1
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Chen Q. Efficacy of different medications in the treatment of gynaecological tumours: a clinical meta-analysis. Front Oncol 2024; 14:1428937. [PMID: 39314635 PMCID: PMC11416918 DOI: 10.3389/fonc.2024.1428937] [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: 05/07/2024] [Accepted: 06/26/2024] [Indexed: 09/25/2024] Open
Abstract
Background A gynaecological tumour is one of the world's leading causes of death for women globally. Among women, cancer is the 8th most common cause of death. Since there are no such programmes, the majority of women who are diagnosed with the condition are either in advanced stages or do not respond well to current treatments. Even if patients react to the treatments, they still risk having the cancer return, at which point any further medical intervention is met with resistance. Method For this study, we selected the systemic reviews and articles that have the use of different medications used for the treatment of gynaecological tumours. Results Regarding metformin use, this study found a positive relationship between higher survival and metformin use. Five of the studies that examined the use of statins revealed a link between statin use and higher overall and/or progression-free survival rates. Individuals on lipophilic and hydrophilic statins would do better. Research evaluating beta-blocker use during neoadjuvant treatment revealed a time-varying effect, with improved survival seen across all users early in the follow-up period. However, only non-selective beta-blocker users demonstrated a correlation with higher survival after five years. One study found that the benefits of aspirin use were significant, but the advantage for continuous users (both before and after diagnosis) was minimal. Conclusion Conclusions on the association between gynaecological tumour survival and NA-NSAIDs, metformin, beta-blockers, and aspirin cannot be drawn due to insufficient evidence. However, the vast majority of statin studies have demonstrated that users had higher rates of survival. Bias, however, bias may affect the results of the studies.
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Affiliation(s)
- Qiaoying Chen
- Department of Gynecology, Women’s and Children’s Hospital of Ningbo
University, Ningbo, Zhejiang, China
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2
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Hagiyama M, Yoneshige A, Otani T, Wada A, Takeuchi F, Shoya Y, Inoue T, Ito A. An antibody-drug conjugate for endometrioid carcinoma based on the expression of cell adhesion molecule 1. Mol Cell Oncol 2024; 11:2399379. [PMID: 39252827 PMCID: PMC11382700 DOI: 10.1080/23723556.2024.2399379] [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: 05/08/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/11/2024]
Abstract
Cell adhesion molecule 1 (CADM1), an immunoglobulin superfamily member, is expressed in endometrial glandular cells highly during the proliferative phase but lowly during the secretory phase. Previously, a CADM1-targeting antibody-drug conjugate (ADC) was generated, in which a humanized anti-CADM1 ectodomain antibody h3E1 was linked with monomethyl auristatin E (h3E1-MMAE ADC). The present study aimed at probing whether this ADC could be useful for the treatment of endometrial neoplasm. Firstly, immunohistochemistry for CADM1 was conducted on proliferative-phase endometrium (n = 13), endometrial hyperplasia (n = 35), and endometrioid carcinoma at various stages (n = 166). CADM1 immunostaining intensity was highest in atypical endometrial hyperplasia and endometrioid carcinoma confined within the endometrium and was decreased stepwise as the carcinoma stage progressed. Next, h3E1-MMAE ADC was examined for its cytotoxicity in vitro using human endometrial adenocarcinoma cell lines expressing CADM1; HEC-1B, HEC-50B, JHUM-3, and OMC-2. The ADC killed these cells in a dose-dependent manner with half maximal inhibitory concentration (IC50) of 12.02 nM for HEC-1B and 2.04 nM for HEC-50B. Collectively, h3E1-MMAE ADC may serve as a noninvasive alternative to simple hysterectomy in the treatment of endometrioid carcinoma confined within the endometrium.
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Affiliation(s)
- Man Hagiyama
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
| | - Azusa Yoneshige
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
| | - Tomoyuki Otani
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
| | - Akihiro Wada
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
| | - Fuka Takeuchi
- Division of Molecular Pathology, Graduate School of Medicine, Kindai University, Osaka-sayama, Osaka, Japan
| | - Yuji Shoya
- Division of Molecular Pathology, Graduate School of Medicine, Kindai University, Osaka-sayama, Osaka, Japan
- Pharma Foods International Co., Ltd., Ohara, Nishikyo-Ku, Kyoto, Japan
| | - Takao Inoue
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
| | - Akihiko Ito
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan
- Division of Molecular Pathology, Graduate School of Medicine, Kindai University, Osaka-sayama, Osaka, Japan
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Oluloro A, Comstock B, Monsell SE, Gross M, Wolff EM, Sage L, Alson J, Lavallee DC, Hempstead B, Moore A, Katz R, Doll KM. Study Protocol for the Social Interventions for Support During Treatment for Endometrial Cancer and Recurrence (SISTER) study: a community engaged national randomized trial. J Comp Eff Res 2024; 13:e230159. [PMID: 38348827 PMCID: PMC10945416 DOI: 10.57264/cer-2023-0159] [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: 10/19/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
Aim: Social isolation in cancer patients is correlated with prognosis and is a potential mediator of treatment completion. Black women with endometrial cancer (EC) are at increased risk for social isolation when compared with White patients. We developed the Social Interventions for Support during Treatment for Endometrial Cancer and Recurrence (SISTER) study to compare and evaluate interventions to address social isolation among Black women with high-risk EC in USA. The primary objective of the SISTER study is to determine whether virtual support interventions improve treatment completion compared with Enhanced Usual Care. Secondary objectives include comparing effectiveness virtual evidence-based interventions and evaluating barriers and facilitators to social support delivery. Patients & methods: This is a multi-site prospective, open-label, community-engaged randomized controlled trial, consisting of three intervention arms: enhanced usual care, facilitated support group and one-to-one peer support. Primary outcome will be measured using relative dose. Qualitative semi-structured interviews will be conducted with a subset of participants to contextualize the relative degree or lack thereof of social isolation, over time. Data analysis: Primary analysis will be based on an intent-to-treat analysis. Multivariable analysis will be performed to determine the effect of the intervention on the primary and secondary outcomes of interest, relative dose and social isolation score. Semi-structured interviews will be qualitatively analyzed using inductive and deductive approaches of content analysis. Discussion/conclusion: Endometrial cancer mortality disproportionately affects Black women, and social isolation contributes to this disparity. The SISTER study aims to identify whether and to what extent differing social support vehicles improve key outcomes for Black women in the United States with high-risk EC. Clinical Trial Registration: NCT04930159 (ClinicalTrials.gov).
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Affiliation(s)
- Ann Oluloro
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
| | - Bryan Comstock
- University of Washington, Center for Biomedical Statistics, Seattle, WA 98195, USA
| | - Sarah E Monsell
- University of Washington, Center for Biomedical Statistics, Seattle, WA 98195, USA
| | - Maya Gross
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
| | - Erika M Wolff
- Department of Urology, University of Washington, Seattle, WA 98195, USA
| | - Liz Sage
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
| | - Julianna Alson
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
| | | | | | - Adrienne Moore
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
| | - Ronit Katz
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
| | - Kemi M Doll
- Department of Obstetrics & Gynecology, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98195, USA
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Khemworapong K, Jaishuen A, Srichaikul P, Inthasorn P, Viriyapak B, Achariyapota V, Jareemit N, Warnnissorn M, Hanamornroongruang S, Sukmee J. The fluorescence imaging for laparoscopic and laparotomic endometrial sentinel lymph node biopsy (FILLES) trial: Siriraj gynecologic sentinel node of endometrial cancer (SiGN-En) study. J Surg Oncol 2024; 129:403-409. [PMID: 37859537 DOI: 10.1002/jso.27486] [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: 08/09/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND AND OBJECTIVES The objective of this study is to establish the detection rate of sentinel lymph node (SLN) biopsies and to determine the sensitivity and false-negative rate of SLN biopsies compared with those of systematic pelvic and para-aortic lymphadenectomies in endometrial cancer. METHODS This prospective cohort study enrolled patients with endometrial cancer who were scheduled for surgical staging. Patients with a history of chemotherapy or radiotherapy, an abnormal liver function test, or an allergy to indocyanine green (ICG) were excluded. All patients underwent surgical staging with an ICG injection at the cervix. SLNs were identified by a near-infrared fluorescent camera. All SLNs were sent to a pathologist for ultrastaging. RESULTS From November 2019 to June 2023, 142 patients underwent SLN mapping and surgical staging. SLNs were not detected bilaterally in 8 patients. The detection rate of the SLN biopsies in this study was 91.2%. Thus, the accuracy of the SLN biopsies was 97.6%. The sensitivity for finding metastatic SLNs was 84.2%, with a negative predictive value of 97.22%. CONCLUSIONS A SLN biopsy in endometrial cancer has a high detection rate and high accuracy. However, surgical expertise and a learning curve are required.
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Affiliation(s)
- Khemanat Khemworapong
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Atthapon Jaishuen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Pisutt Srichaikul
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Perapong Inthasorn
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Boonlert Viriyapak
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Vuthinun Achariyapota
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Nida Jareemit
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Malee Warnnissorn
- Department of Pathology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | | | - Jumnanja Sukmee
- Department of Pathology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
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5
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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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Khan S, Lokman NA, Oehler MK, Ricciardelli C, Yool AJ. Reducing the Invasiveness of Low- and High-Grade Endometrial Cancers in Both Primary Human Cancer Biopsies and Cell Lines by the Inhibition of Aquaporin-1 Channels. Cancers (Basel) 2023; 15:4507. [PMID: 37760476 PMCID: PMC10526386 DOI: 10.3390/cancers15184507] [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: 07/31/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Aquaporin (AQP) channels in endometrial cancer (EC) cells are of interest as pharmacological targets to reduce tumor progression. A panel of compounds, including AQP1 ion channel inhibitors (AqB011 and 5-(phenoxymethyl) furan-2-carbaldehyde, PMFC), were used to test the hypothesis that inhibition of key AQPs can limit the invasiveness of low- and high-grade EC cells. We evaluated the effects on transwell migration in EC cell lines (Ishikawa, MFE-280) and primary EC cells established from surgical tissues (n = 8). Quantitative PCR uncovered classes of AQPs not previously reported in EC that are differentially regulated by hormonal signaling. With estradiol, Ishikawa showed increased AQPs 5, 11, 12, and decreased AQPs 0 and 4; MFE-280 showed increased AQPs 0, 1, 3, 4, 8, and decreased AQP11. Protein expression was confirmed by Western blot and immunocytochemistry. AQPs 1, 4, and 11 were colocalized with plasma membrane marker; AQP8 was intracellular in Ishikawa and not detectable in MFE-280. AQP1 ion channel inhibitors (AqB011; PMFC) reduced invasiveness of EC cell lines in transwell chamber and spheroid dispersal assays. In Ishikawa cells, transwell invasiveness was reduced ~41% by 80 µM AqB011 and ~55% by 0.5 mM 5-PMFC. In MFE-280, 5-PMFC inhibited invasion by ~77%. In contrast, proposed inhibitors of AQP water pores (acetazolamide, ginsenoside, KeenMind, TGN-020, IMD-0354) were not effective. Treatments of cultured primary EC cells with AqB011 or PMFC significantly reduced the invasiveness of both low- and high-grade primary EC cells in transwell chambers. We confirmed the tumors expressed moderate to high levels of AQP1 detected by immunohistochemistry, whereas expression levels of AQP4, AQP8, and AQP11 were substantially lower. The anti-invasive potency of AqB011 treatment for EC tumor tissues showed a positive linear correlation with AQP1 expression levels. In summary, AQP1 ion channels are important for motility in both low- and high-grade EC subtypes. Inhibition of AQP1 is a promising strategy to inhibit EC invasiveness and improve patient outcomes.
