliac and (iii) paraspinal muscle. The clinical information including recurrence-free survival and overall survival were retrospectively collected. These results were validated with external data sets of three hospitals. RESULTS The median values of the sarcopenia index (cm2/m2) ± standard deviation with the first data of 90 patients using the psoas, iliac and paraspinal muscle were 3.4 ± 1.0, 1.7 ± 0.6 and 12.6 ± 3.2, respectively. In univariate analyses, the sarcopenia indexes measured using the psoas or paraspinal muscle were associated with recurrence-free survival and overall survival. On the other hand, in multivariate analyses, only the sarcopenia index using paraspinal muscle was significantly related to recurrence-free survival (hazard ratio = 3.78, 95% confidence intervals = 1.29-5.97, P = 0.009) and overall survival (hazard ratio = 3.13, 95% confidence interval = 1.18-8.26, P = 0.022). Paraspinal sarcopenia index was also related to overall survival (hazard ratio = 3.74, 95% confidence interval = 1.31-10.72, P = 0.014) even in patients with advanced stage. Serum albumin was significantly correlated with the sarcopenia index (P = 0.012). Within the analysis of the validation set, sarcopenia index using paraspinal muscle was related to recurrence-free survival (hazard ratio = 2.06, P = 0.045) in multivariate analysis and recurrence-free survival (P = 0.009) in patients with advanced stage. CONCLUSIONS The sarcopenia index using the paraspinal muscle, not psoas, could be a suitable index to predict recurrence-free survival and overall survival in patients with type-II endometrial cancer even in advanced stage.
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Affiliation(s)
- Kaname Uno
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhisa Kitami
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Sho Mori
- Department of Obstetrics and Gynecology, TOYOTA Memorial Hospital, Toyota, Japan
| | - Takahiro Shibata
- Department of Obstetrics and Gynecology, TOYOTA Memorial Hospital, Toyota, Japan
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Shohei Iyoshi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Spemann Graduate School of Biology and Medicine, University of Freiburg, Freiburg, Germany
| | - Hiroki Fujimoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Discipline of Obstetrics and Gynecology, Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Kazumasa Mogi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satoshi Tamauchi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiki Ikeda
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akira Yokoi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyoshi Kato
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Tsutomu Hoshiba
- Department of Obstetrics and Gynecology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hidenori Oguchi
- Department of Obstetrics and Gynecology, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Chang CS, Lai YL, Choi CH, Kim TJ, Lee JW, Kim BG, Cheng WF, Chen YL, Lee YY. Comparison of Minimally Invasive and Open Surgery for the Treatment of Endometrial Cancer with a High Risk of Recurrence: A Propensity Score Matching Study in Korea and Taiwan. Ann Surg Oncol 2023; 30:6855-6864. [PMID: 37386310 DOI: 10.1245/s10434-023-13695-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/22/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND This study compared oncologic outcomes between minimally invasive surgery (MIS) and open surgery for the treatment of endometrial cancer with a high risk of recurrence. METHODS This study included patients with endometrial cancer who underwent primary surgery at two tertiary centers in Korea and Taiwan. Low-grade advanced-stage endometrial cancer (endometrioid grade 1 or 2) or endometrial cancer with aggressive histology (endometrioid grade 3 or non-endometrioid) at any stage was considered to have a high risk of recurrence. We conducted 1:1 propensity score matching between the MIS and open surgery groups to adjust for the baseline characteristics. RESULTS Of the total of 582 patients, 284 patients were included in analysis after matching. Compared with open surgery, MIS did not show a difference in disease-free survival [hazard ratio (HR) 1.09; 95% confidence interval (CI) 0.67-1.77, P = 0.717] or overall survival (HR 0.67; 95% CI 0.36-1.24, P = 0.198). In the multivariate analysis, non-endometrioid histology, tumor size, tumor cytology, depth of invasion, and lymphovascular space invasion were risk factors for recurrence. There was no association between the surgical approach and either recurrence or mortality in the subgroup analysis according to stage and histology. CONCLUSIONS MIS did not compromise survival outcomes for patients with endometrial cancer with a high risk of recurrence when compared with open surgery.
