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Kidong Kim,Suhyun Hwangbo,Hyojin Kim,Yong-Beom Kim,Jae Hong No,Dong Hoon Suh,Taesung Park 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.3
Objective: The need to perform genetic sequencing to diagnose the polymerase epsilon exonuclease ( ) subtype of endometrial cancer (EC) hinders the adoption of molecular classification. We investigated clinicopathologic and protein markers that distinguish thefrom the copy number (CN)-low subtype in EC. Methods: Ninety-one samples (15 , 76 CN-low) were selected from The Cancer Genome Atlas EC dataset. Clinicopathologic and normalized reverse phase protein array expression data were analyzed for associations with the subtypes. A logistic model including selected markers was constructed by stepwise selection using area under the curve (AUC) from 5-fold cross-validation (CV). The selected markers were validated using immunohistochemistry (IHC) in a separate cohort. Results: Body mass index (BMI) and tumor grade were significantly associated with the subtype. With BMI and tumor grade as covariates, 5 proteins were associated with theEC subtypes. The stepwise selection method identified BMI, cyclin B1, caspase 8, and X-box binding protein 1 (XBP1) as markers distinguishing the from the CN-low subtype. The mean of CV AUC, sensitivity, specificity, and balanced accuracy of the selected model were 0.97, 0.91, 0.87, and 0.89, respectively. IHC validation showed that cyclin B1 expression was significantly higher in the than in the CN-low subtype and receiver operating characteristic curve of cyclin B1 expression in IHC revealed AUC of 0.683. Conclusion: BMI and expression of cyclin B1, caspase 8, and XBP1 are candidate markers distinguishing the from the CN-low subtype. Cyclin B1 IHC may replace sequencing in molecular classification of EC.
Kim, Se Ik,Lee, Maria,Lee, Sungyoung,Suh, Dong Hoon,Kim, Hee Seung,Kim, Kidong,Chung, Hyun Hoon,No, Jae Hong,Kim, Jae-Weon,Park, Noh Hyun,Song, Yong-Sang,Kim, Yong Beom Elsevier 2019 Gynecologic oncology Vol.155 No.1
<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>To compare survival outcomes of primary laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in patients with FIGO stage IB cervical cancer.</P> <P><B>Methods</B></P> <P>We retrospectively identified stage IB1–IB2 cervical cancer patients who received either LRH (<I>n</I> = 343) or ORH (<I>n</I> = 222) at two tertiary institutional hospitals between 2000 and 2018. To adjust for confounders, we conducted Mahalanobis distance-based sample matching for stage, histology, cervical mass size, parametrial invasion, and lymph node metastasis. Then, survival outcomes were compared between the matched groups. Through the independent matching processes, we narrowed the study population to stage IB1 patients and stage IB1 patients with tumor size ≤2 cm on pre-operative MRI.</P> <P><B>Results</B></P> <P>After matching, LRH group showed poorer progression-free survival (PFS) than ORH group (3-year: 85.4% vs. 91.8%; <I>P</I> = 0.036), whereas no significant difference in overall survival (OS) was found. Regarding recurrence patterns, no significant differences in the incidences of pelvic, retroperitoneal lymph node and abdominal recurrences, or distant metastasis were observed between the two groups. Among the matched patients with stage IB1 who had cervical mass size ≤2 cm, the LRH and ORH groups showed similar PFS (3-year: 90.0% vs. 93.1%; <I>P</I> = 0.8) and OS (5-year: 98.6% vs. 96.4%; <I>P</I> = 0.6).</P> <P><B>Conclusions</B></P> <P>Despite the retrospective design, our matched cohort study suggests that ORH might be preferable for the surgical treatment of FIGO stage IB cervical cancer. However, in stage IB1 patients with tumor size ≤2 cm, LRH might be applicable, as equivalent outcomes were found regardless of the surgical approach. Further prospective studies are warranted.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We conducted a matching study to investigate survival of laparoscopic radical hysterectomy (LRH) in stage IB cervical cancer. </LI> <LI> After matching, LRH group showed a higher recurrence rate compared to open group, whereas overall survival was not different. </LI> <LI> In stage IB1 patients with tumor size ≤2 cm, equivalent survival outcomes were observed regardless of the surgical approach. </LI> </UL> </P>