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Affiliation(s)
- Sidra Khan
- School of Biomedicine, University of Adelaide, Adelaide, SA 5000, Australia;
| | - Noor A. Lokman
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.L.); (M.K.O.)
| | - Martin K. Oehler
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.L.); (M.K.O.)
- Department of Gynaecological Oncology, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
| | - Carmela Ricciardelli
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.L.); (M.K.O.)
| | - Andrea J. Yool
- School of Biomedicine, University of Adelaide, Adelaide, SA 5000, Australia;
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Chukkalore D, Rajavel A, Asti D, Dhar M. Genomic determinants in advanced endometrial cancer patients with sustained response to hormonal therapy- case series and review of literature. Front Oncol 2023; 13:1188028. [PMID: 37465112 PMCID: PMC10351014 DOI: 10.3389/fonc.2023.1188028] [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: 03/16/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
The incidence of endometrial cancer is increasing, however treatment options for advanced disease are limited. Hormonal therapy has demonstrated positive outcomes for Stage IV EC. Next generation sequencing (NGS) has increased our understanding of molecular mechanisms driving EC. In this case series, we selected six patients at our institution with Stage IV, hormone receptor positive, endometrial cancer currently being treated with hormonal therapy. All patients achieved SD for at least ≥ 1.5 years. We studied NGS data on all six patients to assess for any common genomic marker which could predict the SD of at least 1.5 years achieved in this group. Institutional Review Board (IRB) approval was obtained from Staten Island University Hospital and Northwell Health, New York. PTEN, PIK3CA, PIK3R1, and ARID1A mutations were found in 83%, 67% 50%, and 67% of patients respectively. TP53 and FGFR2 were both found in 50% of patients. All patients were positive for estrogen and/or progesterone receptor (ER+ and/or PR+). We did not find any one common mutation that could have predicted the observed response (or SD of ≥1.5 years) to hormone therapy. However, our data reflects the prevalence of various mutations reported in literature: (1) Hormone Receptor status is a positive prognostic indicator (2) PTEN/PIK3CA mutations can occur concurrently in EC (3) ARID1A coexists with PTEN (4) FGFR and PTEN pathways may be interlinked. We suggest NGS be employed frequently in patients with endometrial cancer to identify targetable mutations. Additional larger studies are needed to characterize the interplay between mutations.
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Tran L, Christensen P, Barroeta JE, Hunter K, Sookram J, McGregor SM, Wilkinson N, Orsi NM, Lastra RR. Prognostic Significance of Size, Location, and Number of Lymph Node Metastases in Endometrial Carcinoma. Int J Gynecol Pathol 2023; 42:376-389. [PMID: 36044323 DOI: 10.1097/pgp.0000000000000897] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Regional lymph node metastasis is a well-established negative predictive prognostic factor in endometrial carcinomas. Recently, our approach to the pathologic evaluation of lymph nodes in endometrial carcinomas has changed, mainly due to the utilization of immunohistochemical stains in the assessment of sentinel lymph nodes, which may result in the identification of previously unrecognized disease [particularly isolated tumor cells (ITCs)] on hematoxylin and eosin stained slides. However, the clinical significance of this finding is not entirely clear. Following the experience in other organs systems such as breast, the Eight Edition of the American Joint Committee on Cancer's Cancer Staging Manual has recommended utilizing the N0(i+) terminology for this finding, without impact in the final tumor stage. We performed a comparative retrospective multi-institutional survival analysis of 247 patients with endometrial carcinoma with regional lymph node metastasis of various sizes identified in nonsentinel lymphadenectomy, demonstrating that the cumulative survival of patients with isolated tumor cells in regional lymph nodes is not statistically different from patient with negative lymph nodes, and is statistically different from those with lymph nodes showing micrometastasis or larger metastatic deposits. In addition, we evaluated the prognostic implications of the number of involved regional lymph nodes, demonstrating a worsening prognosis as the number of involved lymph nodes increases from none to one, and from one to more than one. Our data suggests that regional lymph nodes with isolated tumor cells in patients with endometrial carcinoma should likely be considered, for staging purposes, as negative lymph nodes, simply indicating their presence with the (i+) terminology.
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Makroum AA, Lee YJ, Lee JY, Nam EJ, Kim S, Kim SW, Kim YT. Comparison of oncological outcomes between sentinel lymph node biopsy and complete lymphadenectomy for endometrial cancer. J Obstet Gynaecol Res 2023. [PMID: 37286510 DOI: 10.1111/jog.15707] [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: 07/13/2022] [Accepted: 05/28/2023] [Indexed: 06/09/2023]
Abstract
AIM Sentinel lymph node (SLN) mapping allows node-negative patients to be spared from the surgical comorbidities associated with total lymphadenectomy. This study aimed to evaluate the oncological outcomes of SLN biopsy versus complete lymph node dissection in patients with early-stage endometrial carcinoma. METHODS Retrospective analyses were performed in patients with pathologically confirmed endometrioid endometrial carcinoma, who underwent minimally invasive surgical staging with SLN biopsy or complete lymph node dissection at Yonsei Cancer Center between 2015 and 2019. RESULTS A total of 301 patients were included in this study. Eighty-two patients underwent SLN biopsy, while 219 underwent complete lymph node dissection. There were no significant differences in patient characteristics between the two groups. In terms of operative characteristics, the SLN biopsy-only group had a significantly shorter surgical duration (p < 0.001) than the lymphadenectomy group. The mean follow-up period was 41.4 months. There were no differences in progression-free survival (PFS) and overall survival (OS) between the two groups (SLN biopsy vs. complete lymph node dissection; p = 0.798 and 0.301, respectively). Multivariate analysis revealed that SLN biopsy was not an independent prognostic factor for PFS or OS. CONCLUSION Our results showed that SLN biopsy provided oncological outcomes similar to those of lymphadenectomy.
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Affiliation(s)
- Amany Abdelwadoud Makroum
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Jae Lee
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung-Yun Lee
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Ji Nam
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Wun Kim
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Tae Kim
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
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Ronsini C, Iavarone I, Reino A, Vastarella MG, De Franciscis P, Sangiovanni A, Della Corte L. Radiotherapy and Chemotherapy Features in the Treatment for Locoregional Recurrence of Endometrial Cancer: A Systematic Review. J Pers Med 2023; 13:886. [PMID: 37373875 DOI: 10.3390/jpm13060886] [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: 04/13/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
Radiation therapy (RT) is the standard of care in patients with locoregional or isolated vaginal recurrence who never underwent irradiation. It is often associated with brachytherapy (BT), whereas chemotherapy (CT) is a rare treatment option. We systematically searched the PubMed and Scopus databases in February 2023. We included patients with relapsed endometrial cancer, describing the treatment of locoregional recurrence, and reporting at least one outcome of interest-disease-free survival (DFS), overall survival (OS), recurrence rate (RR), site of recurrence, and major complications. A total of 15 studies fulfilled the inclusion criteria. Overall, 11 evaluated RT only, 3 evaluated CT, and 1 analyzed oncological outcomes after administration with a combination of CT and RT. In total, 4.5-year OS ranged from 16% to 96%, and DFS ranged from 36.3% to 100% at 4.5 years. RR ranged from 3.7% to 98.2% during a median follow-up of 51.5 months. Overall, RT showed a 4.5-year DFS from 40% to 100%. CT revealed 36.3% DFS at 4.5 years. RT showed a 4.5-year OS ranging from 16% to 96%, whereas CT revealed a 27.7% OS rate. It would be appropriate to test multi-modality regimens to evaluate outcomes and toxicity. EBRT and BT are the most employed options to treat vaginal recurrences.
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Affiliation(s)
- Carlo Ronsini
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Irene Iavarone
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Antonella Reino
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Maria Giovanna Vastarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
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Lee KJ, Kim NH, Kim HS, Kim Y, Lee JJ, Kim JH, Cho HY, Jeong SY, Park ST. The Role of ROR1 in Chemoresistance and EMT in Endometrial Cancer Cells. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050994. [PMID: 37241228 DOI: 10.3390/medicina59050994] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Receptor tyrosine kinase-like orphan receptor type 1 (ROR1) plays a critical role in embryogenesis and is overexpressed in many malignant cells. These characteristics allow ROR1 to be a potential new target for cancer treatment. The aim of this study was to investigate the role of ROR1 through in vitro experiments in endometrial cancer cell lines. Materials and Methods: ROR1 expression was identified in endometrial cancer cell lines using Western blot and RT-qPCR. The effects of ROR1 on cell proliferation, invasion, migration, and epithelial-mesenchymal transition (EMT) markers were analyzed in two endometrial cancer cell lines (HEC-1 and SNU-539) using either ROR1 silencing or overexpression. Additionally, chemoresistance was examined by identifying MDR1 expression and IC50 level of paclitaxel. Results: The ROR1 protein and mRNA were highly expressed in SNU-539 and HEC-1 cells. High ROR1 expression resulted in a significant increase in cell proliferation, migration, and invasion. It also resulted in a change of EMT markers expression, a decrease in E-cadherin expression, and an increase in Snail expression. Moreover, cells with ROR1 overexpression had a higher IC50 of paclitaxel and significantly increased MDR1 expression. Conclusions: These in vitro experiments showed that ROR1 is responsible for EMT and chemoresistance in endometrial cancer cell lines. Targeting ROR1 can inhibit cancer metastasis and may be a potential treatment method for patients with endometrial cancer who exhibit chemoresistance.
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Affiliation(s)
- Kyung-Jun Lee
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
| | - Nam-Hyeok Kim
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
| | - Hyeong Su Kim
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Youngmi Kim
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
| | - Jae-Jun Lee
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Chuncheon Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea
| | - Jung Han Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Hye-Yon Cho
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Obstetrics and Gynecology, Dongtan Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Hwaseong 18450, Republic of Korea
| | - Soo Young Jeong
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Obstetrics and Gynecology, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Sung Taek Park
- Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea
- Department of Obstetrics and Gynecology, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea
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12
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Cao M, Liu Z, You D, Pan Y, Zhang Q. TMT-based quantitative proteomic analysis of spheroid cells of endometrial cancer possessing cancer stem cell properties. Stem Cell Res Ther 2023; 14:119. [PMID: 37143105 PMCID: PMC10161517 DOI: 10.1186/s13287-023-03348-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Cancer stem cells (CSCs) play an important role in endometrial cancer progression and it is potential to isolate CSCs from spheroid cells. Further understanding of spheroid cells at protein level would help find novel CSC markers. METHODS Spheroid cells from endometrial cancer cell lines, Ishikawa and HEC1A, exhibited increased colony forming, subsphere forming, chemo-drug resistance, migration, invasion ability and tumorigenicity, verifying their cancer stem-like cell properties. The up-regulated CD90, CD117, CD133 and W5C5 expression also indicated stemness of spheroid cells. TMT-based quantitative proteomic analysis was performed to explore the potential alterations between parent cells and cancer stem-like spheroid cells. HK2-siRNA was transfected to Ishikawa and HEC1A cells to explore the roles and molecular mechanism of HK2 in endometrial cancer. RESULTS We identified and quantified a total of 5735 proteins and 167 overlapped differentially expressed proteins of two cell types, 43 proteins were up-regulated and 124 were down-regulated in spheroid cells comparing with parent cells. KEGG pathway revealed a significant role of HIF-1 pathway in spheroid cells. qRT-PCR and western blot results of GPRC5A, PFKFB3 and HK2 of HIF-1 pathway confirmed their elevated expressions in spheroid cells which were consistent with proteomic results. HK2 promoted cancer stemness in endometrial cancer. CONCLUSION These findings indicate that spheroid cells from endometrial cancer cell lines possess cancer stem-like cell properties and enrich CSCs. HIF-1 pathway is activated in endometrial cancer stem-like spheroid cells.
