The prognostic value of molecular biomarkers in tissue removed by curettage from FIGO stage 1 and 2 endometrioid type endometrial cancer.
OBJECTIVE
To analyze the prognostic value of molecular biomarkers in curettages of endometrioid endometrial cancer pathologic FIGO stages 1 and 2.


METHODS
Population-based survival analysis in 258 patients of classical prognostic features and molecular biomarkers of cell cycle regulation, (anti)apoptosis, proliferation, squamous differentiation, and PTEN/Akt pathway.


RESULTS
With 74 months median follow-up (range, 1-209), 24 (9.3%) patients had metastases develop. Pathologic FIGO stage 2B (6% of all cases) and age > 68 years had independent multivariate prognostic value. Many molecular biomarkers were prognostic, particularly cell-cycle regulators p16, p21, p27, p53, p63, and the antiapoptosis marker survivin (which mostly stains mitoses). The strong prognostic value of a multivariate model with survivin, p21, and p53 overshadowed all other prognosticators in pathologic FIGO 1 and 2A.


CONCLUSIONS
In pathologic FIGO stage 1 and 2A endometrioid endometrial cancer curettages, combined biomarkers survivin, p21, and p53 expression patterns are prognostically stronger than classical feature combinations.
Steinbakk
Anita
A
Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
Skaland
Ivar
I
Gudlaugsson
Einar
E
Janssen
Emiel A M
EA
Kjellevold
Kjell H
KH
Klos
Jan
J
Løvslett
Kjell
K
Fiane
Bent
B
Baak
Jan P A
JP
D014408:Biomarkers, Tumor / Q000032:analysis*; D018269:Carcinoma, Endometrioid / Q000737:chemistry* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003475:Curettage; D016889:Endometrial Neoplasms / Q000737:chemistry* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009367:Neoplasm Staging; D051058:Oncogene Protein v-akt / Q000032:analysis; D051059:PTEN Phosphohydrolase / Q000032:analysis; D011237:Predictive Value of Tests; D046888:Tissue Array Analysis
D014408:Biomarkers, Tumor; D051058:Oncogene Protein v-akt; D051059:PTEN Phosphohydrolase