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Rui Kitadai,Tadaaki Nishikawa,Hiroshi Yoshida,Chiharu Mizoguch,Kasumi Yamamoto,Tomoyasu Kato,Kan Yonemori 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.2
Objective: This study aimed to evaluate mesothelin (MSLN) expression and determine itsclinical significance and correlation with human epidermal growth factor receptor 2 (HER2)expression in gynecological carcinosarcoma. Methods: We retrospectively evaluated patients with uterine carcinosarcoma (UCS)and ovarian carcinosarcoma (OCS) who under went surger y between 1997 and 2019. Immunohistochemical staining of formalin-fixed, paraffin-embedded specimens for MSLN(clone SP74) and HER2 (clone 4A5) was also performed. MSLN was scored using the H-scoreand 4-tired scoring system (0–3+). MSLN positivity was defined as any positive cell at anyintensity, while high MSLN expression was defined as an intensity of ≥2+ in ≥30% of tumorcells. HER2 expression was scored according to modified 2018 American Society of ClinicalOncology/College of American Pathologists criteria. Results: A total of 128 patients were recruited, including 119 with UCS and 9 with OCS. All cases in UCS exhibited MSLN positivity, and 33.9% showed high-MSLN expression. Clinicopathological characteristics were not significantly associated with high or low-MSLNexpression. However, the high-MSLN group showed more prolonged overall sur vival (OS)than the low-MSLN group (not assessed vs. 36.8 months; hazard ratio=0.48, 95% confidenceinter val=0.26–0.89, p=0.016). HER2-high patients had higher MSLN expression than HER2-negative patients. In high-MSLN and low-MSLN expression groups, HER2 status did notaffect OS. OCS showed 100% MSLN positivity, with 66.6% high-MSLN. Conclusion: MSLN expression is widely obser ved in gynecological carcinosarcomas. Moreover, high-MSLN expression is a favorable prognostic factor for UCS. MSLN could be apromising therapeutic target for UCS, even in the era of anti-HER2 therapy.
Shu Yazaki,Yuki Kojima,Hiroshi Yoshida,Shigemasa Takamizawa,Rui Kitadai,Tadaaki Nishikawa,Tatsunori Shimoi,Kazuki Sudo,Ayumi Saito,Hitomi Sumiyoshi Okuma,Maki Tanioka,Emi Noguchi,Masaya Uno,Mitsuya Is 대한부인종양학회 2022 Journal of Gynecologic Oncology Vol.33 No.6
Objective: Folate receptor α (FRα) is a membrane protein expressed in various solid tumors but has limited expression in normal cells. Therefore, FRα is an attractive target for cancer treatment. This study aimed to investigate the relationship between FRα expression and the clinicopathological characteristics and survivals of cervical cancer. Methods: This retrospective study included patients with cervical cancer who underwent primary surgery between 2000 and 2020 at our institution. Immunohistochemical staining of FRα was performed using an anti-folate-binding protein/FBP antibody. FRα-positive staining was defined as ≥5% of tumor staining and FRα-high as ≥50% tumor staining with ≥2+ intensity. The association between FRα expression and survival was assessed using multivariate Cox regression analysis, adjusting for established prognostic factors. Results: Overall, 123 patients were identified, and 140 tumor samples, including 17 paired primary and metastatic samples, were evaluated. As histological types, 67 patients had squamous cell carcinoma (SCC), and 56 patients had non-SCC. All primary tumors were FRα-positive. High FRα expression was observed in 25% of the cases and differed according to histology (SCC vs. non-SCC, 14.9% vs. 37.5%, p=0.004). FRα expression was significantly higher in metastatic tumors than in primary (170 [IQR, 140–205] vs. 125 [IQR, 110–150], p=0.0006). High FRα expression was significantly associated with worse overall survival (hazard ratio, 6.73; 95% confidence interval, 2.21–20.53; p=0.001). Conclusion: In cervical cancer, FRα expression was elevated in metastatic tumors and high expression was associated with a worse prognosis. Our study supports the development of FRα-targeted therapy for advanced cervical cancer.