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Affiliation(s)
- Mingzhu Cao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, No.63, Duobao Road, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhi Liu
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, No.1838, Baiyun Road North, Guangzhou, China
| | - Danming You
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yingying Pan
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Qingyan Zhang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, No. 1, Zhongshan 2nd Road, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
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13
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Patel C, Shukla T, Thakkar H. Carboplatin-loaded ultradeformable vesicles for the management of endometrial cancer: in vitro and in vivo evaluation. Ther Deliv 2023; 14:105-119. [PMID: 37125431 DOI: 10.4155/tde-2022-0039] [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] [Indexed: 05/02/2023] Open
Abstract
Aim: Present research work aimed to explore intravaginal route for the drug delivery for treatment of endometrial cancer (EC). Material & methods: Carboplatin (CBP)-loaded ultradeformable vesicle (CBP-UDV) was prepared and characterized for in vitro quality attributes and evaluated for its efficacy in rabbits using ultrasound imaging after intravaginal administration. Results & conclusion: The results showed that the formulation capable of carrying and localizing drug in uterus for prolonged period assisted by first uterine pass effect. Ultrasound imaging of the EC-induced rabbit model before and after treatment with CBP-UDV showed considerable regression in the EC tumor mass. The findings serve as the basis of successful utilization of the intravaginal route for management of EC by designing the formulation which can improve patient compliance.
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Affiliation(s)
- Chintankumar Patel
- The Maharaja Sayajirao University of Baroda, Centre for Relevance & Excellence in Novel Drug Delivery Systems, Shri G. H. Patel Building, Donor's Plaza, Pharmacy Department, Faculty of Pharmacy, The Maharaja Sayajirao University of Baroda, Fatehgunj, Vadodara, Gujarat, 390002, India
| | - Tejas Shukla
- Veterinary Polyclinic, Opp. Jyoti Circle, Pandya Bridge, Alkapuri, Vadodara, Gujarat, 390020, India
| | - Hetal Thakkar
- The Maharaja Sayajirao University of Baroda, Centre for Relevance & Excellence in Novel Drug Delivery Systems, Shri G. H. Patel Building, Donor's Plaza, Pharmacy Department, Faculty of Pharmacy, The Maharaja Sayajirao University of Baroda, Fatehgunj, Vadodara, Gujarat, 390002, India
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14
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Abdelmaksoud NM, El-Mahdy HA, Ismail A, Elsakka EGE, El-Husseiny AA, Khidr EG, Ali EM, Rashed MH, El-Demerdash FES, Doghish AS. The role of miRNAs in the pathogenesis and therapeutic resistance of endometrial cancer: a spotlight on the convergence of signaling pathways. Pathol Res Pract 2023; 244:154411. [PMID: 36921547 DOI: 10.1016/j.prp.2023.154411] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
Endometrial cancer (EC) is the 2nd common cancer in females after breast cancer. Besides, it's the most common among gynecological cancers. Several epigenetic factors such as miRNAs have been reported to affect EC aspects including initiation, progression, angiogenesis, and resistance to therapy. miRNAs could regulate the expression of various genes involved in EC pathogenesis. This effect is attributed to miRNAs' effects in proliferation, apoptosis, cell cycle, angiogenesis, invasion, and metastasis. miRNAs also influence crucial EC-related mechanistic pathways such as JAK/STAT axis, EGFR, TGF-β signaling, and P53. Beside pathogenesis, miRNAs also have the potential to affect EC response to treatments including radio and chemotherapy. Thus, this review aims to illustrate the link between miRNAs and EC; focusing on the effects of miRNAs on EC signaling pathways.
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Affiliation(s)
- Nourhan M Abdelmaksoud
- Department of Biochemistry and Biotechnology, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Hesham A El-Mahdy
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt.
| | - Ahmed Ismail
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt
| | - Elsayed G E Elsakka
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt
| | - Ahmed A El-Husseiny
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt; Department of Biochemistry, Faculty of Pharmacy, Egyptian Russian University, Badr City, Cairo 11829, Egypt
| | - Emad Gamil Khidr
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt
| | - Esraa M Ali
- Biochemistry Department, Faculty of Science, Zagazig University, Zagazig 44519, Egypt
| | - Mohammed Helmy Rashed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo 11231, Egypt
| | - Fatma El-Saeed El-Demerdash
- Department of Zoology and Entomology, Faculty of Science (Girls), Al-Azhar University, Nasr City, Cairo 11231, Egypt
| | - Ahmed S Doghish
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt; Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt.
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15
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Dos Santos NS, Gonçalves DR, Balbinot B, Visioli F. Is GRP78 (Glucose-regulated protein 78) a prognostic biomarker in differents types of cancer? A systematic review and meta-analysis. Pathol Res Pract 2023; 242:154301. [PMID: 36610326 DOI: 10.1016/j.prp.2023.154301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
GRP78 is a chaperone with anti-apoptotic function associated with aggressive tumors. This systematic review aimed to evaluate GRP78 expression in cancer and its relation to prognosis outcomes. This review was conducted in different databases searching for human cancer studies assessing GRP78 immunohistochemical levels on tissue samples. A total of 98 manuscripts were included. In 62% of the studies, GRP78 was associated with a worse prognosis. A meta-analysis included 29 studies that detected a significantly higher expression of GRP78 in cancer tissues (RR= 2.35, 95% CI 1.75-3.15) compared to control. A meta-analysis of 3 and 5-years Overall Survival revealed an increased risk of death for tumors with high expression of GRP78 (RR=1.36, 95%CI 1.16-1,59, I2 = 57%) and (RR=1.65, 95%CI 1.22-2.21, I2 =64%), respectively. GRP78 is an important prognostic biomarker for different types of cancer and a promising therapeutic target.
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Affiliation(s)
- Natália Souza Dos Santos
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Brazil
| | - Douglas Rodrigues Gonçalves
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Brazil; Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Brazil
| | - Bianca Balbinot
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Brazil; Experimental Center Research, Hospital de Clínicas de Porto Alegre, Brazil.
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16
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Abu-Rustum N, Yashar C, Arend R, Barber E, Bradley K, Brooks R, Campos SM, Chino J, Chon HS, Chu C, Crispens MA, Damast S, Fisher CM, Frederick P, Gaffney DK, Giuntoli R, Han E, Holmes J, Howitt BE, Lea J, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Podoll M, Salani R, Schorge J, Siedel J, Sisodia R, Soliman P, Ueda S, Urban R, Wethington SL, Wyse E, Zanotti K, McMillian NR, Aggarwal S. Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2023; 21:181-209. [PMID: 36791750 DOI: 10.6004/jnccn.2023.0006] [Citation(s) in RCA: 123] [Impact Index Per Article: 123.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Adenocarcinoma of the endometrium (also known as endometrial cancer, or more broadly as uterine cancer or carcinoma of the uterine corpus) is the most common malignancy of the female genital tract in the United States. It is estimated that 65,950 new uterine cancer cases will have occurred in 2022, with 12,550 deaths resulting from the disease. Endometrial carcinoma includes pure endometrioid cancer and carcinomas with high-risk endometrial histology (including uterine serous carcinoma, clear cell carcinoma, carcinosarcoma [also known as malignant mixed Müllerian tumor], and undifferentiated/dedifferentiated carcinoma). Stromal or mesenchymal sarcomas are uncommon subtypes accounting for approximately 3% of all uterine cancers. This selection from the NCCN Guidelines for Uterine Neoplasms focuses on the diagnosis, staging, and management of pure endometrioid carcinoma. The complete version of the NCCN Guidelines for Uterine Neoplasms is available online at NCCN.org.
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Affiliation(s)
| | | | | | - Emma Barber
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Susana M Campos
- Dana-Farber/Brigham and Women's Cancer Center
- Massachusetts General Hospital Cancer Center
| | | | | | | | | | | | | | | | | | | | | | - Jordan Holmes
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | - Jayanthi Lea
- UT Southwestern Simmons Comprehensive Cancer Center
| | | | - David Mutch
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Christa Nagel
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Larissa Nekhlyudov
- Dana-Farber/Brigham and Women's Cancer Center
- Massachusetts General Hospital Cancer Center
| | | | | | - John Schorge
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | - Rachel Sisodia
- Dana-Farber/Brigham and Women's Cancer Center
- Massachusetts General Hospital Cancer Center
| | | | - Stefanie Ueda
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | - Kristine Zanotti
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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17
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Khan S, Varricchio A, Ricciardelli C, Yool AJ. Invasiveness of endometrial cancer cell lines is potentiated by estradiol and blocked by a traditional medicine Guizhi Fuling at clinically relevant doses. Front Oncol 2023; 12:1015708. [PMID: 36727068 PMCID: PMC9885141 DOI: 10.3389/fonc.2022.1015708] [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: 08/10/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Abstract
The Traditional Chinese medicine, Guizhi Fuling (here called Fuling), has been confirmed in meta-analysis studies to reduce recurrence of endometriosis and improve pregnancy outcomes; however, the possible use of Fuling as a fertility-preserving treatment in endometrial cancer has not previously been tested. Results here are the first to demonstrate dose-dependent inhibition of cell motility by Fuling in two endometrial cancer cell lines, classified as Grade I which is responsive to progesterone treatment, and Grade III (MFE-280) which is resistant. The major outcome of this study was the novel demonstration that Fuling (30-80 µg/ml) significantly inhibits invasiveness in both high and low grades of EC cells, achieving 70-80% block of trans-barrier migration without cytotoxicity. This effective dose range is estimated to be comparable to that used in human clinical trials and traditional practice. Results here further show that clinically relevant doses of Fuling override the motility-promoting effects of estradiol in endometrial cancer cell lines. Medroxyprogesterone acetate has to date been the standard therapy to treat metastatic or inoperable endometrial cancers; however, success rates are low with high rates of recurrence, due in part to acquired resistance to medroxyprogesterone acetate therapy. The discovery here that Fuling appears to control the spread of treatment-resistant advanced cancers is an exciting prospect.
