title: The frequency and significance of WT-1 expression in serous endometrial carcinoma.
abstract: Serous endometrial carcinoma is an aggressive type of endometrial carcinoma. Wilms tumor gene 1 (WT-1) is commonly expressed in ovarian serous carcinomas and considered a diagnostic marker of these tumors. However, it is generally believed that WT-1 is rarely expressed by endometrial serous carcinoma. The aim of this study was to evaluate the frequency and significance of WT-1 expression in endometrial serous carcinoma. We studied the expression of WT-1 in formalin-fixed, paraffin-embedded tumor sections from 77 cases of endometrial serous carcinoma. Thirty-four tumors showed positive expression for WT-1 (44%). There was a statistically significant association between the presence of WT-1 expression and disease-free survival (DFS), where patients with tumors expressing WT-1 had a shorter DFS compared with those with no WT-1 expression (P = .031; median DFS, 15 and 38 months, respectively). By multivariate Cox regression analysis, DFS was independent from other clinicopathological data (tumor stage, presence of lymphovascular space invasion, cervical involvement, and extrauterine spread), indicating that WT-1 expression is independently associated with DFS. Our study shows that WT-1 is expressed in a considerable percentage of endometrial serous carcinomas, suggesting a role for WT-1 in the pathology of these tumors. This has therapeutic significance, as WT-1 is an emerging target for immunotherapy. Moreover, our results show that WT-1 has prognostic value, being predictive of DFS. As a potential prognostic marker and therapeutic target, we recommend that WT-1 expression should be included in histopathologic reports of endometrial serous carcinoma.
authors.affiliation: School of Medicine, Imperial College London, London, United Kingdom SW7 2AZ.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hedley
authors.affiliation: Epigenetics Group, International Agency for Research on Cancer, Lyon, France CEDEX 08.
authors.forename: Ruethairat
authors.initials: R
authors.lastname: Sriraksa
authors.affiliation: Department of Clinical Pathology, Alexandria Regional Center for Women's Health and Development, Alexandria, Egypt; Department of Histopathology, Hammersmith Hospital, Imperial College London, London, United Kingdom W12 0HS.
authors.forename: Rania
authors.initials: R
authors.lastname: Showeil
authors.affiliation: Department of Histopathology, Hammersmith Hospital, Imperial College London, London, United Kingdom W12 0HS.
authors.forename: Susan
authors.initials: S
authors.lastname: Van Noorden
authors.affiliation: Department of Histopathology, Hammersmith Hospital, Imperial College London, London, United Kingdom W12 0HS; Department of Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt. Electronic address: m.elbahrawy@imperial.ac.uk.
authors.forename: Mona
authors.initials: M
authors.lastname: El-Bahrawy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018269:Carcinoma, Endometrioid / Q000378:metabolism* / Q000473:pathology; D015331:Cohort Studies; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism* / Q000473:pathology; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D016612:Paraffin Embedding; D011379:Prognosis; D025721:WT1 Proteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D025721:WT1 Proteins; C583751:WT1 protein, human
keywords: Endometrial cancer; Prognostic marker; Serous carcinoma; Therapeutic target; WT-1