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Affiliation(s)
- Chi-Son Chang
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, Korea
| | - Yen-Ling Lai
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chel Hun Choi
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Joong Kim
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wen-Fang Cheng
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Li Chen
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Obstetrics and Gynecology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan.
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Capozzi VA, Armano G, Maglietta G, Rosati A, Vargiu V, Scarpelli E, Sozzi G, Chiantera V, Cosentino F, Gioè A, Catena U, Scambia G, Fanfani F, Di Spiezio Sardo A, Ghi T, Berretta R. Hysteroscopic endometrial tumor localization and sentinel lymph node mapping. An upgrade of the hysteroscopic role in endometrial cancer patients. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106952. [PMID: 37328309 DOI: 10.1016/j.ejso.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Given the growing interest in sentinel node mapping (SLN) biopsy in Endometrial Cancer (EC) patients, many efforts have been made to maximize the SLN bilateral detection rate. However, at present, no previous research assessed the potential correlation between primary EC location in the uterine cavity and SLN mapping. In this context, this study aims to investigate the possible role of intrauterine EC hysteroscopic localization in predicting SLN nodal placement. MATERIALS AND METHODS EC patients surgically treated from January 2017 to December 2021 were retrospectively analyzed. All patients underwent hysterectomy, bilateral salpingo-oophorectomy, and SLN mapping. During hysteroscopy, the location of the neoplastic lesion was described as follows: uterine fundus (comprising the most cranial portion of the uterine cavity up to the tubal ostium including the cornual areas), corpus uteri (from the tubal ostium to the inner uterine orifice), and diffuse (when the tumor invades more than 50% of the uterine cavity). RESULTS Three hundred ninety patients met the inclusion criteria. The tumor pattern diffused to the whole uterine cavity was statistically associated with SLN uptake on common iliac lymph nodes (OR 2.4, 95%CI 1-5.8, p = 0.05). Patients'age is an independent factor associated with SLN failure (OR: 0.95, 95%CI 0.93-0.98, p < 0.001). CONCLUSIONS The study showed a statistically significant association between EC hysteroscopically spread throughout the whole uterine cavity and SLN uptake at the common iliac lymph nodes. Furthermore, patient age negatively affected the SLN detection rate.
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Affiliation(s)
- Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy.
| | - Giulia Armano
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Giuseppe Maglietta
- Clinical and Epidemiological Research Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | - Andrea Rosati
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Virginia Vargiu
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Oncology, Gemelli Molise Spa, Campobasso, Italy
| | - Elisa Scarpelli
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Giulio Sozzi
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - Vito Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - Francesco Cosentino
- Department of Oncology, Gemelli Molise Spa, Campobasso, Italy; Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università del Molise, Campobasso, Italy
| | - Alessandro Gioè
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ursula Catena
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Attilio Di Spiezio Sardo
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Tullio Ghi
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Roberto Berretta
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
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Wang Y, Chen S, Wang C, Guo F. Nanocarrier-based targeting of metabolic pathways for endometrial cancer: Status and future perspectives. Biomed Pharmacother 2023; 166:115348. [PMID: 37639743 DOI: 10.1016/j.biopha.2023.115348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023] Open
Abstract
Cancer is the second-most lethal global disease, as per health reports, and is responsible for around 70% of deaths in low- and middle-income countries. Endometrial cancer is one of the emerging malignancies and has been predicted as a public health challenge for the future. Insulin resistance, obesity, and diabetes mellitus are the key metabolic factors that promote risks for the development of endometrial cancer. Various signaling pathways and associated genes are involved in the genesis of endometrial cancer, and any mutation or deletion in such related factors leads to the induction of endometrial cancer. The conventional way of drug delivery has been used for ages but is associated with poor management of cancer due to non-targeting of the endometrial cancer cells, low efficacy of the therapy, and toxicity issues as well. In this context, nanocarrier-based therapy for the management of endometrial cancer is an effective alternate choice that overcomes the problems associated with conventional therapy. In this review article, we highlighted the nanocarrier-based targeting of endometrial cancer, with a special focus on targeting various metabolic signaling pathways. Furthermore, the future perspectives of nanocarrier-based targeting of metabolic pathways in endometrial cancer were also underpinned. It is concluded that targeting metabolic signaling pathways in endometrial cancer via nanocarrier scaffolds is the future of pharmaceutical design for the significant management and treatment of endometrial cancer.