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Affiliation(s)
- Sidra Khan
- School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
| | - Alanah Varricchio
- School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
| | - Carmela Ricciardelli
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Andrea J. Yool
- School of Biomedicine, University of Adelaide, Adelaide, SA, Australia,*Correspondence: Andrea J. Yool,
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18
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Bloom EA, Peters PN, Whitaker R, Russell S, Albright B, Cummings S, Timms KM, Slavin T, Probst B, Strickland KC, Previs RA. Association of Genomic Instability Score, Tumor Mutational Burden, and Tumor-Infiltrating Lymphocytes as Biomarkers in Uterine Serous Carcinoma. Cancers (Basel) 2023; 15:528. [PMID: 36672477 PMCID: PMC9856872 DOI: 10.3390/cancers15020528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/22/2022] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Uterine serous carcinomas represent 10% of uterine carcinomas but account for nearly 40% of deaths from the disease. Improved molecular characterization of these tumors is instrumental in guiding targeted treatment and improving outcomes. This study assessed the genomic instability score (GIS), tumor mutational burden (TMB), and tumor-infiltrating lymphocytes (TILs) in patients with USC. Methods: A retrospective cohort study evaluated patients with USC following staging surgery. The GIS and TMB were determined from archived specimens. We evaluated the tumoral expression of CD3, CD4, CD8, FOXP3, and CD68 using immunohistochemistry. T-tests were used to assess associations of TILs with the GIS. Results: We evaluated 53 patients with USC. The median GIS was 31 (range: 0−52) and a higher GIS was not associated with progression-free (PFS) or overall survival (OS). The median TMB was 1.35 mt/Mb; patients with TMB > 1.35 mt/Mb had improved PFS and OS (p = 0.005; p = 0.002, respectively). Tumors with increased CD3+ and CD4+ immune cells had a higher mean GIS (p = 0.013, p = 0.002). Conclusions: TMB > 1.35 mt/Mb was associated with improved survival in USC patients, whereas the GIS was not. Lower TMB thresholds may provide prognostic value for less immunogenic tumors such as USC. In this limited cohort, we observed that increased TIL populations were correlated with a higher GIS.
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Affiliation(s)
- Elizabeth A. Bloom
- Duke University School of Medicine, Duke University, Durham, NC 27710, USA
| | - Pamela N. Peters
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Regina Whitaker
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Shonagh Russell
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Benjamin Albright
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Shelly Cummings
- Myriad Genetics Laboratories, Inc., Salt Lake City, UT 84108, USA
| | - Kirsten M. Timms
- Myriad Genetics Laboratories, Inc., Salt Lake City, UT 84108, USA
| | - Thomas Slavin
- Myriad Genetics Laboratories, Inc., Salt Lake City, UT 84108, USA
| | - Braden Probst
- Myriad Genetics Laboratories, Inc., Salt Lake City, UT 84108, USA
| | | | - Rebecca A. Previs
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC 27710, USA
- Labcorp Oncology, Durham, NC 27560, USA
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19
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Exploring uterine targeting potential of 99mTc-Paclitaxel loaded ultradeformable vesicles designed for endometrial cancer. J Drug Deliv Sci Technol 2023. [DOI: 10.1016/j.jddst.2023.104154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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20
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Institutional Accuracy Matters: How the Correlation between Frozen Section and Final Pathology Depends on Institutes while Evaluating Lymph Node Involvement in Endometrial Adenocarcinoma. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background and Purpose: The frozen section analysis results help determine the appropriate surgery and treatment for patients with endometrial adenocarcinoma. This study investigates the degree of compliance between the results of frozen section analysis and final pathology reports in patients with endometrial cancer.
Methods: This study included 357 patients with endometrial adenocarcinoma who underwent operation, follow-up, and treatment at our hospital. The patients’ demographic, clinical, surgical, and pathological data were retrospectively analyzed. We compared the results of the frozen section and pathological specimens in terms of final pathology, tumor grade, myometrial invasion, tumor size, and lymphovascular system involvement (LVSI).
Results: The frozen section analysis and final pathology results for tumor size and LVSI were significantly correlated when patients were divided by tumor type (tumor size: P=0.006, LVSI: P=0.024) or by risk for lymph node involvement (P=0.000).
Overall, the frozen section analysis had an accuracy of 70% for tumor grades.
The histological results of the frozen section analysis had an accuracy of 77.1% for type 1 tumors and 72.7% for type 2 tumors. Overall, the frozen section analysis had an accuracy of 95% for myometrial invasion.
Conclusion: Intraoperative frozen section analysis can prevent unnecessary lymph node dissection when performed at qualified institutions.
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21
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Zhang X, Ba W, Zhao X, Wang C, Li Q, Zhang Y, Lu S, Wang L, Wang S, Song Z, Shen D. Clinical-grade endometrial cancer detection system via whole-slide images using deep learning. Front Oncol 2022; 12:1040238. [PMID: 36408137 PMCID: PMC9668742 DOI: 10.3389/fonc.2022.1040238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
The accurate pathological diagnosis of endometrial cancer (EC) improves the curative effect and reduces the mortality rate. Deep learning has demonstrated expert-level performance in pathological diagnosis of a variety of organ systems using whole-slide images (WSIs). It is urgent to build the deep learning system for endometrial cancer detection using WSIs. The deep learning model was trained and validated using a dataset of 601 WSIs from PUPH. The model performance was tested on three independent datasets containing a total of 1,190 WSIs. For the retrospective test, we evaluated the model performance on 581 WSIs from PUPH. In the prospective study, 317 consecutive WSIs from PUPH were collected from April 2022 to May 2022. To further evaluate the generalizability of the model, 292 WSIs were gathered from PLAHG as part of the external test set. The predictions were thoroughly analyzed by expert pathologists. The model achieved an area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of 0.928, 0.924, and 0.801, respectively, on 1,190 WSIs in classifying EC and non-EC. On the retrospective dataset from PUPH/PLAGH, the model achieved an AUC, sensitivity, and specificity of 0.948/0.971, 0.928/0.947, and 0.80/0.938, respectively. On the prospective dataset, the AUC, sensitivity, and specificity were, in order, 0.933, 0.934, and 0.837. Falsely predicted results were analyzed to further improve the pathologists’ confidence in the model. The deep learning model achieved a high degree of accuracy in identifying EC using WSIs. By pre-screening the suspicious EC regions, it would serve as an assisted diagnostic tool to improve working efficiency for pathologists.
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Affiliation(s)
- Xiaobo Zhang
- Department of Pathology, Peking University People’s Hospital, Beijing, China
| | - Wei Ba
- Department of Pathology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoya Zhao
- Department of Pathology, Peking University People’s Hospital, Beijing, China
| | - Chen Wang
- Department of Pathology, Peking University People’s Hospital, Beijing, China
| | - Qiting Li
- R&D Department, China Academy of Launch Vehicle Technology, Beijing, China
| | - Yinli Zhang
- Department of Pathology, Peking University People’s Hospital, Beijing, China
| | - Shanshan Lu
- Department of Pathology, Peking University People’s Hospital, Beijing, China
| | - Lang Wang
- Thorough Lab, Thorough Future, Beijing, China
| | - Shuhao Wang
- Thorough Lab, Thorough Future, Beijing, China
- *Correspondence: Danhua Shen, ; Zhigang Song, ; Shuhao Wang,
| | - Zhigang Song
- Department of Pathology, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Danhua Shen, ; Zhigang Song, ; Shuhao Wang,
| | - Danhua Shen
- Department of Pathology, Peking University People’s Hospital, Beijing, China
- *Correspondence: Danhua Shen, ; Zhigang Song, ; Shuhao Wang,
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22
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Mohammadi M, Cooper J, Arandelović O, Fell C, Morrison D, Syed S, Konanahalli P, Bell S, Bryson G, Harrison DJ, Harris-Birtill D. Weakly supervised learning and interpretability for endometrial whole slide image diagnosis. Exp Biol Med (Maywood) 2022; 247:2025-2037. [PMID: 36281799 PMCID: PMC9791308 DOI: 10.1177/15353702221126560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Fully supervised learning for whole slide image-based diagnostic tasks in histopathology is problematic due to the requirement for costly and time-consuming manual annotation by experts. Weakly supervised learning that utilizes only slide-level labels during training is becoming more widespread as it relieves this burden, but has not yet been applied to endometrial whole slide images, in iSyntax format. In this work, we apply a weakly supervised learning algorithm to a real-world dataset of this type for the first time, with over 85% validation accuracy and over 87% test accuracy. We then employ interpretability methods including attention heatmapping, feature visualization, and a novel end-to-end saliency-mapping approach to identify distinct morphologies learned by the model and build an understanding of its behavior. These interpretability methods, alongside consultation with expert pathologists, allow us to make comparisons between machine-learned knowledge and consensus in the field. This work contributes to the state of the art by demonstrating a robust practical application of weakly supervised learning on a real-world digital pathology dataset and shows the importance of fine-grained interpretability to support understanding and evaluation of model performance in this high-stakes use case.
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Affiliation(s)
- Mahnaz Mohammadi
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK,Mahnaz Mohammadi.
| | - Jessica Cooper
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK
| | - Ognjen Arandelović
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK
| | - Christina Fell
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK
| | - David Morrison
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK
| | - Sheeba Syed
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Prakash Konanahalli
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Sarah Bell
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Gareth Bryson
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - David J Harrison
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK
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23
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Matias-Guiu X, Selinger CI, Anderson L, Buza N, Ellenson LH, Fadare O, Ganesan R, Ip PPC, Palacios J, Parra-Herran C, Raspollini MR, Soslow RA, Werner HMJ, Lax SF, McCluggage WG. Data Set for the Reporting of Endometrial Cancer: Recommendations From the International Collaboration on Cancer Reporting (ICCR). Int J Gynecol Pathol 2022; 41:S90-S118. [PMID: 36305536 DOI: 10.1097/pgp.0000000000000901] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Endometrial cancer is one of the most common cancers among women. The International Collaboration on Cancer Reporting (ICCR) developed a standardized endometrial cancer data set in 2011, which provided detailed recommendations for the reporting of resection specimens of these neoplasms. A new data set has been developed, which incorporates the updated 2020 World Health Organization Classification of Female Genital Tumors, the Cancer Genome Atlas (TCGA) molecular classification of endometrial cancers, and other major advances in endometrial cancer reporting, all of which necessitated a major revision of the data set. This updated data set has been produced by a panel of expert pathologists and an expert clinician and has been subject to international open consultation. The data set includes core elements which are unanimously agreed upon as essential for cancer diagnosis, clinical management, staging, or prognosis and noncore elements which are clinically important, but not essential. Explanatory notes are provided for each element. Adoption of this updated data set will result in improvements in endometrial cancer patient care.
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24
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Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer. J Clin Med 2022; 11:jcm11216462. [DOI: 10.3390/jcm11216462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
Abstract
Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality of life of the patients. The sentinel lymph node is the first lymph node that tumor cells drain to, and sentinel lymph node biopsy has emerged as an acceptable alternative to full lymphadenectomy in both low-risk and high-risk endometrial cancer. Evidence has demonstrated a high detection rate, sensitivity and negative predictive value of sentinel lymph node biopsy. It can also reduce surgical morbidity and improve the detection of lymph node metastases compared with systematic lymphadenectomy. This review summarizes the current techniques of sentinel lymph node mapping, the applications and oncological outcomes of sentinel lymph node biopsy in low-risk and high-risk endometrial cancer, and the management of isolated tumor cells in sentinel lymph nodes. We also illustrate a revised sentinel lymph node biopsy algorithm and advocate to repeat the tracer injection and explore the presacral and paraaortic areas if sentinel lymph nodes are not found in the hemipelvis.
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25
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Chen L, Zhu G, Liu Y, Shao Y, Pan B, Zheng J. Identification of inflammatory-related gene signatures to predict prognosis of endometrial carcinoma. BMC Genom Data 2022; 23:74. [PMID: 36207698 PMCID: PMC9541080 DOI: 10.1186/s12863-022-01088-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022] Open
Abstract
Little is known about the prognostic risk factors of endometrial cancer. Therefore, finding effective prognostic factors of endometrial cancer is the vital for clinical theranostic. In this study, we constructed an inflammatory-related risk assessment model based on TCGA database to predict prognosis of endometrial cancer. We screened inflammatory genes by differential expression and prognostic correlation, and constructed a prognostic model using LASSO regression analysis. We fully utilized bioinformatics tools, including ROC curve, Kaplan-Meier analysis, univariate and multivariate Cox regression analysis and in vitro experiments to verify the accuracy of the prognostic model. Finally, we further analyzed the characteristics of tumor microenvironment and drug sensitivity of these inflammatory genes. The higher the score of the endometrial cancer risk model we constructed, the worse the prognosis, which can effectively provide decision-making help for clinical endometrial diagnosis and treatment.
