pHH3 and survivin are co-expressed in high-risk endometrial cancer and are prognostic relevant.
BACKGROUND
Phosphohistone-H3 (pHH3) is a promising reliable mitotic count biomarker. Our purpose was to study the relationship between the novel proliferation marker pHH3 and the established anti-apoptotic marker survivin and consider their prognostic relevance in endometrial cancer.


METHODS
A total of 106 patients with endometrial cancer (type I/endometrioid, n=81; type II carcinomas, n=18) and simple hyperplasia without atypia (n=7) were investigated. pHH3 and survivin expression were assessed using immunohistochemistry from paraffin-embedded tissue blocks.


RESULTS
A strong positive correlation was observed between pHH3 and survivin expression (P<0.0001). Patients with high-grade tumours and patients with type II carcinomas expressed significantly more pHH3 and survivin than low grade and endometrioid tumours (P<0.0001, P<0.0001, P<0.0001, and P<0.0001, respectively). In univariate survival analysis, overexpression of pHH3 and survivin were associated with increased recurrence and mortality (P<0.0001, P<0.0001, P<0.0001, and P<0.0001, respectively), in the multivariable Cox regression analyses both pHH3 and survivin could be identified as independent parameters for overall survival (P=0.004, and P=0.023, respectively).


CONCLUSIONS
In endometrial cancer, pHH3 and survivin were strongly positive correlated and were both associated with type II and high-grade tumours. Increasing expression levels of pHH3 and survivin were associated with adverse prognostic factors.
Department of Obstetrics and Gynecology, Landesklinikum Thermenregion Moedling/Vienna, Sr. Maria Restitutag. 12A-2340, Moedling/Vienna, Austria. andreas.brunner@meduniwien.ac.at
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Brunner
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Riss
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Heinze
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Brustmann
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006657:Histones / Q000378:metabolism*; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D008875:Middle Aged; D011379:Prognosis; D012306:Risk; D000077022:Survivin
C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D006657:Histones; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin