title: Changes in Chromatin Structure in Curettage Specimens Identifies High-Risk Patients in Endometrial Cancer.
abstract: Most endometrial carcinoma patients are diagnosed at an early stage with a good prognosis. However, a relatively low fraction with lethal disease constitutes a substantial number of patients due to the high incidence rate. Preoperative identification of patients with high risk and low risk for poor outcome is necessary to tailor treatment. Nucleotyping refers to characterization of cell nuclei by image cytometry, including the assessment of chromatin structure by nuclear texture analysis. This method is a strong prognostic marker in many cancers but has not been evaluated in preoperative curettage specimens from endometrial carcinoma.
  
  
  
  The prognostic impact of changes in chromatin structure quantified with Nucleotyping was evaluated in preoperative curettage specimens from 791 endometrial carcinoma patients prospectively included in the MoMaTEC multicenter trial.
  
  
  
  Nucleotyping was an independent prognostic marker of disease-specific survival in preoperative curettage specimens among patients with Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage I-II disease (HR=2.9; 95% CI, 1.2-6.5; P = 0.013) and significantly associated with age, FIGO stage, histologic type, histologic grade, myometrial infiltration, lymph node status, curettage histology type, and DNA ploidy.
  
  
  
  Nucleotyping in preoperative curettage specimens is an independent prognostic marker for disease-specific survival, with potential to supplement existing parameters for risk stratification to tailor treatment.
  
  
  
  This is the first study to evaluate the prognostic impact of Nucleotyping in curettage specimens from endometrial carcinoma and shows that this may be a clinically useful prognostic marker in endometrial cancer. External validation is warranted. Cancer Epidemiol Biomarkers Prev; 26(1); 61-67. ©2016 AACR.
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.|Department of Informatics, University of Oslo, Oslo, Norway.
authors: Tarjei S
authors: TS
authors: Hveem
authors: KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.|Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors: Tormund S
authors: TS
authors: Njølstad
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
authors: Birgitte
authors: B
authors: Nielsen
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
authors: Rolf Anders
authors: RA
authors: Syvertsen
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
authors: John Arne
authors: JA
authors: Nesheim
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
authors: Marna L
authors: ML
authors: Kjæreng
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
authors: Wanja
authors: W
authors: Kildal
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.
authors: Manohar
authors: M
authors: Pradhan
authors: Department of Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Department of Obstetrics and Gynecology, Halland's Hospital Varberg, Varberg, Sweden.
authors: Janusz
authors: J
authors: Marcickiewicz
authors: Department of Gynecology, St. Olav's Hospital, Trondheim, Norway.
authors: Solveig
authors: S
authors: Tingulstad
authors: Department of Gynecology, Oslo University Hospital, Ullevål, Oslo, Norway.
authors: Anne C
authors: AC
authors: Staff
authors: Department of Pathology, The Gade Institute, Haukeland University Hospital, Bergen, Norway.
authors: Hans K
authors: HK
authors: Haugland
authors: Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.|University of Oslo, Oslo, Norway.
authors: Runar
authors: R
authors: Eraker
authors: Department of Obstetrics and Gynecology, Haugesund Hospital, Haugesund, Norway.
authors: Klaus
authors: K
authors: Oddenes
authors: Department of Obstetrics and Gynecology, Hospital of Vestfold, Tønsberg, Norway.
authors: Jan A
authors: JA
authors: Rokne
authors: Department of Obstetrics and Gynecology, Førde Hospital, Førde, Norway.
authors: Jostein
authors: J
authors: Tjugum
authors: Department of Obstetrics and Gynecology, Ålesund Hospital, Ålesund, Norway.
authors: Margaret S
authors: MS
authors: Lode
authors: Department of Gynecologic Oncology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium.
authors: Frederic
authors: F
authors: Amant
authors: KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.|Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors: Henrica M J
authors: HM
authors: Werner
authors: Line
authors: L
authors: Bjørge
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.|Department of Informatics, University of Oslo, Oslo, Norway.
authors: Fritz
authors: F
authors: Albregtsen
authors: Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.|Department of Informatics, University of Oslo, Oslo, Norway.
authors: Knut
authors: K
authors: Liestøl
authors: KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.|Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors: Helga B
authors: HB
authors: Salvesen
authors: KG Jebsen Center for Gynecologic Cancer Research, Haukeland University Hospital, Bergen, Norway.|Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors: Jone
authors: J
authors: Trovik
authors: Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway. hdaniels@labmed.uio.no.|Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway.|Department of Informatics, University of Oslo, Oslo, Norway.|Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, United Kingdom.
authors: Håvard E
authors: HE
authors: Danielsen
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000032:analysis*; D002843:Chromatin / Q000235:genetics*; D004247:DNA / Q000235:genetics*; D016208:Databases, Factual; D004107:Dilatation and Curettage / Q000379:methods; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009664:Norway; D011003:Ploidies; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D013048:Specimen Handling; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D002843:Chromatin; D004247:DNA