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Affiliation(s)
- Linlin Chen
- grid.417168.d0000 0004 4666 9789Tongde Hospital of Zhejiang Province, Hangzhou, 310012 China
| | - Guang Zhu
- grid.417168.d0000 0004 4666 9789Tongde Hospital of Zhejiang Province, Hangzhou, 310012 China
| | - Yanbo Liu
- grid.417168.d0000 0004 4666 9789Tongde Hospital of Zhejiang Province, Hangzhou, 310012 China
| | - Yupei Shao
- grid.417168.d0000 0004 4666 9789Tongde Hospital of Zhejiang Province, Hangzhou, 310012 China
| | - Bing Pan
- grid.417168.d0000 0004 4666 9789Tongde Hospital of Zhejiang Province, Hangzhou, 310012 China
| | - Jianhong Zheng
- grid.417168.d0000 0004 4666 9789Tongde Hospital of Zhejiang Province, Hangzhou, 310012 China
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26
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Xu T, Ding H, Chen J, Lei J, Zhao M, Ji B, Chen Y, Qin S, Gao Q. Research Progress of DNA Methylation in Endometrial Cancer. Biomolecules 2022; 12:938. [PMID: 35883495 PMCID: PMC9312849 DOI: 10.3390/biom12070938] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Endometrial cancer (EC)) is one of the most common malignant tumors of the female genital system, with an increasing incidence and mortality, worldwide. Although the therapeutic strategy of EC is still complicated and challenging, further understanding of carcinogenesis from a gene perspective would allow an effort to improve therapeutic precision in this complex malignancy. DNA methylation is the most widely studied epigenetic alteration in human tumors. Aberrant DNA methylation events, resulting in altered gene expression, are features of many tumor types. In this review, we provide an update on evidence about the roles of aberrant DNA methylation within some classical tumor suppressor genes and oncogenes in endometrial carcinogenesis, and report on recent advances in the understanding of the contribution of aberrant DNA methylation to EC, as well as opportunities and challenges of DNA methylation in EC management and prevention.
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Affiliation(s)
- Ting Xu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (T.X.); (J.L.); (M.Z.); (B.J.)
| | - Hongmei Ding
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (H.D.); (J.C.)
| | - Jie Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (H.D.); (J.C.)
| | - Jiahui Lei
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (T.X.); (J.L.); (M.Z.); (B.J.)
| | - Meng Zhao
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (T.X.); (J.L.); (M.Z.); (B.J.)
| | - Bingyu Ji
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (T.X.); (J.L.); (M.Z.); (B.J.)
| | - Youguo Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (H.D.); (J.C.)
| | - Songbing Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Qinqin Gao
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; (T.X.); (J.L.); (M.Z.); (B.J.)
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Åkesson Å, Adok C, Dahm-Kähler P. Increased survival in non-endometrioid endometrial cancer after introducing lymphadenectomy and tailoring radiotherapy – A population-based cohort study. Eur J Cancer 2022; 169:54-63. [DOI: 10.1016/j.ejca.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/22/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022]
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Haloperidol Instigates Endometrial Carcinogenesis and Cancer Progression by the NF-κB/CSF-1 Signaling Cascade. Cancers (Basel) 2022; 14:cancers14133089. [PMID: 35804859 PMCID: PMC9265032 DOI: 10.3390/cancers14133089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Haloperidol, a typical antipsychotic, is widely used in schizophrenia and palliative care of cancer; however, the role and impact of chronic haloperidol treatment in endometrial cancer (EC) development are unclear. Here, we showed that haloperidol is a carcinogenic compound capable of inducing endometrial hyperplasia and promoting EC progression in rodents. Mechanistically, haloperidol stimulates the production of colony-stimulating factor 1 (CSF-1) on tumor cells by activating nuclear factor kappa B (NF-κB), and its downstream autocrine oncogenic CSF-1 receptor signaling contributes to this carcinogenesis. Furthermore, we demonstrated that the use of haloperidol is associated with increased EC-specific mortality in EC patients. Overall, these findings highlighted that physicians should be cautious about the use of haloperidol in female patients. Abstract Haloperidol is a routine drug for schizophrenia and palliative care of cancer; it also has antitumor effects in several types of cancer. However, the role of haloperidol in endometrial cancer (EC) development is still unclear. Here, we show that chronic haloperidol treatment in clinically relevant doses induced endometrial hyperplasia in normal mice and promoted tumor growth and malignancy in mice with orthotopic EC. The pharmacokinetic study indicated that haloperidol highly accumulated in the uterus of mice. In vitro studies revealed that haloperidol stimulated the cellular transformation of human endometrial epithelial cells (HECCs) and promoted the proliferation, migration, and invasion of human endometrial carcinoma cells (HECCs) by activating nuclear factor kappa B (NF-κB) and its downstream signaling target, colony-stimulating factor 1 (CSF-1). Gain of function of CSF-1 promotes the cellular transformation of HEECs and the malignant progression of HECCs. Moreover, blockade of CSF-1 inhibited haloperidol-promoted EC progression in vitro and in vivo. A population-based cohort study of EC patients further demonstrated that the use of haloperidol was associated with increased EC-specific mortality. Collectively, these findings indicate that clinical use of haloperidol could potentially be harmful to female patients with EC.
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29
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Nagase Y, Hiramatsu K, Funauchi M, Shiomi M, Masuda T, Kakuda M, Nakagawa S, Miyoshi A, Matsuzaki S, Kobayashi E, Kimura T, Serada S, Ueda Y, Naka T, Kimura T. Anti-lipolysis-stimulated lipoprotein receptor monoclonal antibody as a novel therapeutic agent for endometrial cancer. BMC Cancer 2022; 22:679. [PMID: 35729527 PMCID: PMC9210735 DOI: 10.1186/s12885-022-09789-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/16/2022] [Indexed: 12/29/2022] Open
Abstract
Background Endometrial cancer (EC) is a common gynecologic malignancy and patients with advanced and recurrent EC have a poor prognosis. Although chemotherapy is administered for those patients, the efficacy of current chemotherapy is limited. Therefore, it is necessary to develop novel therapeutic agents for EC. In this study, we focused on lipolysis-stimulated lipoprotein receptor (LSR), a membrane protein highly expressed in EC cells, and developed a chimeric chicken–mouse anti-LSR monoclonal antibody (mAb). This study investigated the antitumor effect of an anti-LSR mAb and the function of LSR in EC. Methods We examined the expression of LSR in 228 patients with EC using immunohistochemistry and divided them into two groups: high-LSR (n = 153) and low-LSR groups (n = 75). We developed a novel anti-LSR mAb and assessed its antitumor activity in an EC cell xenograft mouse model. Pathway enrichment analysis was performed using protein expression data of EC samples. LSR-knockdown EC cell lines (HEC1 and HEC116) were generated by transfected with small interfering RNA and used for assays in vitro. Results High expression of LSR was associated with poor overall survival (hazard ratio: 3.53, 95% confidence interval: 1.35–9.24, p = 0.01), advanced stage disease (p = 0.045), deep myometrial invasion (p = 0.045), and distant metastasis (p < 0.01). In EC with deep myometrial invasion, matrix metalloproteinase (MMP) 2 was highly expressed along with LSR. Anti-LSR mAb significantly inhibited the tumor growth in EC cell xenograft mouse model (tumor volume, 407.1 mm3versus 726.3 mm3, p = 0.019). Pathway enrichment analysis identified the mitogen-activated protein kinase (MAPK) pathway as a signaling pathway associated with LSR expression. Anti-LSR mAb suppressed the activity of MAPK in vivo. In vitro assays using EC cell lines demonstrated that LSR regulated cell proliferation, invasion, and migration through MAPK signaling, particularly MEK/ERK signaling and membrane-type 1 MMP (MT1-MMP) and MMP2. Moreover, ERK1/2-knockdown suppressed cell proliferation, invasion, migration, and the expression of MT1-MMP and MMP2. Conclusions Our results suggest that LSR contributes to tumor growth, invasion, metastasis, and poor prognosis of EC through MAPK signaling. Anti-LSR mAb is a potential therapeutic agent for EC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09789-6.
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Affiliation(s)
- Yoshikazu Nagase
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kosuke Hiramatsu
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Masashi Funauchi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Division of Clinical Immunology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate, Japan.,Institute for Biomedical Sciences Molecular Pathophysiology, Iwate Medical University, Iwate, Japan.,Department of Clinical Immunology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mayu Shiomi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tatsuo Masuda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Mamoru Kakuda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoshi Nakagawa
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ai Miyoshi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shinya Matsuzaki
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan
| | - Eiji Kobayashi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toshihiro Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoshi Serada
- Institute for Biomedical Sciences Molecular Pathophysiology, Iwate Medical University, Iwate, Japan.,Department of Clinical Immunology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tetsuji Naka
- Division of Clinical Immunology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate, Japan.,Institute for Biomedical Sciences Molecular Pathophysiology, Iwate Medical University, Iwate, Japan.,Department of Clinical Immunology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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30
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PET-CT in Clinical Adult Oncology-IV. Gynecologic and Genitourinary Malignancies. Cancers (Basel) 2022; 14:cancers14123000. [PMID: 35740665 PMCID: PMC9220973 DOI: 10.3390/cancers14123000] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Positron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With concurrently acquired positron emission tomography and computed tomography (PET-CT), a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan provides information to allow better visualization of radioactivity from deep or dense structures and to provide detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging and surveillance. This series of six review articles provides an overview of the value, applications, and imaging interpretive strategies for PET-CT in the more common adult malignancies. The fourth report in this series provides a review of PET-CT imaging in gynecologic and genitourinary malignancies. Abstract Concurrently acquired positron emission tomography and computed tomography (PET-CT) is an advanced imaging modality with diverse oncologic applications, including staging, therapeutic assessment, restaging and longitudinal surveillance. This series of six review articles focuses on providing practical information to providers and imaging professionals regarding the best use and interpretative strategies of PET-CT for oncologic indications in adult patients. In this fourth article of the series, the more common gynecological and adult genitourinary malignancies encountered in clinical practice are addressed, with an emphasis on Food and Drug Administration (FDA)-approved and clinically available radiopharmaceuticals. The advent of new FDA-approved radiopharmaceuticals for prostate cancer imaging has revolutionized PET-CT imaging in this important disease, and these are addressed in this report. However, [18F]F-fluoro-2-deoxy-d-glucose (FDG) remains the mainstay for PET-CT imaging of gynecologic and many other genitourinary malignancies. This information will serve as a guide for the appropriate role of PET-CT in the clinical management of gynecologic and genitourinary cancer patients for health care professionals caring for adult cancer patients. It also addresses the nuances and provides guidance in the accurate interpretation of FDG PET-CT in gynecological and genitourinary malignancies for imaging providers, including radiologists, nuclear medicine physicians and their trainees.
