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Çakır İ, Gülseren V, Özdemir İA, Abacı H, Talu ECK, Çakır ZE, Ata C, Kuru O, Gökçü M, Sancı M, Güngördük K. Characteristics of patients with late recurrence endometrial cancer. J Cancer Res Ther 2024; 20:232-237. [PMID: 38554326 DOI: 10.4103/jcrt.jcrt_888_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/18/2022] [Indexed: 04/01/2024]
Abstract
AIM We planned this study to assess endometrial cancer (EC) patients who had late metastasis. MATERIALS AND METHODS This retrospective study constituted a review of the records of patients who were diagnosed with EC and underwent hysterectomy at the Gynecologic Oncology Clinic between 1996 and 2018. Relapses occurring after the first three years following primary treatment of EC are considered late recurrences. Post-relapse survival (PRS) refers to the time to the last follow-up or the patient's death after relapse. RESULTS Late metastases were identified in 42 patients, 20 (47.6%) of whom had locoregional recurrence and 22 of whom (52.4%) had extrapelvic recurrence. Median disease-free survival (DFS) times were 61 (range: 43-78) and 65 (range: 48-81) months for the groups with locoregional and extrapelvic recurrences, respectively (P = 0.462). The 5-year PRS rate for the patients was 61.1%, with 63.8% having locoregional and 59.4% having extrapelvic late metastasis (P = 0.969). CONCLUSION Among the patients with late metastases, those with endometrioid type EC were found to have a better prognosis. It has been shown that locoregional or extrapelvic organ recurrence does not significantly affect survival in patients with late relapse. Although our results are not statistically significant for cases of locoregional late metastases, surgical resection increases survival rates.
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Affiliation(s)
- İlker Çakır
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Varol Gülseren
- Department of Obstetrics and Gynecology, Faculty of Medicine, Division of Gynecologic Oncology, Erciyes University, Kayseri, Turkey
| | - İsa Aykut Özdemir
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Sadi Konuk Education and Research Hospital, İstanbul, Turkey
| | - Hüseyin Abacı
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | | | | | - Can Ata
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Oğuzhan Kuru
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Mehmet Gökçü
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Muzaffer Sancı
- Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, İzmir, Turkey
| | - Kemal Güngördük
- Department of Obstetrics and Gynecology, Faculty of Medicine, Division of Gynecologic Oncology, Sıtkı Koçman University, Muğla, Turkey
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Wang L, Li Y, Han L. Pulmonary metastasis of stage I, low-grade endometrioid carcinoma: two case reports and the literature review. Front Oncol 2023; 13:1266485. [PMID: 37901321 PMCID: PMC10602667 DOI: 10.3389/fonc.2023.1266485] [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: 07/25/2023] [Accepted: 09/20/2023] [Indexed: 10/31/2023] Open
Abstract
Endometrial cancer (EC) is the most common malignant tumor of the female reproductive system, and the majority of ECs are low histological grade and confined to the uterus, resulting in a good prognosis. However, metastasis to the lung from a low-grade and early-stage endometrial endometrioid carcinoma (EEC) is extremely rare. Therefore, it is crucial to accurately differentiate between primary pulmonary malignancy and extra-thoracic malignancy presenting as metastatic disease, and flexible bronchoscopy with tissue acquisition plays a key role in this process. Despite its importance, there is limited literature available on the cytology of metastatic endometrial carcinoma in liquid-based cytology of bronchial brush (BB). In this article, we present two rare cases of lung metastasis from low-grade and early-stage EEC, along with a detailed analysis of the cytologic features observed in BB samples. These cases highlight the significance of cytological and histological pathology, complemented by immunohistochemistry (ICH) analysis, in the diagnosis and management of EEC patients. Pathologists should pay close attention to these aspects, while gynecologists need to be mindful of the follow-up and management of early-stage, low-grade EEC patients. By focusing on these areas, healthcare professionals can effectively contribute to the improved care and outcomes of patients with EEC.
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Affiliation(s)
- Li Wang
- Department of Gynecology & Obstetrics, Liaocheng People's Hospital, School of Medicine, Liaocheng University, Liaocheng, China
- Biomedical Laboratory, School of Medicine, Liaocheng University, Liaocheng, China
| | - Yingxue Li
- Department of Pathology, Liaocheng People's Hospital, Liaocheng, China
| | - Lin Han
- Department of Pathology, Liaocheng People's Hospital, Liaocheng, China
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Ono M, Yamanoi K, Okunomiya A, Sagae Y, Okamoto H, Sunada M, Taki M, Ukita M, Chigusa Y, Horie A, Yamaguchi K, Hamanishi J, Mandai M. A case of solitary lymph node recurrence 9 years after initial treatment for advanced premenopausal endometrioid endometrial cancer; clinical usefulness of hormonal replacement therapy. Int Cancer Conf J 2023; 12:168-172. [PMID: 37251011 PMCID: PMC10212858 DOI: 10.1007/s13691-023-00599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
There is no consensus on the use of hormone replacement therapy (HRT) after treatment of advanced corpus cancer. We report a case of advanced corpus cancer at a young age, in which HRT was initiated 7 years after surgery, and regional lymph node recurrence was later detected. The patient was 35 years old at the time of initial treatment in X year, when she was diagnosed with stageIIIC2 corpus cancer and underwent a hysterectomy with bilateral salpingo-oophorectomy and a retroperitoneal lymphadenectomy. HRT was started at X + 7 years, and at X + 9 years, a 25 × 12-mm-sized mass was found in the hilum of the right kidney. A laparoscopic resection revealed regional lymph node recurrence of the corpus cancer. A retrospective study further revealed that a tumor measuring 12 × 3 mm was found at X + 3 years and grew to 18 × 7 mm in X + 6 years, just before the start of the HRT. We hypothesize that HRT did not induce tumor recurrence; instead, it allowed for long-term follow-up and early diagnosis.
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Affiliation(s)
- Maaya Ono
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Koji Yamanoi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Asuka Okunomiya
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Yusuke Sagae
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Haruko Okamoto
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Masumi Sunada
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Mana Taki
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Masayo Ukita
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Ken Yamaguchi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Junzo Hamanishi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507 Japan
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Chibbar R, Foerstner S, Suresh J, Chibbar R, Piche A, Kundapur D, Kanthan R, Kundapur V, Lee CH, Agrawal A, Lai R. Estrogen/Progesterone Receptor Loss, CTNNB1 and KRAS Mutations Are Associated With Local Recurrence or Distant Metastasis in Low-Grade Endometrial Endometrioid Carcinoma. Appl Immunohistochem Mol Morphol 2023; 31:181-188. [PMID: 36695555 PMCID: PMC9988232 DOI: 10.1097/pai.0000000000001102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/28/2022] [Indexed: 01/26/2023]
Abstract
A subset of endometrial endometrioid carcinomas (EECs) with low-grade histology recur with poor outcomes. Published evidence suggests that poor outcomes may be associated with loss of expression of ER-alpha (ER-α) as well as with β-Catenin-1 ( CTNNB1 ) and Kirsten rat sarcoma viral oncogene homolog ( KRAS ) mutations. This study reports on institutional experience with the incidence of recurrence in low-grade EEC and their association with CTNNB1 and KRAS mutations as well as estrogen/progesterone receptor (ER/PR) expression. Forty-eight (8.5%) out of 568 cases of low-grade EEC with biopsy-proven recurrence were identified; and were analyzed by immunohistochemistry for ER, PR, p53, MMR protein, and mutation analysis for exon 3 of the CTNNB1 and exon 2 of KRAS in relation to recurrence type, local or distant metastasis/recurrence. Twenty-three patients (4%) developed local, and 25 patients (4.4%) developed distant metastases/recurrence. Decreased expression or loss of ER/PR was found in 17/44 (38.6%) patients with recurrence. Eighty-four percent of patients with low-grade EEC and local recurrence had CTNNB1 mutations. Seventy-three percent of patients with distant metastasis/recurrence had KRAS mutations. The association of these mutations with the type of recurrence was statistically significant for both. Five cases with the morphology of low-grade EEC were reclassified as mesonephric-like carcinoma and were universally characterized by distant metastasis/recurrence, loss of ER/PR expression, large tumor size, absence of CTNNB1 mutations, and the presence of KRAS mutations. In low-grade EEC, CTNNB1 and KRAS mutations are associated with local recurrence and distant metastasis/recurrence, respectively, suggesting that these 2 different progression types may be conditioned by tumor genotype. ER/PR immunohistochemistry may be helpful in identifying poor performers in low-grade EEC. Furthermore, identification of the decreased expression or loss of ER/PR in tumors with low-grade histology should prompt consideration of mesonephric-like carcinoma, which is a more aggressive tumor than the low-grade EEC. KRAS mutations were associated with distant metastasis/recurrence in tumors with and without mesonephric-like phenotype.