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Affiliation(s)
- Yichao Wang
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130000, China
| | - Siyao Chen
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130000, China
| | - Chunling Wang
- Medical Affairs Department, The Second Hospital of Jilin University, Changchun 130000, China
| | - Fengjun Guo
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130000, China.
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Erturk E, Soyler O, Pehlivan FS, Arslan C. Case report-right atrial mass: a very rare presentation of endometrial cancer metastasis. Eur Heart J Case Rep 2023; 7:ytad461. [PMID: 37811158 PMCID: PMC10551060 DOI: 10.1093/ehjcr/ytad461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023]
Abstract
Background We report a case of a 47-year-old woman with right atrial metastasis of endometrioid adenocarcinoma, which is an uncommon clinical presentation for patients with endometrial cancer (EC). The principal aim of this case is to demonstrate the possibility of distant metastasis, something rarely encountered among this group of patients. Case summary Our patient, diagnosed with EC and receiving chemotherapy and radiotherapy after surgery, was found to have enhanced 18-fluorodeoxyglucose uptake inside the right atrium on the repeat positron emission tomography-computed tomography scan at the ninth month after initial diagnosis. Following trans-oesophageal echocardiography, cardiac magnetic resonance imaging showed a hyper-vascular mass with right atrial lateral wall involvement likely to be malignant in nature. A right atrial tumour was successfully removed by cardiovascular surgeons, and a pericardial patch was placed at the site of the excised atrium. The pathological examination showed EC metastasis. Following surgery, systemic treatment was planned for recurrent EC. The patient had an uneventful recovery after the surgery. Discussion Endometrial cancer is the most common gynaecologic malignancy and the fourth most common cancer in women. The lymphatic pathway is the main metastatic behaviour of EC; however, haematogenous metastases are not uncommon, especially in patients with higher stages of the disease. Our patient did not show any signs and symptoms of cardiac involvement. Nevertheless, clinicians should be alert for symptoms of cardiac involvement like new-onset murmur, embolism, or dyspnoea. Having known the behavioural pattern of the primary tumour, timely utilization of diagnostic imaging methods in accordance with clinical suspicions in patients with rapidly growing tumours can be lifesaving.
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Affiliation(s)
- Emre Erturk
- Department of Cardiology, Izmir University of Economics Medicalpoint Hospital, Imbatli Mah., 1825 sokak, No:12, Izmir 35575, Turkey
| | - Onur Soyler
- Department of Cardiovascular Surgery, Izmir University of Economics Medicalpoint Hospital, Izmir, Turkey
| | | | - Cagatay Arslan
- Department of Medical Oncology, Izmir University of Economics Medicalpoint Hospital, Izmir, Turkey
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94
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Kim Y, Aiob A, Kim H, Suh DH, Kim K, Kim YB, No JH. Clinical Implication of PD-L1 Expression in Patients with Endometrial Cancer. Biomedicines 2023; 11:2691. [PMID: 37893065 PMCID: PMC10603999 DOI: 10.3390/biomedicines11102691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
This study investigated PD-L1 expression in endometrial cancer, its links with prognostic factors, and survival outcomes in 232 patients. Of these, 73 (31.5%) had PD-L1-positive tumors and 159 (68.5%) had PD-L1-negative tumors. PD-L1 expression significantly correlated with adverse prognostic factors. The PD-L1-positive group had higher rates of high-grade tumors (37.0% vs. 19.1%, p = 0.004), deep myometrial invasion (35.6% vs. 24.4%, p = 0.004), lymphovascular space invasion (LVSI) (39.7% vs. 25.6%, p = 0.023), and lymph node metastasis (7.2% vs. 17.1%, p = 0.024) than the PD-L1-negative group. While 5-year progression-free survival (PFS) favored the PD-L1-negative group (94.1% vs. 86.3%), this difference lacked statistical significance (p = 0.139). No significant variations emerged in overall survival (OS) (p = 0.596) or recurrence rates between the groups. Although outcomes lack statistical significance, they suggest a plausible link between PD-L1 and established adverse prognostic factors, such as histological grade, myometrial invasion depth, LVSI, and lymph node metastasis in endometrial cancer. These insights hint at PD-L1's potential as an informal prognostic indicator, potentially aiding in endometrial cancer patient management.
