title: Endometrial cancer: can nodal status be predicted with curettage?
abstract: OBJECTIVE
  To determine whether histologic or molecular markers assessed in pretreatment curettage specimens predict nodal metastasis in endometrial cancer.
  
  
  METHODS
  Phenotypic and molecular variables (ploidy, proliferating cell nuclear antigen, MIB-1, p53, HER-2/neu, and bcl-2) were analyzed in preoperative specimens from 82 patients with endometrial cancer who had lymph nodes dissected. These 82 patients had been selected from a total population of 283 patients with endometrial cancer, using a case-cohort design. Weighted logistic regressions were then used to determine significant predictors of positive lymph nodes, and results were estimated for the total population of 283 patients.
  
  
  RESULTS
  Of the overall population, 12% of patients were estimated to have positive lymph nodes. Histologic subtype, p53, and bcl-2 each were significantly correlated (P <0.05) with lymph node status. With application of stepwise logistic regression, p53 was the only independent predictor of lymph node status. In addition, a statistical model predictive of positive lymph nodes was generated which incorporated the risk factors p53, bcl-2, and histologic subtype.
  
  
  CONCLUSIONS
  In pretreatment curettage specimens, the presence of unfavorable levels of p53 or bcl-2 or of nonendometrioid histologic features, or combinations of those, significantly predicted lymph node status, thus facilitating the preoperative identification of patients at risk of lymph node metastases.
authors.affiliation: Section of Gynecologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mariani
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Sebo
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Katzmann
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Roche
authors.forename: Gary L
authors.initials: GL
authors.lastname: Keeney
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Lesnick
authors.forename: Karl C
authors.initials: KC
authors.lastname: Podratz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002453:Cell Cycle / Q000502:physiology; D015331:Cohort Studies; D003475:Curettage / Q000379:methods*; D016889:Endometrial Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011003:Ploidies; D011237:Predictive Value of Tests