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Affiliation(s)
- Rajni Chibbar
- Department of Laboratory Medicine and Pathology, University of Saskatchewan, Saskatoon, SK
| | - Sabrina Foerstner
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB
| | - Janarathnee Suresh
- Department of Laboratory Medicine and Pathology, University of Saskatchewan, Saskatoon, SK
| | | | - Alexandre Piche
- Department of Laboratory Medicine and Pathology, University of Saskatchewan, Saskatoon, SK
| | | | - Rani Kanthan
- Department of Laboratory Medicine and Pathology, University of Saskatchewan, Saskatoon, SK
| | | | - Cheng Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB
| | - Anita Agrawal
- Department of Obstetrics and Gynecology, Queen’s University, Kingston, ON
| | - Raymond Lai
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB
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Unusual Ovarian Tumors With Endometrioid Proliferations Co-Expressing Estrogen Receptor and CDX-2 Arising in Cystadenofibromatous Background: Report of 3 Cases. Int J Gynecol Pathol 2023; 42:93-100. [PMID: 35149615 DOI: 10.1097/pgp.0000000000000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This report describes 3 cases of ovarian tumors with unusual glandular proliferations co-expressing estrogen receptor and CDX-2 by immunohistochemistry set in cystadenofibromatous background. Targeted next-generation sequencing was performed on the cyst lining epithelium and glandular proliferations for all cases; CTNNB1 mutations were detected in the glandular proliferations of all neoplasms. The cyst lining of case 1 demonstrated a different CTNNB1 mutation from the matched glandular proliferation. No mutations were detected in the cyst lining from case 2. The cyst lining and glandular proliferation for case 3 harbored identical ATM and PIK3CA mutations with an additional CTNNB1 mutation in the glandular proliferation. To our knowledge, this is the first reported series of endometrioid proliferations with co-expression of estrogen receptor and CDX-2 in cystadenofibromatous background.
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Otsuka I. Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy. Cancers (Basel) 2022; 14:cancers14184516. [PMID: 36139675 PMCID: PMC9497184 DOI: 10.3390/cancers14184516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Endometrial cancer is the most common gynecological tract malignancy in developed countries. Extrauterine disease, in particular lymph node metastasis, is an important prognostic factor. Nevertheless, pelvic lymphadenectomy is not considered to have a therapeutic benefit, as it did not improve survival in randomized studies. However, lymphadenectomy may have a therapeutic benefit if adjuvant therapy can be omitted without decreasing oncological outcomes, as the long-term quality of life is maintained by avoiding morbidities associated with adjuvant therapy. In intermediate- and high-risk endometrioid endometrial carcinomas, adjuvant therapy may be safely omitted without decreasing long-term survival by open surgery including systematic pelvic and para-aortic lymphadenectomy when patients are node-negative. Systematic lymphadenectomy may remove undetectable low-volume lymph node metastasis in both pelvic and para-aortic regions, and open surgery may reduce vaginal recurrence even without vaginal brachytherapy. However, lymphadenectomy may not improve survival in elderly patients and patients with p53-mutant tumors. Abstract Endometrial cancer is the most common gynecological tract malignancy in developed countries, and its incidence has been increasing globally with rising obesity rates and longer life expectancy. In endometrial cancer, extrauterine disease, in particular lymph node metastasis, is an important prognostic factor. Nevertheless, pelvic lymphadenectomy is not considered to have a therapeutic benefit, as it did not improve survival in randomized studies. However, lymphadenectomy may have a therapeutic benefit if adjuvant therapy can be omitted without decreasing oncological outcomes, as the long-term quality of life is maintained by avoiding morbidities associated with adjuvant therapy. In intermediate- and high-risk endometrioid endometrial carcinomas, adjuvant therapy may be safely omitted without decreasing long-term survival by open surgery including systematic pelvic and para-aortic lymphadenectomy when patients are node-negative. Systematic lymphadenectomy may remove undetectable low-volume lymph node metastasis in both pelvic and para-aortic regions, and open surgery may reduce vaginal recurrence even without vaginal brachytherapy. However, lymphadenectomy may not improve survival in elderly patients and patients with p53-mutant tumors. In this review, I discuss the characteristics of lymph node metastasis, the methods of lymph node assessment, and the therapeutic benefits of systematic lymphadenectomy in patients with intermediate- and high-risk endometrioid endometrial carcinoma.