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Affiliation(s)
- Yeorae Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (Y.K.); (D.H.S.); (K.K.); (Y.B.K.)
| | - Ala Aiob
- Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya 22100, Israel;
- Azrieli Faculty of Medicine, Bar Ilan University, Safed 5290002, Israel
| | - Hyojin Kim
- Department of Pathology, Seoul National University Bundang Hospital and College of Medicine, Seoul National University, Seongnam 13620, Republic of Korea;
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (Y.K.); (D.H.S.); (K.K.); (Y.B.K.)
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Kidong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (Y.K.); (D.H.S.); (K.K.); (Y.B.K.)
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Yong Beom Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (Y.K.); (D.H.S.); (K.K.); (Y.B.K.)
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jae Hong No
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; (Y.K.); (D.H.S.); (K.K.); (Y.B.K.)
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
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95
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Song C, Kim KB, Lee GS, Shin S, Kim B. Is HOXA5 a Novel Prognostic Biomarker for Uterine Corpus Endometrioid Adenocarcinoma? Int J Mol Sci 2023; 24:14758. [PMID: 37834206 PMCID: PMC10573156 DOI: 10.3390/ijms241914758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Endometrial cancer (EC) is one of the most pervasive malignancies in females worldwide. HOXA5 is a member of the homeobox (HOX) family and encodes the HOXA5 protein. HOXA5 is associated with various cancers; however, its association with EC remains unclear. This study aimed to determine the association between HOXA5 gene expression and the prognosis of endometrioid adenocarcinoma, a subtype of EC (EAEC). Microarray data of HOXA5 were collected from the Gene Expression Omnibus datasets, consisting of 79 samples from GSE17025 and 20 samples from GSE29981. RNA-sequencing, clinical, and survival data on EC were obtained from The Cancer Genome Atlas cohort. Survival analysis revealed that HOXA5 overexpression was associated with poor overall survival in patients with EAEC (p = 0.044, HR = 1.832, 95% CI = 1.006-3.334). Cox regression analysis revealed that HOXA5 was an independent risk factor for poor prognosis in EAEC. The overexpression of HOXA5 was associated with a higher histological grade of EAEC, and it was also associated with TP53 mutation or the high copy number of EC. Our findings suggest the potential of HOXA5 as a novel biomarker for predicting poor survival outcomes in patients with EAEC.
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Affiliation(s)
- Changho Song
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan 44033, Republic of Korea;
| | - Kyoung Bo Kim
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
| | - Gi Su Lee
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
| | - Soyoung Shin
- Department of Pediatrics, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
| | - Byoungje Kim
- Department of Radiology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
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96
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Yang N, Zhou F. Comparison of the effects of laparoscopic and open hysterectomy on surgical site wound infections in patients with endometrial cancer: A meta-analysis. Int Wound J 2023; 21:e14415. [PMID: 37743352 PMCID: PMC10824626 DOI: 10.1111/iwj.14415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023] Open
Abstract
This meta-analysis aimed to compare laparoscopic hysterectomy (LH) and open hysterectomy (OH) in terms of surgical site wound infection, length of hospital stay, and postoperative complications in patients with endometrial cancer (EC). PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched for studies on OH and LH for EC published between 2008 and July 2023, in any language. The literature was screened according to the inclusion and exclusion criteria, and the quality of the included case-control studies was assessed using the Newcastle-Ottawa Scale. Data were collated and analysed using Stata 17.0 software. A total of 1245 articles were screened according to the search strategy, and ultimately 15 studies were included in this meta-analysis, with a total of 1606 patients with EC, of which 751 were treated with LH and 855 with OH. The results showed that the rate of postoperative wound infection was significantly higher (OR: 0.290; 95% CI: 0.169-0.496, p < 0.001), the length of hospital stay was significantly longer (SMD: -1.976, 95% CI: -2.669 to -1.283, p < 0.001), and the incidence of postoperative complications was significantly higher (OR: 0.366; 95% CI: 0.280-0.478, p < 0.001) in the OH group than in the LH group. This study showed that LH was superior to OH for the treatment of EC and is associated with a lower rate of wound infection, shorter length of hospitalisation, and a reduced risk of complications. Thus, our findings support the choice of LH over OH for EC.
