Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.

Autor: da Silva JL; Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., de Albuquerque LZ; Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Rodrigues FR; Division of Pathology, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Bastos NC; Division of Pathology, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Small IA; Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Barroso EBC; Clinical Oncology Section, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Cordero FL; Gynecologic Oncology Section, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Fernandes DS; Gynecologic Oncology Section, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Paulino E; Clinical Oncology Section, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., de Melo AC; Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 May 18; Vol. 18 (5), pp. e0285447. Date of Electronic Publication: 2023 May 18 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0285447
Abstrakt: Background: Uterine Carcinosarcomas (UCS) are a rare type of cancer composed of an admixture of high-grade carcinomatous and sarcomatous elements. Clinicopathological prognostic factors in UCS are well established, but studies that approach the impact of biomarkers in this unusual disease are scarce. The study objective was to evaluate the prevalence and prognostic impact of a panel of prominent biomarkers in uterine carcinosarcoma (UCS) using an immunohistochemical characterization with four biomarkers.
Methods and Findings: The internal database of a single Brazilian institution was carefully explored to select women diagnosed with UCS who were submitted to surgery and postoperative chemotherapy with carboplatin and paclitaxel between January 2012 and December 2017. Tissue microarrays containing UCS samples were evaluated by immunohistochemistry for L1CAM, CDX2, p53 and microsatellite instability markers. A total of 57 cases were included. The mean age was 65.3 years (standard deviation, SD 7.0). L1CAM was negative (score 0, no staining) in 27 (47.4%) patients. Of L1CAM-positive, 10 (17.5%) showed weak (score 1, <10%), 6 (10.5%) showed moderate (score 2, between 10-50%), and 14 (24.6%) showed strong L1CAM staining (score 3, ≧50%). dMMR occurred in 3 (5.3%) cases. The p53 was aberrantly expressed in 15 (26.3%) tumors. CDX2 was positive in 3 (5.3%) patients. The three-year progression-free survival (PFS) rate in the general population of the study was 21.2% (95% CI: 11.7-38.1) and the three-year overall survival (OS) rate was 29.4% (95% CI: 18.1-47.6). By multivariate analysis, the presence of metastases and CDX2-positive were significantly associated with poorer PFS (p < 0.001 and p = 0.002, respectively) and OS (p < 0.001 and p = 0.009, respectively).
Conclusion: The strong influence of CDX2 on prognosis requires further investigation. Biological or molecular variability may have impaired the assessment of the impact of the other markers on survival.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 da Silva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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