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31
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Azadehrah M, Vosoogh S, Azadehrah M. The roles and therapeutic applications of cytokines in endometrial cancer. J Reprod Immunol 2022; 152:103652. [PMID: 35753146 DOI: 10.1016/j.jri.2022.103652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/21/2022] [Accepted: 06/05/2022] [Indexed: 12/26/2022]
Abstract
Endometrial cancer (EC) is a common gynecological cancer globally and the most frequent gynecologic malignancy in industrialized countries. Patients are typically diagnosed when the disease is still restricted to the uterus. 5-year overall survival ranges from 70 % to 90 % in patients without metastatic disease; however, the metastatic form of the disease affects 16 % of EC patients, with a 5-year survival rate of 16.8 %. The immune system can detect abnormal cells as non-self in the early stages of carcinogenesis, producing the appropriate pro-inflammatory environment to eliminate cancer cells. In a second phase, cancer cells use various immune-editing systems to alter the profile of the immune response from pro to anti-inflammatory, resulting in immune escape. The directors of this immune switching mechanism are cytokines. Studies have reported the increased expression of several pro-and anti-inflammatory cytokines in EC tissues and cell lines, including Interleukin (IL)- 6, IL-8, IL-31, IL-33, IL-10, TGF-β, VEGF, and IL-1Ra. Immune cells producing these cytokines have also been reported to be present in EC tissues. Therefore, in this study, we aimed to show the possible mechanisms of the mentioned cytokines on EC progression, as well as the most current and prospective advancements in cytokine-based therapeutic applications.
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Affiliation(s)
- Malihe Azadehrah
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shohre Vosoogh
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan university of Medical Sciences, Gorgan, Iran
| | - Mahboobeh Azadehrah
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
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32
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Loukovaara M, Pasanen A, Bützow R. Molecular classification of endometrial carcinoma: a clinically oriented review. J Clin Pathol 2022; 75:jclinpath-2022-208345. [PMID: 35636924 DOI: 10.1136/jclinpath-2022-208345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/16/2022] [Indexed: 12/24/2022]
Abstract
The Cancer Genome Atlas research network performed a genome-wide analysis of endometrial carcinomas in 2013 and classified tumours into four distinct subgroups: polymerase-ϵ ultramutated, microsatellite unstable hypermutated, copy-number low and copy-number high. These molecular alterations are mostly mutually exclusive as only about 3% of tumours exhibit more than one molecular signature. Apart from the polymerase-ϵ ultramutated subgroup, molecular classification can be reproduced by using surrogate markers. This has facilitated the implementation of molecular diagnostics into routine patient care. Molecular subgroups are associated with different prognoses; thus, improved risk assessment is their most obvious clinical application. However, based on their unique molecular architectures, molecular subgroups should not be regarded simply as risk groups but rather as distinct diseases. This has prompted us and others to examine the role of molecular subgroups in modifying the prognostic effect of traditional risk factors, including clinical factors, uterine factors and tissue biomarkers, and in predicting the response to adjuvant therapies. In the following review, we summarise the current knowledge of molecularly classified endometrial carcinoma and present, based on our own experience, a proposal for implementing molecular classification into daily practice in pathology laboratories.
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Affiliation(s)
- Mikko Loukovaara
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Annukka Pasanen
- Department of Pathology, Helsinki University Hospital and Research Program in Applied Tumor Genomics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ralf Bützow
- Department of Pathology, Helsinki University Hospital and Research Program in Applied Tumor Genomics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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33
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Di Tucci C, Galati G, Mattei G, Chinè A, Fracassi A, Muzii L. Fertility after Cancer: Risks and Successes. Cancers (Basel) 2022; 14:2500. [PMID: 35626104 PMCID: PMC9139810 DOI: 10.3390/cancers14102500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/08/2022] [Accepted: 05/16/2022] [Indexed: 12/22/2022] Open
Abstract
The incidence of cancer in reproductive-aged women is 7%, but, despite the increased number of cancer cases, advances in early diagnosis and treatment have raised the survival rate. Furthermore, in the last four decades, there has been a rising trend of delaying childbearing. There has been an increasing number of couples referred to Reproductive Medicine Centers for infertility problems after one partner has been treated for cancer. In these cases, the main cause of reduced fertility derives from treatments. In this review, we describe the effects and the risks of chemotherapy, radiotherapy, and surgery in women with cancer, and we will focus on available fertility preservation techniques and their efficacy in terms of success in pregnancy and live birth rates.
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Affiliation(s)
- Chiara Di Tucci
- Department of Obstetrics and Gynecology, “Sapienza” University, 00185 Rome, Italy; (G.G.); (G.M.); (A.C.); (A.F.); (L.M.)
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34
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Utilization and Outcomes of Sentinel Lymph Node Biopsy for Early Endometrial Cancer. Obstet Gynecol 2022; 139:809-820. [PMID: 35576340 DOI: 10.1097/aog.0000000000004733] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/04/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine trends, characteristics, and oncologic outcomes of sentinel lymph node biopsy for early endometrial cancer. METHODS This observational study queried the National Cancer Institute's Surveillance, Epidemiology, and End Results Program by examining 83,139 women with endometrial cancer who underwent primary hysterectomy with nodal evaluation for T1 disease from 2003 to 2018. Primary outcome measures were the temporal trends in utilization of sentinel lymph node biopsy and patient characteristics associated with sentinel lymph node biopsy use, assessed by multivariable binary logistic regression models. Secondary outcome measure was endometrial cancer-specific mortality associated with sentinel lymph node biopsy, assessed by propensity score inverse probability of treatment weighting. RESULTS The utilization of sentinel lymph node biopsy increased from 0.2 to 29.7% from 2005 to 2018 (P<.001). The uptake was higher for women with endometrioid (0.3-31.6% between 2005 and 2018) compared with nonendometrioid (0.6-21.0% between 2006 and 2018) histologic subtypes (both P<.001). In a multivariable analysis, more recent year surgery, endometrioid histology, well-differentiated tumors, T1a disease, and smaller tumor size were independently associated with sentinel lymph node biopsy use (P<.05). Performance of sentinel lymph node biopsy was not associated with increased endometrial cancer-specific mortality compared with lymphadenectomy for endometrioid tumors (subdistribution hazard ratio [HR] 0.96, 95% CI 0.82-1.13) or nonendometrioid tumors (subdistribution HR 0.85, 95% CI 0.69-1.04). For low-risk endometrial cancer, the increase in sentinel lymph node biopsy resulted in a 15.3 percentage-point (1.4-fold) increase in surgical nodal evaluation by 2018 (expected vs observed rates, 37.8 vs 53.1%). CONCLUSION The landscape of surgical nodal evaluation is shifting from lymphadenectomy to sentinel lymph node biopsy for early endometrial cancer in the United States, with no indication of a negative effect on cancer-specific survival.
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Rashid S, Arafah MA, Akhtar M. The Many Faces of Serous Neoplasms and Related Lesions of the Female Pelvis: A Review. Adv Anat Pathol 2022; 29:154-167. [PMID: 35180738 PMCID: PMC8989637 DOI: 10.1097/pap.0000000000000334] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Ovarian serous tumors and related lesions are one of the most common conditions of the female genital tract. While ovarian high-grade serous carcinoma carries high mortality and adverse prognosis, most other serous lesions have better clinical behavior. In recent years, significant progress has been made in understanding the nature and histogenesis of these lesions that has contributed to better and more precise clinical management. Most of the high-grade serous carcinomas involve the ovaries and/or peritoneum, although in most cases, their origin seems to be in the fallopian tube. This view is supported by the recognition of precursor lesions in the fallopian tube, such as p53 signature and serous tubular in situ carcinoma. This paper presents salient morphologic, immunohistochemical, and molecular data related to serous tumors and related lesions of the female pelvis and discusses the histogenetic interrelationship among these lesions in light of current knowledge.
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Affiliation(s)
- Sameera Rashid
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Maria A. Arafah
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Akhtar
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
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Clinical Value Analysis of Combined Vaginal Ultrasound, Magnetic Resonance Dispersion Weighted Imaging, and Multilayer Spiral CT in the Diagnosis of Endometrial Cancer Using Deep VGG-16 AdaBoost Hybrid Classifier. JOURNAL OF ONCOLOGY 2022; 2022:7677004. [PMID: 35518783 PMCID: PMC9064493 DOI: 10.1155/2022/7677004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022]
Abstract
Endometrial carcinoma is one of the most common disorders of the female reproductive system. Every year, around 76,000 women die from endometrial cancer around the world. Endometrial cancer is a significant factor in women’s health, particularly in industrialized nations, where the prevalence of this tumor type is the greatest. It is an important concern in women’s health because of disease mortality and the rising number of new diagnoses. The aim of the study was to investigate the clinical value of combined transvaginal ultrasound, magnetic resonance dispersion weighted imaging, and multilayer spiral computed tomography (CT) in the diagnosis of early-stage endometrial cancer. Initially, the dataset is collected that consisted of a total of 100 cases and split into the control group and experimental group of 50 cases in each group. The control group is diagnosed using conventional Doppler ultrasound diagnostic machine. The experimental group is diagnosed with combined ultrasound method. The ultrasound images thus obtained are preprocessed using the speckle-free adaptive wiener filter. The preprocessed images are segmented using the fuzzy clustering segmentation method. The features are extracted by the independent component analysis (ICA) method. We have proposed the deep VGG-16 AdaBoost hybrid classifier for classifying the normal and abnormal images. The clinical value of the diagnosis is analyzed using the parameters like diagnostic accuracy, specificity, sensitivity, and kappa coefficient. It is observed that the clinical value is better for the experimental group than the control group.
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Díaz-Ayala R, López-Nieves M, Colón Berlingeri ES, Cabrera CR, Cunci L, González CI, Escobar PF. Test Strip Platform Spin-Off for Telomerase Activity Detection: Development of an Electrochemical Biosensor. ACS OMEGA 2022; 7:9964-9972. [PMID: 35356692 PMCID: PMC8944542 DOI: 10.1021/acsomega.2c00713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Telomerase overexpression has been associated directly with cancer, and the enzyme itself is recognized within the scientific community as a cancer biomarker. BIDEA's biosensing strip (BBS) is an innovative technology capable of detecting the presence of telomerase activity (TA) using electrochemical impedance spectroscopy (EIS). This BBS is an interdigital gold (GID) electrode array similar in size and handling to a portable glucose sensor. For the detection of the biomarker, BBS was modified by the immobilization of a telomere-like single strand DNA (ssDNA) on its surface. The sensor was exposed to telomerase-positive extract from commercially available cancer cells, and the EIS spectra were measured. Telomerase recognizes the sequence of this immobilized ssDNA probe on the BBS, and the reverse transcription process that occurs in cancer cells is replicated, resulting in the ssDNA probe elongation. This surface process caused by the presence of TA generates changes in the capacitive process on the electrode array microchip surface, which is followed by EIS as the sensing tool and correlated with the presence of cancer cells. The telomerases' total cell extraction protocol results demonstrate significant changes in the charge-transfer resistance (R ct) change rate after exposure to telomerase-positive extract with a detection limit of 2.94 × 104 cells/mL. Finally, a preliminary study with a small set of "blind" uterine biopsy samples suggests the feasibility of using the changes in the R ct magnitude change rate (Δ(ΔR ct/R cti)/Δt) to distinguish positive from negative endometrial adenocarcinoma samples by the presence or absence of TA.