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Affiliation(s)
- Nian Yang
- Department of Obstetrics and Gynaecology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Fei Zhou
- Department of Obstetrics and Gynaecology, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
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97
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Li J, Li X, Quan C, Li X, Wan C, Wu X. Genomic profile of Chinese patients with endometrial carcinoma. BMC Cancer 2023; 23:888. [PMID: 37730563 PMCID: PMC10512642 DOI: 10.1186/s12885-023-11382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUNDS Endometrial carcinoma (EC) is one of the most commonly diagnosed gynecologic malignancy in China. However, the genetic profile of Chinese EC patients has not been well established yet. METHODS In current study, 158 Chinese EC patients were subjected to next-generation sequencing assay (74 took testing of EC-related 20-genes panel, and 84 took the expanded panel). Of the 158 patients, 91 patients were performed germline mutation testing using the expanded panel. Moreover, the public datasets from TCGA and MSKCC were utilized to compare the genomic differences between Chinese and Western EC patients. The proteomic and transcriptomic from CPTAC and TCGA were derived and performed unsupervised clustering to identify molecular subtypes. RESULTS Among the 158 patients analyzed, a significant majority (85.4%) exihibited at least one somatic alteration, with the most prevalent alterations occurring in PTEN, PIK3CA, TP53, and ARID1A. These genomic alterations were mainly enriched in the PI3K, cell cycle, RAS/RAF/MAPK, Epigenetic modifiers/Chromatin remodelers, and DNA damage repair (DDR) signaling pathways. Additionally, we identified ten individuals (11.0%) with pathogenic or likely pathogenic germline alterations in seven genes, with the DDR pathway being predominantly involved. Compared to Western EC patients, Chinese EC patients displayed different prevalence in AKT1, MET, PMS2, PIK3R1, and CTCF. Notably, 69.6% of Chinese EC patients were identified with actionable alterations. In addition, we discovered novel molecular subtypes in ARID1A wild-type patients, characterized by an inferior prognosis, higher TP53 but fewer PTEN and PIK3CA alterations. Additionally, this subtype exhibited a significantly higher abundance of macrophages and activated dendritic cells. CONCLUSION Our study has contributed valuable insights into the unique germline and somatic genomic profiles of Chinese EC patients, enhancing our understanding of their biological characteristics and potential therapeutic avenues. Furthermore, we have highlighted the presence of molecular heterogeneity in ARID1A-wild type EC patients, shedding light on the complexity of this subgroup.
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Affiliation(s)
- Jin Li
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Fudan University, 200032, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, 200032, Shanghai, China
| | - Xiaoqi Li
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Fudan University, 200032, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, 200032, Shanghai, China
| | - Chenlian Quan
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Fudan University, 200032, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, 200032, Shanghai, China
| | - Xiaoqiu Li
- Department of Pathology, Fudan University Shanghai Cancer Center, Fudan University, 200032, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, 200032, Shanghai, China
| | - Chong Wan
- Precision Medicine Center, Yangtze Delta Region Institute of Tsinghua University, Jiaxing, China
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Fudan University, 200032, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, 200032, Shanghai, China.
