The association of progesterone receptor and abnormal p53 expression in endometrioid endometrial cancer.

Authors

Ting-Chang Chang

Ting-Chang Chang

Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

Ting-Chang Chang , Ren-Chin Wu , Shih-Ming Jung , Shir-Hwa Ueng , Wei-Yang Chang , Hung-Hsueh Chou , Kuan-Gen Huang , Huei-Jean Huang , Angel Chao , Yun-Hsin Tang , Perera Lynn , Chyong-Huey Lai

Organizations

Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan, Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan; Gynecologic Cancer Research Center, Chang Gung Memo, Taoyuan City, Taiwan, Department of Pathology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Linkou Chang Gung Memorial Hospital of Linkou, Taoyuan, Taiwan, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou branch, Taoyuan, Taiwan, Gynecologic Cancer Research Center, Chang Gung Memorial Hospital; Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Chang Gung Memorial Hospital, Taoyuan City, Taiwan, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan

Research Funding

Other Government Agency
Ministry of Science and Technology, Taiwan, Chang Gung Medical Foundation

Background: Based on the TCGA endometrial cancer study results, a clinically applicable classification that identifies distinct subgroups with prognostic signature, the Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE), has been built and validated. It shows that those with abnormal expression of p53 (p53abn) are the group with the worst prognosis. We attempted to explore the association of p53abn and progesterone receptor (PR) in endometrioid endometrial cancer. Methods: We included 397 consecutive endometrial cancer cases of endometrioid histology with adequate tumor tissue in the formalin-fixed, paraffin-embedded (FFPE) block and available follow-up information. This study was granted by Chang Gung Medical Foundation IRB 201702242B0D001. Sanger sequencing to assess the POLE exonuclease domain hotspot mutations of exon 9-14 and immunohistochemical staining on FFPE tumor tissue sections for p53, ER, PR, and mismatch repair proteins were performed. Immunohistochemical p53 expression of cancer cell nucleus was recorded as completely negative (0%), weakly positive (1-59%), and diffusely strong positive (>60%). Tumors with weak positive p53 staining were defined as p53 wild type (p53wt), while the other two were defined as p53 abnormal (p53abn). PR scores were calculated by multiplying the average staining intensity by the tumor cell nucleus stained percentage. We arbitrarily defined a progesterone receptor score of 100 or higher as positive (PR+). Progression-free and endometrial cancer-specific overall survivals starting at the date of diagnosis were evaluated using Kaplan-Meier method and compared by log-rank test between groups. Results: PR was positive in 82% of all studied cases. Of the 48 cases with p53abn tumor, 35(73%) were PR (+). With a median follow-up of 74 months, the progression-free survival and cancer-specific survival of patients with PR+ tumors (N = 310) were 93% and 96.8%, respectively, compared with 75% and 85.7% of those with PR- tumors (N = 70) (both p < 0.001, log-rank test). Among those with P53abn, PR expression was associated with a favorable progression-free survival (p = 0.081) and better cancer-specific survival (p = 0.044). POLEmut, POLE mutated; dMMR, deficient mismatch repair PR+, progesterone receptor score ≥100, ER+, estrogen receptor score ≥100; p53abn, abnormal p53 expression. MMR was undetermined in 32 cases, PR in 17 cases, ER in 17 cases, and p53 was undetermined in 10 cases. POLE status was detected in all cases. Cases with POLE wild type, proficient mismatch repair, progesterone score < 100, estrogen score < 100 and wild type p53 were not listed in this table. Conclusions: Our study showed that incorporating PR into prognostic molecular markers for endometrioid endometrial cancer might provide further risk stratification.

POLEmutdMMRPR+ER+P53abn
POLEmut44
dMMR376
PR+2954310
ER+1933176187
P53abn16351248

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Uterine Cancer

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e17611)

DOI

10.1200/JCO.2023.41.16_suppl.e17611

Abstract #

e17611

Abstract Disclosures