Mari Kyllesø Halle1, Akinyemi I Ojesina2, Hilde Engerud1, Kathrine Woie3, Ingvild Løberg Tangen1, Frederik Holst1, Erling Høivik1, Kanthida Kusonmano4, Ingfrid S Haldorsen5, Olav K Vintermyr6, Jone Trovik1, Bjørn I Bertelsen7, Helga B Salvesen1, Camilla Krakstad8. 1. Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway; Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Norway. 2. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL; HudsonAlpha Institute for Biotechnology, Huntsville, AL. 3. Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway. 4. Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Norway; Computational Biology Unit, University of Bergen, Norway; Bioinformatics and Systems Biology Program, School of Bioresources and Technology, King Mongkut's University of Technology Thonburi, Bangkhuntien, Bangkok, Thailand. 5. Department of Radiology, Haukeland University Hospital, Bergen, Norway; Section of Radiology, Department of Clinical Medicine, University of Bergen, Norway. 6. Department of Pathology, Haukeland University Hospital, Bergen, Norway; The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Norway. 7. Department of Pathology, Haukeland University Hospital, Bergen, Norway. 8. Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway; Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Norway. Electronic address: camilla.krakstad@uib.no.
Abstract
BACKGROUND: Cervical cancer is a major health problem worldwide. Identification of effective clinicopathologic and molecular markers is vital to improve treatment stratification. OBJECTIVES: The purpose of this study was to validate a set of well-defined clinicopathologic features in a large population-based, prospectively collected cervical cancer cohort to support their use in the clinic. Further, we explored p53 and human epidermal growth factor receptor 2 as potential prognostic markers in cervical cancer. STUDY DESIGN: Tissue was collected from 401 patients with cervical cancer. Clinical data that included follow-up evaluations were collected from patient journals. Histopathologic data were evaluated and revised by an expert pathologist. The prognostic impact of selected clinicopathologic variables was analyzed in the whole cohort. Tissue microarrays were prepared from 292 carcinomas, and p53 and human epidermal growth factor receptor 2 protein levels were evaluated by immunohistochemistry. Fresh frozen samples from overlapping cervical carcinomas previously were subjected to human papilloma virus typing (n=94), whole exome (n=100) and RNA (n=79) sequencing; the results were available for our analyses. RESULTS: Among the clinicopathologic variables, vascular space invasion, histologic type, and tumor size were verified as strong independent prognostic markers. High p53 protein levels were associated significantly with markers for aggressive phenotype and survival, also in multivariate survival analysis, but did not reflect TP53 mutational status. High human epidermal growth factor receptor 2 protein levels were identified in 21% of all tumors. ERBB2 amplification was associated with poor outcome (P=.003); human epidermal growth factor receptor 2 protein level was not. CONCLUSIONS: Our findings support that the Féderation Internationale de Gynécologie et d'Obstétrique s guidelines should include vascular space invasion and tumor size 2-4 cm and that careful selection of histologic type is essential for stratification of patient risk groups. High p53 levels independently predict poor survival yet do not reflect mutational status in cervical cancer. Amplified ERBB2 significantly links to poor survival, while HercepTest does not. With optimal stratification, human epidermal growth factor receptor 2-based therapy may improve cervical cancer treatment.
BACKGROUND:Cervical cancer is a major health problem worldwide. Identification of effective clinicopathologic and molecular markers is vital to improve treatment stratification. OBJECTIVES: The purpose of this study was to validate a set of well-defined clinicopathologic features in a large population-based, prospectively collected cervical cancer cohort to support their use in the clinic. Further, we explored p53 and humanepidermal growth factor receptor 2 as potential prognostic markers in cervical cancer. STUDY DESIGN: Tissue was collected from 401 patients with cervical cancer. Clinical data that included follow-up evaluations were collected from patient journals. Histopathologic data were evaluated and revised by an expert pathologist. The prognostic impact of selected clinicopathologic variables was analyzed in the whole cohort. Tissue microarrays were prepared from 292 carcinomas, and p53 and humanepidermal growth factor receptor 2 protein levels were evaluated by immunohistochemistry. Fresh frozen samples from overlapping cervical carcinomas previously were subjected to human papilloma virus typing (n=94), whole exome (n=100) and RNA (n=79) sequencing; the results were available for our analyses. RESULTS: Among the clinicopathologic variables, vascular space invasion, histologic type, and tumor size were verified as strong independent prognostic markers. High p53 protein levels were associated significantly with markers for aggressive phenotype and survival, also in multivariate survival analysis, but did not reflect TP53 mutational status. High humanepidermal growth factor receptor 2 protein levels were identified in 21% of all tumors. ERBB2 amplification was associated with poor outcome (P=.003); humanepidermal growth factor receptor 2 protein level was not. CONCLUSIONS: Our findings support that the Féderation Internationale de Gynécologie et d'Obstétrique s guidelines should include vascular space invasion and tumor size 2-4 cm and that careful selection of histologic type is essential for stratification of patient risk groups. High p53 levels independently predict poor survival yet do not reflect mutational status in cervical cancer. Amplified ERBB2 significantly links to poor survival, while HercepTest does not. With optimal stratification, humanepidermal growth factor receptor 2-based therapy may improve cervical cancer treatment.
Authors: Njål Lura; Kari S Wagner-Larsen; David Forsse; Jone Trovik; Mari K Halle; Bjørn I Bertelsen; Øyvind Salvesen; Kathrine Woie; Camilla Krakstad; Ingfrid S Haldorsen Journal: Insights Imaging Date: 2022-06-17
Authors: Benjamin W Wormald; Simon J Doran; Thomas Ej Ind; James D'Arcy; James Petts; Nandita M deSouza Journal: Gynecol Oncol Date: 2019-11-02 Impact factor: 5.482