The cutoff for estrogen and progesterone receptor expression in endometrial cancer revisited: a European Network for Individualized Treatment of Endometrial Cancer collaboration study

被引：29

作者：

van Weelden, Willem Jan ^{[1
]}

Reijnen, Casper ^{[1
,2
]}

Kusters-Vandevelde, Heidi V. N. ^{[3
]}

Bulten, Johan ^{[4
]}

Bult, Peter ^{[4
]}

Leung, Samuel ^{[5
]}

Visser, Nicole C. M. ^{[6
]}

Santacana, Maria ^{[7
,8
]}

Bronsert, Peter ^{[9
]}

Hirschfeld, Marc ^{[10
,11
]}

Colas, Eva ^{[12
]}

Gil-Moreno, Antonio ^{[12
,13
]}

Reques, Armando ^{[14
]}

Mancebo, Gemma ^{[15
]}

Huvila, Jutta ^{[16
]}

Koskas, Martin ^{[17
]}

Weinberger, Vit ^{[18
]}

Bednarikova, Marketa ^{[19
]}

Hausnerova, Jitka ^{[20
]}

Snijders, Marc P. L. M. ^{[2
]}

Matias-Guiu, Xavier ^{[7
,8
]}

Amant, Frederic ^{[21
,22
,23
]}

机构：

[1] Radboud Univ Nijmegen, Med Ctr, Dept Obstet & Gynaecol, NL-6525 GA Nijmegen, Netherlands

[2] Canisius Wilhelmina Hosp, Dept Obstet & Gynaecol, NL-6532 SZ Nijmegen, Netherlands

[3] Canisius Wilhelmina Hosp, Dept Pathol, NL-6532 SZ Nijmegen, Netherlands

[4] Radboud Univ Nijmegen, Med Ctr, Dept Pathol, NL-6525 GA Nijmegen, Netherlands

[5] Vancouver Gen Hosp, Genet Pathol Evaluat Ctr, Vancouver, BC V5Z 1M9, Canada

[6] Fdn Lab Pathol & Med Microbiol PAMM, NL-5623 EJ Eindhoven, Netherlands

[7] Univ Lleida, IRBLleida, CIBERONC, Hosp Univ Arnau de Vilanova,Dept Pathol & Mol Gen, Lleida 25198, Spain

[8] Univ Lleida, IRBLleida, CIBERONC, Hosp Univ Arnau de Vilanova,Res Lab, Lleida 25198, Spain

[9] Univ Med Ctr, Inst Pathol, D-79106 Freiburg, Germany

[10] Univ Med Ctr, Dept Obstet & Gynecol, D-79106 Freiburg, Germany

[11] Georg August Univ, Inst Vet Med, D-37073 Gottingen, Germany

[12] Univ Autonoma Barcelona, CIBERONC, Vall Hebron Inst Res, Biomed Res Grp Gynecol, Barcelona 08035, Spain

[13] Vall Hebron Univ Hosp, CIBERONC, Gynecol Dept, Barcelona 08035, Spain

[14] Vall Hebron Univ Hosp, CIBERONC, Pathol Dept, Barcelona 08035, Spain

[15] Hosp del Mar, PSMAR, Dept Obstet & Gynecol, Barcelona 08003, Spain

[16] Univ Turku, Dept Pathol, Turku 20500, Finland

[17] Bichat Claude Bernard Hosp, Obstet & Gynecol Dept, F-75018 Paris, France

[18] Masaryk Univ, Fac Med, Dept Gynecol & Obstet, Brno 62500, Czech Republic

[19] Masaryk Univ, Fac Med, Dept Internal Med Oncol & Hematol, Brno 62500, Czech Republic

[20] Masaryk Univ, Fac Med, Inst Pathol, Brno 62500, Czech Republic

[21] Katholieke Univ Leuven, Dept Oncol, B-3000 Leuven, Belgium

[22] Netherlands Canc Inst, Ctr Gynaecol Oncol, NL-1066 CX Amsterdam, Netherlands

[23] Univ Amsterdam, Med Ctr, NL-1066 CX Amsterdam, Netherlands

来源：

HUMAN PATHOLOGY | 2021年 / 109卷

关键词：

Endometrial cancer; Estrogen receptor; Progesterone receptor; Cutoff; Prognostic biomarker; ALPHA ER-ALPHA; BREAST-CANCER; PROGNOSTIC-SIGNIFICANCE; SURGICAL SPECIMENS; CARCINOMA; BETA; THERAPY;

D O I：

10.1016/j.humpath.2020.12.003

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

There is no consensus on the cutoff for positivity of estrogen receptor (ER) and progesterone receptor (PR) in endometrial cancer (EC). Therefore, we determined the cutoff value for ER and PR expression with the strongest prognostic impact on the outcome. Immunohistochemical expression of ER and PR was scored as a percentage of positive EC cell nuclei. Cutoff values were related to disease-specific survival (DSS) and disease-free survival (DFS) using sensitivity, specificity, and multivariable regression analysis. The results were validated in an independent cohort. The study cohort (n = 527) included 82% of grade 1-2 and 18% of grade 3 EC. Specificity for DSS and DFS was highest for the cutoff values of 1-30%. Sensitivity was highest for the cutoff values of 80-90%. ER and PR expression were independent markers for DSS at cutoff values of 10% and 80%. Consequently, three subgroups with distinct clinical outcomes were identified: 0-10% of ER/PR expression with, unfavorable outcome (5-year DSS = 75.9-83.3%); 20-80% of ER/PR expression with, intermediate outcome (5-year DSS = 93.0-93.9%); and 90-100% of ER/PR expression with, favorable outcome (5-year DSS = 97.8-100%). The association between ER/PR subgroups and outcomes was confirmed in the validation cohort (n = 265). We propose classification of ER and PR expression based on a high-risk (0-10%), intermediate-risk (20-80%), and low-risk (90-100%) group. (C) 2020 Published by Elsevier Inc.

引用

页码：80 / 91

页数：12

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