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98
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Yu Y, Zhang Y, Li Z, Dong Y, Huang H, Yang B, Zhao E, Chen Y, Yang L, Lu J, Qiu F. An EMT-related genes signature as a prognostic biomarker for patients with endometrial cancer. BMC Cancer 2023; 23:879. [PMID: 37723477 PMCID: PMC10506329 DOI: 10.1186/s12885-023-11358-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/31/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The epithelial-mesenchymal transition (EMT) plays an indispensable role in the development and progression of Endometrial cancer (EC). Nevertheless, little evidence is reported to uncover the functionality and application of EMT-related molecules in the prognosis of EC. This study aims to develop novel molecular markers for prognosis prediction in patients with EC. METHODS RNA sequencing profiles of EC patients obtained from The Cancer Genome Atlas (TCGA) database were used to screen differential expression genes (DEGs) between tumors and normal tissues. The Cox regression model with the LASSO method was utilized to identify survival-related DEGs and to establish a prognostic signature whose performance was evaluated by Kaplan-Meier curve, receiver operating characteristic (ROC) and calibration curve. Eventually, functional enrichment analysis and cellular experiments were performed to reveal the roles of prognosis-related genes in EC progression. RESULTS A total of 540 EMT-related DEGs in EC were screened, and subsequently a four-gene risk signature comprising SIRT2, SIX1, CDKN2A and PGR was established to predict overall survival of EC. This risk signature could serve as a meaningfully independent indicator for EC prognosis via multivariate Cox regression (HR = 2.002, 95%CI = 1.433-2.798; P < 0.001). The nomogram integrating the risk signature and clinical characteristics exhibited robust validity and performance at predicting EC overall survival indicated by ROC and calibration curve. Functional enrichment analysis revealed that the EMT-related genes risk signature was associated with extracellular matrix organization, mesenchymal development and cellular component morphogenesis, suggesting its possible relevance to epithelial-mesenchymal transition and cancer progression. Functionally, we demonstrated that the silencing of SIX1, SIRT2 and CDKN2A expression could accelerate the migratory and invasive capacities of tumor cells, whereas the downregulation of PGR dramatically inhibited cancer cells migration and invasion. CONCLUSIONS Altogether, a novel four-EMT-related genes signature was a potential biomarker for EC prognosis. These findings might help to ameliorate the individualized prognostication and therapeutic treatment of EC patients.
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Affiliation(s)
- Yonghui Yu
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China
| | - Yiwen Zhang
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhi Li
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China
| | - Yongshun Dong
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China
| | - Hongmei Huang
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China
| | - Binyao Yang
- Innovation Center for Advanced Interdisciplinary Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Eryong Zhao
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China
| | - Yongxiu Chen
- Department of Gynaecology and Obstetrics, Guangdong Women's and Children's Hospital, Guangzhou, Guangdong, China
| | - Lei Yang
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China
| | - Jiachun Lu
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China
| | - Fuman Qiu
- State Key Lab of Respiratory Disease, Institute for Chemical Carcinogenesis, Collaborative Innovation Center for Environmental Toxicity, School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Xinzao, Panyu District, Guangzhou, 511436, China.
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99
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Wang C, Li J, Liu W, Li S, Zhang Y, Jin Y, Cui J. Comprehensive analysis and experimental validation reveal elevated CLCN4 is a promising biomarker in endometrial cancer. Aging (Albany NY) 2023; 15:8744-8769. [PMID: 37671947 PMCID: PMC10522378 DOI: 10.18632/aging.204994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/25/2023] [Indexed: 09/07/2023]
Abstract
Several studies have reported the role of CLCN4 in tumor progression. However, its mechanism remains to be thoroughly studied. The objective of this study was to explore the potential pathogenic role of CLCN4 in endometrial carcinoma (UCEC) with a better understanding of the pathological mechanisms involved. The potential roles of CLCN4 in different tumors were explored based on The Cancer Genome Atlas (TCGA), the expression difference, mutation, survival, pathological stage, Immunity subtypes, Immune infiltration, tumor microenvironment (TME), tumor mutation burden (TMB), microsatellite instability (MSI), mismatch repair (MMR) related to CLCN4 were analyzed. Then, the expression, prognosis, mutation, and functional enrichment of CLCN4 in UCEC were analyzed. Immunohistochemical experiment was used to verify the expression of CLCN4 in endometrial cancer tissues and normal tissues. In vitro, we knocked down of CLCN4 in HEC-1-A cells and performed CCK8, WB, RT-PCR, wound-healing, transwell assays to further validation of the molecular function. Results revealed that high expression of CLCN4 was observed in 20 cancer types of TCGA. CLCN4 expression correlates with poor survival in MESO, BLCA, THCA, especially UCEC tumors. CLCN4 expression was significantly associated with CD4+ T-cell infiltration, especially CD4+ Th1-cell. Immunohistochemical experiment reveals that CLCN4 is high expressed in endometrial tumors, in vitro experiment reveals that knockdown of CLCN4 inhibits the cells proliferation, migration and invasion. Our study is the first to offer a comprehensive understanding of the oncogenic roles of CLCN4 on different tumors. CLCN4 may become a potential biomarker in UCEC.