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Affiliation(s)
- Ramonita Díaz-Ayala
- BIDEA
LLC, Molecular Science Research Center, Lab 2-43, 1390 Ave. Ponce de León, San Juan 002926-2614, Puerto Rico
| | - Marjorie López-Nieves
- BIDEA
LLC, Molecular Science Research Center, Lab 2-43, 1390 Ave. Ponce de León, San Juan 002926-2614, Puerto Rico
| | - Etienne S. Colón Berlingeri
- BIDEA
LLC, Molecular Science Research Center, Lab 2-43, 1390 Ave. Ponce de León, San Juan 002926-2614, Puerto Rico
| | - Carlos R. Cabrera
- BIDEA
LLC, Molecular Science Research Center, Lab 2-43, 1390 Ave. Ponce de León, San Juan 002926-2614, Puerto Rico
- Department
of Chemistry and Biochemistry, University
of Texas at El Paso, 500 W. University Ave., El Paso, Texas 79968, United
States
| | - Lisandro Cunci
- BIDEA
LLC, Molecular Science Research Center, Lab 2-43, 1390 Ave. Ponce de León, San Juan 002926-2614, Puerto Rico
- School
of Natural Sciences and Technology, Universidad
Ana G. Méndez, Gurabo Campus, Gurabo, Puerto Rico 00778, United States
| | - Carlos I. González
- BIDEA
LLC, Molecular Science Research Center, Lab 2-43, 1390 Ave. Ponce de León, San Juan 002926-2614, Puerto Rico
- Department
of Biology, University of Puerto Rico, Río Piedras Campus, San Juan 00931-3346, Puerto Rico
| | - Pedro F. Escobar
- Department
of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Puerto Rico, School of Medicine, Medical Sciences Campus, San Juan 00926, Puerto Rico
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Schnarr KL, Seow H, Pond GR, Helpman L, Elit LM, O'Leary E, Kong I. The impact of preoperative imaging on wait times, surgical approach and overall survival in endometrioid endometrial cancers. Gynecol Oncol 2022; 165:317-322. [DOI: 10.1016/j.ygyno.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 11/04/2022]
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Contreras NA, Sabadell J, Verdaguer P, Julià C, Fernández-Montolí ME. Fertility-Sparing Approaches in Atypical Endometrial Hyperplasia and Endometrial Cancer Patients: Current Evidence and Future Directions. Int J Mol Sci 2022; 23:ijms23052531. [PMID: 35269674 PMCID: PMC8910633 DOI: 10.3390/ijms23052531] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
Endometrial cancer (EC) is the fourth most common cancer in women in developed countries. Although it is usually diagnosed in postmenopausal women, its incidence has increased in young women, as well in recent decades, with an estimated rate of 4% in those under 40 years of age. Factors involved in this increase, particularly in resource-rich countries, include delayed childbearing and the rise in obesity. The new molecular classification of EC should help to personalize treatment, through appropriate candidate selection. With the currently available evidence, the use of oral progestin either alone or in combination with other drugs such as metformin, levonorgestrel-releasing intrauterine devices and hysteroscopic resection, seems to be feasible and safe in women with early-stage EC limited to the endometrium. However, there is a lack of high-quality evidence of the efficacy and safety of conservative management in EC. Randomized clinical trials in younger women and obese patients are currently underway.
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Affiliation(s)
| | - Jordi Sabadell
- Department of Gynaecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Paula Verdaguer
- Department of Gynaecology-ASSIR, Ronda General Prim 35, Mataró, 08302 Barcelona, Spain;
| | - Carla Julià
- Department of Gynaecology, Hospital de Viladecans, Avda de Gavà 38, Viladecans, 08840 Barcelona, Spain;
| | - Maria-Eulalia Fernández-Montolí
- Department of Gynaecology, Hospital Universitari de Bellvitge, Universitat de Barcelona-IDIBELL, Feixa Llarga s/n, L´Hospitalet de LLobregat, 08907 Barcelona, Spain
- Correspondence: or
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Frozen Section as an Intraoperative Guide to Tailor Surgical Staging in Early-Stage Endometrial Cancer. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2021. [DOI: 10.1007/s40944-021-00601-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kifle ZD, Tadele M, Alemu E, Gedamu T, Ayele AG. A recent development of new therapeutic agents and novel drug targets for cancer treatment. SAGE Open Med 2021; 9:20503121211067083. [PMID: 34992782 PMCID: PMC8725032 DOI: 10.1177/20503121211067083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Despite recent advances in cancer diagnosis, prevention, detection, as well as management, the disease is expected to be the top cause of death globally. The chemotherapy approach for cancer has become more advanced in its design, yet no medication can cure enough against all types of cancer and its stage. Thus, this review aimed to summarize a recent development of new therapeutic agents and novel drug targets for the treatment of cancer. Several obstacles stand in the way of effective cancer treatment and drug development, including inaccessibility of tumor site by appropriate drug concentration, debilitating untoward effects caused by non-selective tissue distribution of chemotherapeutic agents, and occurrence of drug resistance, which leads to cross-resistance to a variety of drugs. Resistance to treatment with anticancer drugs results from multiple factors and the most common reason for acquiring drug resistance is marking and expelling drugs that prevent cancer cells to be targeted by chemotherapeutic agents. Moreover, insensitivity to drug-induced apoptosis, alteration, and mutation of drug target and interference/change of DNA replication are other main causes of treatment failure.
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Affiliation(s)
- Zemene Demelash Kifle
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Meklit Tadele
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eyerusalem Alemu
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Gedamu
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Akeberegn Gorems Ayele
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Ko EM, Bekelman JE, Hicks-Courant K, Brensinger CM, Kanter GP. Association of gynecologic oncology versus medical oncology specialty with survival, utilization, and spending for treatment of gynecologic cancers. Gynecol Oncol 2021; 164:295-303. [PMID: 34949437 DOI: 10.1016/j.ygyno.2021.12.001] [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: 10/07/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND We examined the association of gynecologic oncology (GYO) versus medical oncology (MEDONC) based care with survival, health care utilization and spending outcomes in women undergoing chemotherapy for advanced gynecologic cancers. METHODS Women with newly diagnosed stage III-IV uterine, ovarian, and cervical cancers from 2000 to 2015 were identified in SEER-Medicare. We assessed the association of provider specialty with overall survival, emergency department utilization, admissions, and spending. Outcomes were assessed using unadjusted and Inverse Treatment Probability Weighted propensity-score applied, multi-variable cox modeling, Poisson regression, and generalized models of log-transformed data. RESULTS We identified 7930 gynecologic cancer patients (4360 ovarian, 2934 uterine, 643 cervix). 37% were treated by GYO and 63% by MEDONC. For ovarian patients, GYO care was associated with improved OS (median OS 3.3 v. 2.9 years; HR 0.85, 95%CI 0.80, 0.91, p < .0001) and similar mean spending per month ($4015 v. $4316, mean ratio 0.97 (95% CI 0.93, 1.02), p = .19), compared to MEDONC in adjusted analyses. For uterine patients, GYO care was associated with similar OS, but decreased spending ($3573 v. $4081, mean ratio 0.87 (95% CI.81, 0.93), p < .0001), and decreased ED utilization (RR 0.76, 95% CI 0.69, 0.85, p < .0001). For cervical patients, GYO care was associated with similar OS, and similar spending. Admissions were more likely in ovarian (RR 1.23, 95%CI 1.11, 1.37, p = .0001) and cervical patients (RR 1.26, 95% CI 1.05, 1.51, p = .015) treated by GYO, in adjusted analyses. CONCLUSIONS GYO based care was associated with improved OS and equal spending for patients with advanced stage ovarian cancer. Uterine and cervix patients had similar OS, and less or equal spending respectively, when treated by GYO compared to MEDONC.
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Affiliation(s)
- Emily M Ko
- Department of Obstetrics and Gynecology: Division of Gynecologic Oncology, Perelman School of Medicine, University of Pennsylvania, USA; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, USA.
| | - Justin E Bekelman
- Department of Obstetrics and Gynecology: Division of Gynecologic Oncology, Perelman School of Medicine, University of Pennsylvania, USA; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, USA; Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, USA.
| | - Katherine Hicks-Courant
- Department of Obstetrics and Gynecology: Division of Gynecologic Oncology, Perelman School of Medicine, University of Pennsylvania, USA; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, USA.
| | - Colleen M Brensinger
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, USA.
| | - Genevieve P Kanter
- Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, USA; Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, USA; General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, USA.
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Gullo G, Etrusco A, Cucinella G, Perino A, Chiantera V, Laganà AS, Tomaiuolo R, Vitagliano A, Giampaolino P, Noventa M, Andrisani A, Buzzaccarini G. Fertility-Sparing Approach in Women Affected by Stage I and Low-Grade Endometrial Carcinoma: An Updated Overview. Int J Mol Sci 2021; 22:11825. [PMID: 34769256 PMCID: PMC8583899 DOI: 10.3390/ijms222111825] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Endometrial cancer (EC) is a deleterious condition which strongly affects a woman's quality of life. Although aggressive interventions should be considered to treat high-grade EC, a conservative approach should be taken into consideration for women wishing to conceive. In this scenario, we present an overview about the EC fertility-sparing approach state of art. Type I EC at low stage is the only histological type which can be addressed with a fertility-sparing approach. Moreover, no myometrium and/or adnexal invasion should be seen, and lymph-vascular space should not be involved. Regarding the pharmaceutical target, progestins, in particular medroxyprogesterone acetate (MPA) or megestrol acetate (MA), are the most employed agent in conservative treatment of early-stage EC. The metformin usage and hysteroscopic assessment is still under debate, despite promising results. Particularly strict and imperious attention should be given to the follow-up and psychological wellbeing of women, especially because of the double detrimental impairment: both EC and EC-related infertility consequences.
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Affiliation(s)
- Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Andrea Etrusco
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy;
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Antonino Perino
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Vito Chiantera
- Department of Gynecology Oncology, University of Palermo, 90146 Palermo, Italy;
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
| | | | - Amerigo Vitagliano
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | | | - Marco Noventa
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | - Alessandra Andrisani
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | - Giovanni Buzzaccarini
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
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Multi-tissue transcriptome-wide association study identifies eight candidate genes and tissue-specific gene expression underlying endometrial cancer susceptibility. Commun Biol 2021; 4:1211. [PMID: 34675350 PMCID: PMC8531339 DOI: 10.1038/s42003-021-02745-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 09/27/2021] [Indexed: 11/24/2022] Open
Abstract
Genome-wide association studies (GWAS) have revealed sixteen risk loci for endoemtrial cancer but the identification of candidate susceptibility genes remains challenging. Here, we perform transcriptome-wide association study (TWAS) analyses using the largest endometrial cancer GWAS and gene expression from six relevant tissues, prioritizing eight candidate endometrial cancer susceptibility genes, one of which (EEFSEC) is located at a potentially novel endometrial cancer risk locus. We also show evidence of biologically relevant tissue-specific expression associations for CYP19A1 (adipose), HEY2 (ovary) and SKAP1 (whole blood). A phenome-wide association study demonstrates associations of candidate susceptibility genes with anthropometric, cardiovascular, diabetes, bone health and sex hormone traits that are related to endometrial cancer risk factors. Lastly, analysis of TWAS data highlights candidate compounds for endometrial cancer repurposing. In summary, this study reveals endometrial cancer susceptibility genes, including those with evidence of tissue specificity, providing insights into endometrial cancer aetiology and avenues for therapeutic development. Pik Fang Kho et al. conduct multi-tissue transcriptome-wide association studies of endometrial cancer risk. Their results identify potential susceptibility genes for endometrial cancer, and provide avenues for the development of future treatments for this disease.
