Highlights
- •ASRGL1 is a promising biomarker in endometrioid endometrial cancer.
- •An immunopanel consisting of p53 and ASRGL1 is a useful tool in EEC risk assessment.
- •Different EEC subgroups can be characterized using sophisticated statistical methods.
Abstract
Objective
In clinical practise, prognostication of endometrial cancer is based on clinicopathological
risk factors. The use of immunohistochemistry-based markers as prognostic tools is
generally not recommended and a systematic analysis of their utility as a panel is
lacking. We evaluated whether an immunohistochemical marker panel could reliably assess
endometrioid endometrial cancer (EEC) outcome independent of clinicopathological information.
Methods
A cohort of 306 EEC specimens was profiled using tissue microarray (TMA). Cost- and
time-efficient immunohistochemical analysis of well-established tissue biomarkers
(ER, PR, HER2, Ki-67, MLH1 and p53) and two new biomarkers (L1CAM and ASRGL1) was
carried out. Statistical modelling with embedded variable selection was applied on
the staining results to identify minimal prognostic panels with maximal prognostic
accuracy without compromising generalizability.
Results
A panel including p53 and ASRGL1 immunohistochemistry was identified as the most accurate
predictor of relapse-free and disease-specific survival. Within this panel, patients
were allocated into high- (5.9%), intermediate- (29.5%) and low- (64.6%) risk groups
where high-risk patients had a 30-fold risk (P < 0.001) of dying of EEC compared to the low-risk group.
Conclusions
P53 and ASRGL1 immunoprofiling stratifies EEC patients into three risk groups with
significantly different outcomes. This simple and easily applicable panel could provide
a useful tool in EEC risk stratification and guiding the allocation of treatment modalities.
Keywords
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Article info
Publication history
Published online: February 24, 2018
Accepted:
February 18,
2018
Received in revised form:
February 16,
2018
Received:
January 11,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