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Affiliation(s)
- Isao Otsuka
- Department of Obstetrics and Gynecology, Kameda Medical Center, Kamogawa 296-8602, Chiba, Japan
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Li L, Qiu W, Lin L, Liu J, Shi X, Shi Y. Predicting recurrence and metastasis risk of endometrial carcinoma via prognostic signatures identified from multi-omics data. Front Oncol 2022; 12:982452. [PMID: 36059678 PMCID: PMC9438970 DOI: 10.3389/fonc.2022.982452] [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: 06/30/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesEndometrial carcinoma (EC) is one of the three major gynecological malignancies, in which 15% - 20% patients will have recurrence and metastasis. Though there are many studies on the prognosis on this cancer, the performances of existing models evaluating the risk of its recurrence and metastasis are yet to be improved. In addition, a comprehensive multi-omics analyses on the prognostic signatures of EC are on demand. In this study, we aimed to construct a relatively stable and reliable model for predicting recurrence and metastasis of EC. This will help determine the risk level of patients and choose appropriate adjuvant therapy, thereby avoiding improper treatment, and improving the prognosis of patients.MethodsThe mRNA, microRNA (miRNA), long non-coding RNA (lncRNA), copy number variation (CNV) data and clinical information of patients with EC were downloaded from The Cancer Genome Atlas (TCGA). Differential expression analyses were performed between the recurrence or metastasis group and the non-recurrence/metastasis group. Then, we screened potential prognostic markers from the four kinds of omics data respectively and established prediction models using three classifiers.ResultsWe achieved differential expressed mRNAs, lncRNAs, miRNAs and CNVs between the two groups. According to feature selection scores by the random forest algorithm, 275 CNV features, 50 lncRNA features, 150 miRNA features and 150 mRNA features were selected, respectively. And the prediction model constructed by the features of lncRNA data using random forest method showed the best performance, with an area under the curve of 0.763, and an accuracy of 0.819 under 10-fold cross-validation.ConclusionWe developed a computational model using omics information, which is able to predicting recurrence and metastasis risk of EC accurately.
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Affiliation(s)
- Ling Li
- Department of Gynecological Oncology Surgery, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Wenjing Qiu
- Science System Department, Geneis Beijing Co., Ltd., Beijing, China
| | - Liang Lin
- Department of Gynecological Oncology Surgery, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jinyang Liu
- Science System Department, Geneis Beijing Co., Ltd., Beijing, China
- Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
| | - Xiaoli Shi
- Science System Department, Geneis Beijing Co., Ltd., Beijing, China
- Qingdao Geneis Institute of Big Data Mining and Precision Medicine, Qingdao, China
- *Correspondence: Yi Shi, ; Xiaoli Shi,
| | - Yi Shi
- Department of Molecular Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
- *Correspondence: Yi Shi, ; Xiaoli Shi,
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Analysis of Prognostic Factors and Treatment Modes of Patients with Recurrent Endometrial Carcinoma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8793187. [PMID: 34707677 PMCID: PMC8545576 DOI: 10.1155/2021/8793187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022]
Abstract
Objective Recurrence of endometrial cancer after initial treatment can be complex and difficult to treat. The current main treatment modalities for patients with recurrent endometrial cancer (REC) include chemotherapy, radiotherapy, and surgery, which vary according to the individual patient. However, REC is often associated with a poor prognosis, and it is therefore important to investigate the risk factors affecting REC prognosis and to explore appropriate treatment modalities to improve the prognosis and treatment strategies for patients with REC. Methods Totally, 100 patients with REC admitted to our hospital from January 2013 to January 2018 were chosen to be research objects. Their pathological data were analyzed, including age, disease-free interval (DFI), recurrence site, and treatment plan after relapse (definitive local therapy (DLT) and palliative chemotherapy (PC)). According to these parameters, univariate and multivariate factors affecting the prognosis of REC patients and the curative effect of PC were analyzed, and