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Hong R, Liu W, DeLair D, Razavian N, Fenyö D. Predicting endometrial cancer subtypes and molecular features from histopathology images using multi-resolution deep learning models. Cell Rep Med 2021; 2:100400. [PMID: 34622237 PMCID: PMC8484685 DOI: 10.1016/j.xcrm.2021.100400] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/29/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023]
Abstract
The determination of endometrial carcinoma histological subtypes, molecular subtypes, and mutation status is critical for the diagnostic process, and directly affects patients' prognosis and treatment. Sequencing, albeit slower and more expensive, can provide additional information on molecular subtypes and mutations that can be used to better select treatments. Here, we implement a customized multi-resolution deep convolutional neural network, Panoptes, that predicts not only the histological subtypes but also the molecular subtypes and 18 common gene mutations based on digitized H&E-stained pathological images. The model achieves high accuracy and generalizes well on independent datasets. Our results suggest that Panoptes, with further refinement, has the potential for clinical application to help pathologists determine molecular subtypes and mutations of endometrial carcinoma without sequencing.
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Affiliation(s)
- Runyu Hong
- Institute for Systems Genetics, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Wenke Liu
- Institute for Systems Genetics, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Deborah DeLair
- Department of Pathology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Narges Razavian
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Radiology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - David Fenyö
- Institute for Systems Genetics, NYU Grossman School of Medicine, New York, NY 10016, USA
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY 10016, USA
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Diagnostic Accuracy in Assessment of Depth of Myometrial Invasion in Low-grade Endometrioid Carcinoma: A 2 Center Comparative Study by MRI and Intraoperative Assessment. Int J Gynecol Pathol 2021; 40:495-500. [PMID: 32897954 DOI: 10.1097/pgp.0000000000000703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The role of lymphadenectomy in endometrial carcinomas is controversial, especially in low-grade endometrioid carcinomas. In many institutions, lymphadenectomy in the latter neoplasms is undertaken only when there is deep myometrial invasion, defined as invasion involving 50% or more of the myometrium (FIGO stage IB). There has been considerable debate as to the best modality to detect deep myometrial invasion. In Europe, preoperative magnetic resonance imaging (MRI) is the most commonly used modality while in North America, intraoperative assessment (IOA) is undertaken in most, but not all, institutions. The aim of this study was to compare the diagnostic accuracy of these 2 modalities in identifying deep myometrial invasion in low-grade endometrioid carcinomas. Two patient cohorts were studied from Belfast, UK (n=253) and Boston, USA (n=276). With respect to detecting deep myometrial invasion, MRI had a sensitivity of 72.84%, positive predictive value of 75.64% and a positive likelihood ratio of 6.59 (95% confidence interval; 4.23-10.28). IOA had a sensitivity of 78.26%, positive predictive value of 80% and a positive likelihood ratio of 20.00 (95% confidence interval; 10.35-38.63). The superior positive likelihood ratio suggests that IOA is better than MRI in determining deep myometrial invasion and the nonoverlapping 95% confidence intervals suggest this is a significant finding. However, there are significant resource implications associated with IOA and preoperative MRI carries other advantages that are discussed herein.
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Multiparametric magnetic resonance imaging facilitates the selection of patients prior to fertility-sparing management of endometrial cancer. Abdom Radiol (NY) 2021; 46:4410-4419. [PMID: 33825929 PMCID: PMC10152338 DOI: 10.1007/s00261-021-03050-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE To compare the diagnostic performance of biparametric magnetic resonance imaging (bpMRI) versus multiparametric MRI (mpMRI) for the staging of well-differentiated endometrioid endometrial cancer (EC) in potential candidates for fertility-sparing management. METHODS This multi-center retrospective study included 48 potential candidates for fertility-sparing management (age <46 years, grade 1 endometroid EC) who did not wish to undergo fertility-sparing management and thus underwent definitive surgery. Two readers (R1, R2) independently reviewed bpMRI (T1, T2, and diffusion-weighted imaging) and mpMRI (bpMRI and dynamic contrast-enhanced imaging, DCE) during two separate sessions spaced one month apart for the presence of myometrial invasion (MI), cervical stromal involvement (CSI), malignant adnexal disease (mAD), and pelvic lymphadenopathy (pLNM). Each reader also recorded maximum tumor diameter, tumor volume, and tumor-to-uterine volume ratio (TVR) on T2-weighted imaging. The diagnostic performance of bpMRI and mpMRI was determined for each reader with surgical pathology serving as a gold standard. RESULTS The area under the receiver operating curve (AUC) for bpMRI versus mpMRI was 0.76/0.78 (R1/R2) versus 0.84/0.83 for MI, 0.79/0.76 versus 0.99/0.80 for CSI, 0.84/0.84 versus 0.84/0.80 for mAD, and 0.82/0.82 for pLMN. The sensitivity and specificity of MRI for detecting tumor spread beyond the endometrium were 71%/77% and 71%/65% for bpMRI (R1/R2) vs. 84%/90% and 71%/65% for mpMRI (R1/R2), respectively. The AUC of maximum tumor diameter, tumor volume, and TVR for MI was 0.71/0.61, 0.73/0.75, and 0.75/0.77 for R1/R2, respectively. CONCLUSION MRI had moderate diagnostic performance across potential candidates for fertility-sparing treatment of EC. mpMRI outperformed bpMRI for detecting EC spreading beyond the endometrium.
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Karaboğa Arslan AK, Paşayeva L, Esen MA, Tugay O. Synergistic Growth Inhibitory Effects of Eryngium kotschyi Extracts with Conventional Cytotoxic Agents: Cisplatin and Doxorubicin Against Human Endometrium Cancer Cells. Curr Pharm Biotechnol 2021; 23:740-748. [PMID: 34445948 DOI: 10.2174/1389201022666210826160307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/19/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Endometrial cancer is one of the most common types of cancer. For this reason, various studies have been carried out on its treatment and the effects of natural products on this disease. OBJECTIVE This study aimed to examine the growth inhibitory effects of Eryngium kotschyi Boiss. ethyl acetate [EKE] and butanol [EKB] obtained from the main methanol [EKM] extract from the aerial parts on human endometrium carcinoma [RL95-2] cells and their synergistic effect with cisplatin or doxorubicin. METHODS RL95-2 cells were treated with E. kotschyi extracts either alone or in combination with cisplatin or doxorubicin. The effects on cell growth were determined using the MTT assay and real-time cell analysis xCELLigence. RESULTS The extracts demonstrated growth inhibitory activity, with a certain degree of selectivity against the RL95-2 cell line. Synergistic effects of EKE/cisplatin or doxorubicin at different concentration levels were demonstrated in RL95-2 cells. In some instances, the EKE/doxorubicin combinations resulted in antagonistic effects. The reduction level of cell viability was different and specific to each combination for the RL95-2 cell line. CONCLUSION The growth inhibitory activity of cisplatin or doxorubicin, as a single agent, may be modified by combinations of the extracts and be synergistically enhanced in some cases. A significant synergistic effect of EKE on the RL95-2 cell line with cisplatin and doxorubicin was observed. This cytotoxic effect can be investigated in terms of molecular mechanisms. This study is the first of its kind in the literature. The mechanisms involved in this interaction between chemotherapeutic drugs and plant extracts remain unclear and should be further evaluated.
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Affiliation(s)
| | - Leyla Paşayeva
- Department of Pharmacognosy, Faculty of Pharmacy, Erciyes University, Kayseri 38039. Turkey
| | - Merve Ayşe Esen
- Department of Pharmacology, Faculty of Pharmacy, Erciyes University, Kayseri 38039. Turkey
| | - Osman Tugay
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Selçuk University, Konya 42450. Turkey
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Straubhar AM, Parsons MW, Francis S, Gaffney D, Maurer KA. Refusal of surgery and survival outcomes in endometrial cancer. Int J Gynecol Cancer 2021; 31:1236-1241. [PMID: 34385179 DOI: 10.1136/ijgc-2021-002692] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The goal of this study was to determine the impact refusal of surgery has on overall survival in patients with endometrial cancer. METHODS From January 2004 to December 2015, the National Cancer Database was queried for patients with pathologically proven endometrial cancer who were recommended surgery and refused. Inverse probability of treatment weighting was used to account for differences in baseline characteristics between patients who underwent surgery and those who refused. Kaplan-Meier analyses and doubly robust estimation with multivariate Cox proportional hazards modeling were used to analyze overall survival. RESULTS Of the 300 675 patients identified, 534 patients (0.2%) were recommended surgical treatment but refused: 18% (95/534) were age ≤40 years. The 5-year overall survival for all patients who refused surgery was significantly decreased compared with patients who underwent surgery (29.2% vs 71.9%, P<0.01). This was demonstrated at ages 41-64 years (65.5% vs 91.0%, P<0.01) and ≥65 years (23.4% vs 75.3%, P<0.01). The 5-year overall survival did not meet statistical significance at age ≤40 years (90.1% vs 87.8% P<0.19). However, there were few patients in this cohort. On multivariate analysis, factors associated with refusal of surgery included: Medicaid insurance, Black race, Hispanic Race, Charlson Comorbidity Index scores of 2 or greater, stage II or III, and if patient received external beam radiation therapy alone. Factors associated with undergoing surgery included: age greater than 41, stage IB, and if the patient received brachytherapy. CONCLUSIONS Refusal of surgery for endometrial cancer is uncommon and leads to decreased overall survival.
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Affiliation(s)
- Alli M Straubhar
- Department of Obstetrics and Gynecology, The University of Utah, Salt Lake City, Utah, USA
| | - Matthew W Parsons
- Department of Radiation Oncology, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Samual Francis
- Department of Radiation Oncology, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - David Gaffney
- Department of Radiation Oncology, Huntsman Cancer Institute, Salt Lake City, Utah, USA.,University of Utah, Salt Lake City, Utah, USA
| | - Kathryn A Maurer
- Department of Obstetrics and Gynecology, The University of Utah, Salt Lake City, Utah, USA
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Expression of the Receptor for Hyaluronic Acid-Mediated Motility (RHAMM) in Endometrial Cancer is Associated With Adverse Histologic Parameters and Tumor Progression. Appl Immunohistochem Mol Morphol 2021; 28:453-459. [PMID: 30920393 DOI: 10.1097/pai.0000000000000763] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Endometrial cancer is one of the most common gynecologic malignancies worldwide. Only 2 agents have been approved by Food and Drug Administration for endometrial cancer since 1971. There is a need to identify molecular targets to treat advanced endometrial cancer. The receptor for hyaluronic acid-mediated motility (RHAMM) is upregulated in various types of cancer. Here, we aimed to determine the clinical significance of RHAMM expression in endometrial cancer. Two hundred twenty-five cases of endometrial cancer, including serous and endometrioid types, and 8 cases of normal endometrium were used for studying RHAMM protein levels. The Cancer Genome Atlas database was also queried for RHAMM mRNA expression in endometrial cancer. Increased expression of RHAMM protein was seen in endometrial cancer compared with no or weak expression in normal endometrium. RHAMM expression positively correlated with tumor grade. RHAMM expression was significantly increased in endometrial serous carcinomas, which are high-grade, aggressive types of endometrial cancer, compared with the relatively less aggressive endometrioid carcinomas. RHAMM expression also correlated with the presence of lymphovascular invasion. RHAMM mRNA expression correlated with decreased survival in The Cancer Genome Atlas cohort. Therefore, increased RHAMM expression in endometrial cancer is associated with high-grade tumors and is indicative of more aggressive behavior. These findings suggest RHAMM as a prognostic factor in endometrial cancer and as a potential therapeutic target in advanced endometrial cancer for future studies.
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