Endometrial cancer type that is difficult to distinguish, identified by body weight and biomarker
Jul 15, 2024
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Endometrial cancer is a cancer that occurs in the endometrium that forms the inner wall of the uterine body where the fetus grows. It is rarely found by regular check-ups, and most of them suspect cancer through bleeding symptoms and are diagnosed only after a biopsy. It is difficult to get regular tests like cervical cancer because the method of biopsy is difficult and pain occurs. According to the ProMisE analysis based on immunohistochemical staining, endometrial cancer is classified into four types: POLE mutated, p53 Wild, p53 normal, and dMMR (Mismatch Repair Deficient) depending on gene mutation and specific substance expression.
Clear discrimination of types in endometrial cancer is important because it has a large impact on treatment planning and prognosis. The four known subtypes can be partially distinguished through immunohistochemical staining, but there has been a demand for a test method that can be used inexpensively in the field because expensive genetic analysis is required to identify POLE mutated and p53 wild.
Professor Kim Ki-dong's research team previously reported that immunohistochemical staining using biomarkers 'cycline B1' is useful in distinguishing between POLE mutated and p53 wild subtypes. In this study, immunohistochemical staining of cyclin B1 and various clinical variables were used together to build an optimal model to distinguish two subtypes, POLE mutated and p53 wild, and their performance was evaluated.
This study used subtype data of 24 POLE-mutated type and 131 p53 wild type among 155 patients who underwent surgery for endometrial cancer at Seoul National University Bundang Hospital from 2006 to 2013, who were the subjects of the preliminary study. Additionally, various clinical variables (age, height, weight, BMI, tumor stage, subtype of molecule, etc.) and cyclin B1 immunohistochemical staining results were investigated to compare and analyze the expression level of cyclin B1 in each clinical variable. A major single antibody was used for cyclin B1 immunohistochemical staining, and the expression level of cyclin B1 was scored based on the percentage of positive cells and the staining intensity.
The optimal model built through the study is a decision tree model based on 'weight' and 'Cyclin B1 score'. Based on this analysis, 36% of the patients under 54.3 kg and over 54.3 kg, 16% of the group with a cyclin B1 score higher than 1, 54.3 kg, and only 6% of the group with a cyclin B1 score higher than 1 or lower showed POLE mutated subtypes, showing a significant difference between groups.
Professor Kim Ki-dong said, "This study shows the possibility of distinguishing between POLE mutated and p53 wild subtypes based on body weight and cyclin B1 scores. "Immunohistochemical staining excludes p53 abnormal and dMMR subtypes, and POLE mutated genetic testing may be considered for endometrial cancer patients weighing 54.3 kg or less."."
The findings are published in the Journal of Gynecological Oncology. 논문명은 'Enrichment for the POLE mutated against p53 wild subtype using clinicopathologic factors and cyclin B1 immunohistochemistry in endometrial cancer'이다.
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