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Affiliation(s)
- Chenyang Wang
- Department of Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450000, China
| | - Jing Li
- Department of Gynecology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong 266000, China
| | - Weina Liu
- Department of Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450000, China
| | - Shiya Li
- Department of Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450000, China
| | - Yi Zhang
- Department of Gynecology, The University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Yanbin Jin
- Department of Gynecology, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311, China
| | - Jinquan Cui
- Department of Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450000, China
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100
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Piedimonte S, Rosa G, Gerstl B, Sopocado M, Coronel A, Lleno S, Vicus D. Evaluating the use of machine learning in endometrial cancer: a systematic review. Int J Gynecol Cancer 2023; 33:1383-1393. [PMID: 37666535 DOI: 10.1136/ijgc-2023-004622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE To review the literature on machine learning in endometrial cancer, report the most commonly used algorithms, and compare performance with traditional prediction models. METHODS This is a systematic review of the literature from January 1985 to March 2021 on the use of machine learning in endometrial cancer. An extensive search of electronic databases was conducted. Four independent reviewers screened studies initially by title then full text. Quality was assessed using the MINORS (Methodological Index for Non-Randomized Studies) criteria. P values were derived using the Pearson's Χ2 test in JMP 15.0. RESULTS Among 4295 articles screened, 30 studies on machine learning in endometrial cancer were included. The most frequent applications were in patient datasets (33.3%, n=10), pre-operative diagnostics (30%, n=9), genomics (23.3%, n=7), and serum biomarkers (13.3%, n=4). The most commonly used models were neural networks (n=10, 33.3%) and support vector machine (n=6, 20%).The number of publications on machine learning in endometrial cancer increased from 1 in 2010 to 29 in 2021.Eight studies compared machine learning with traditional statistics. Among patient dataset studies, two machine learning models (20%) performed similarly to logistic regression (accuracy: 0.85 vs 0.82, p=0.16). Machine learning algorithms performed similarly to detect endometrial cancer based on MRI (accuracy: 0.87 vs 0.82, p=0.24) while outperforming traditional methods in predicting extra-uterine disease in one serum biomarker study (accuracy: 0.81 vs 0.61). For survival outcomes, one study compared machine learning with Kaplan-Meier and reported no difference in concordance index (83.8% vs 83.1%). CONCLUSION Although machine learning is an innovative and emerging technology, performance is similar to that of traditional regression models in endometrial cancer. More studies are needed to assess its role in endometrial cancer. PROSPERO REGISTRATION NUMBER CRD42021269565.
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Affiliation(s)
- Sabrina Piedimonte
- Department of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada
| | | | - Brigitte Gerstl
- The Rosa Institute, Sydney, New South Wales, Australia
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Mars Sopocado
- The Rosa Institute, Sydney, New South Wales, Australia
| | - Ana Coronel
- The Rosa Institute, Sydney, New South Wales, Australia
| | | | - Danielle Vicus
- Department of Gynecologic Oncology, University of Toronto, Toronto, Ontario, Canada
- Department of Gynecologic Oncology, Sunnybrook Health Sciences, Toronto, Ontario, Canada
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