the 3-year overall survival (OS) curve and progression-free survival (PFS) curve were drawn. Results After 3 years of follow-up, 30 patients had a poor prognosis and 70 had a good prognosis, according to which a single multifactorial analysis was performed for different prognoses, where the results of the single-factor analysis showed significant differences between patients with different prognoses in terms of pathomorphology, pathological grading, TFI, and treatment modality after relapse. Further multifactorial analysis showed that TFI and treatment modality after recurrence were independent factors affecting poor prognosis in REC patients. The 3-year OS and 3-year PFS of REC patients were 74.00% and 70.00%, respectively. Patients whose DFI was less than 12 months or treated with PC after relapse were notably associated with lower levels of 3-year OS and 3-year PFS. In addition, radiotherapy and chemotherapy, DFI, and chemotherapy plan after primary surgery were independent risk factors that affected the PC efficacy of REC patients. Conclusion DFI and treatment mode after relapse are independent factors affecting the prognosis of REC patients. DLT can obviously improve the prognosis of REC patients. For patients who can only choose PC, chemoradiotherapy and DFI after primary surgery are helpful to predict the chemotherapy effect, and the combination of paclitaxel and platinum drugs should be the first choice for chemotherapy.
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Yan X, Zhang H, Ke J, Zhang Y, Dai C, Zhu M, Jiang F, Zhu H, Zhang L, Zuo X, Li W, Yin X, Wan X. Progesterone receptor inhibits the proliferation and invasion of endometrial cancer cells by up regulating Krüppel-like factor 9. Transl Cancer Res 2020; 9:2220-2230. [PMID: 35117582 PMCID: PMC8798504 DOI: 10.21037/tcr.2020.03.53] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 01/10/2020] [Indexed: 12/19/2022]
Abstract
Background Krüppel-like factor 9 (KLF9) is one of the most important members of the KLF family, and is abnormally expressed in many tumors. However, the detailed function of KLF9 in endometrial cancer (EC) was barely investigated. Methods In this study, a total of 52 paired EC tissues were recruited to detect the KLF9 expression. Then a serial of phenotypic experiments and mechanism researches were performed. Results The results showed that KLF9 expression was decreased in EC tissues, and the reduced expression of KLF9 is associated with highly metastatic capacity of EC cells. KLF9 could inhibit the proliferation and invasion of EC cells by inhibiting the Wnt/β-catenin signaling pathway. Progesterone receptor (PR) could bind to KLF9 promoter and a positive correlation between KLF9 and PR expression was witnessed. Conclusions Taken together, the reduction of KLF9 induced by PR might participate in the development of EC and targeting KLF9 may provide a novel strategy for EC management.
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Affiliation(s)
- Xiaofang Yan
- Department of Obstetrics and Gynecology, Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China.,Department of Gynecology and Obstetrics, Yixing People's Hospital, Yixing 214200, China
| | - Huilin Zhang
- Department of Obstetrics and Gynecology, Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China.,Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210000, China
| | - Jieqi Ke
- Department of Obstetrics and Gynecology, Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China
| | - Yongli Zhang
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200080, China
| | - Chenyun Dai
- Department of Translation Medicine, Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 210000, China
| | - Mei Zhu
- Department of Translation Medicine, Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 210000, China
| | - Feizhou Jiang
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Hongdi Zhu
- Department of Gynecology and Obstetrics, Yixing People's Hospital, Yixing 214200, China
| | - Ling Zhang
- Department of Gynecology and Obstetrics, Yixing People's Hospital, Yixing 214200, China
| | - Xin Zuo
- Department of Gynecology and Obstetrics, Yixing People's Hospital, Yixing 214200, China
| | - Weiling Li
- Department of Gynecology and Obstetrics, Yixing People's Hospital, Yixing 214200, China
| | - Xiufeng Yin
- Department of Gynecology and Obstetrics, Yixing People's Hospital, Yixing 214200, China
| | - Xiaoping Wan
- Department of Obstetrics and Gynecology, Shanghai General Hospital of Nanjing Medical University, Shanghai 200000, China.,Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200080, China
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