Deoxyribonucleic acid ploidy in endometrial carcinoma: a reproducible and valid prognostic marker in a routine diagnostic setting

Wik, Elisabeth; Trovik, Jone; Iversen, Ole Erik; Engelsen, Ingeborg B.; Stefansson, Ingunn M.; Vestrheim, Liv C.; Haugland, Hans Kristian; Akslen, Lars A.; Salvesen, Helga B.

doi:10.1016/j.ajog.2009.07.029

Cited by 25 publications

(36 citation statements)

References 355 publications

(505 reference statements)

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“…MSS-aneuploid subtype tumors had pathological features similar to those of MSI tumors, since they frequently presented higher grade, advanced stage and vascular involvement. The association of aneuploidy with a more aggressive clinical phenotype in EC is well documented [4, 27, 28]. According to our data, MSS-diploid tumors display a more benign phenotype (differentiated grade, early stage and absence of vascular invasion) compared to MSI and MSS-aneuploid tumors.…”

Section: Discussionsupporting

confidence: 70%

“…Conversely, several groups have referred an association of MSI with better [23, 24], or worse [25] outcome in series including only endometrioid tumors or both histological types. As for the prognostic value of ploidy in EC, latest publications suggest that is a statistically independent prognosticator of poor outcome through multivariate analysis [4, 27, 28]. …”

Section: Discussionmentioning

confidence: 99%

“…Published data about the clinical impact of MSI are conflicting [21-26], and recent studies have related aneuploidy to worse clinical behavior [4, 27, 28]. …”

Section: Introductionmentioning

confidence: 99%

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Microsatellite instability and ploidy status define three categories with distinctive prognostic impact in endometrioid endometrial cancer

et al. 2014

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Microsatellite instability (MSI) and aneuploidy are inversely related phenomena. We tested whether ploidy status influences the clinical impact of MSI in endometrioid endometrial cancer (EEC). We analyzed 167 EECs for MSI and ploidy. Tumors were classified in three categories according to MSI and ploidy status. Associations with clinicopathological and molecular variables, survival, and treatment response were assessed.All MSI tumors (23%) were scored as diploid, and 14% of microsatellite stable (MSS) tumors presented aneuploidy. MSI tumors associated with older age at diagnosis, non-obesity, high histological grade, and advanced surgical stage. MSS-aneuploid tumors also associated with higher grade and advanced stage. In multivariate survival analysis MSI did not influence disease-free survival (DFS) or cancer-specific survival (CSS). However, when just diploid tumors were considered for the analysis, MSI significantly contributed to worse DFS and CSS, and the same was observed for aneuploidy when MSS tumors were analyzed alone. In diploid tumors, a differential response to postoperative radiotherapy (RT) was observed according to MSI, since it predicted poor DFS and CSS in the multivariate analysis.We conclude that ploidy status influences the clinical impact of MSI in EEC. Among diploid tumors those with MSI have poor clinical outcome and respond worse to RT.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Microsatellite instability and ploidy status define three categories with distinctive prognostic impact in endometrioid endometrial cancer

et al. 2014

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“…132 Small-scale studies 163 Regarding plasma level of GDF-15, further studies are needed to explore the applicability of GDF-15 measurements as a marker for stratification for lymph node sampling or for early detection of recurrence in routine follow-up.…”

Section: Future Perspectivesmentioning

confidence: 99%

Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective

Trovik

Mauland

Werner

et al. 2012

Gynecologic Oncology

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“…Tumor DNA ploidy, a relatively objective parameter, has been shown to be an important prognostic marker for patients with EC in several studies (7)(8)(9)(10)(11), outperforming even surgical staging (9), and has been suggested as a predictive factor when included in treatment planning (12,13). Patients with DNA diploid EC have significantly lower death rates and longer recurrence-free survival compared with those with DNA aneuploid tumors (7,9,14,15).…”

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confidence: 99%

DNA Ploidy Heterogeneity in Endometrial Carcinoma

Pradhan

Abeler

Davidson

et al. 2010

International Journal of Gynecological Pathology

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DNA ploidy has been reported to be a prognostic marker for patients with endometrial carcinoma. In this study, DNA ploidy and histologic heterogeneity were evaluated by comparing curettage and hysterectomy specimens in 99 consecutive patients diagnosed with endometrial carcinoma. High-resolution DNA ploidy image analysis and review of histologic specimens were performed. The histologic subtypes were identical in 77 (78%) and differed in 22 (22%) cases. The DNA ploidy results were concordant in the curettage and hysterectomy specimens in 72 (72.7%) and discordant in 27 (27.3%) cases. Histologic heterogeneity was significantly associated with DNA ploidy heterogeneity (P=0.03). On the basis of histologic heterogeneity, DNA ploidy-discordant cases were divided into 2 groups. One group (16.2% of cases) consisted of specimens with similar histology in curettage and hysterectomy, all belonging to the endometrioid subtype. This group showed DNA ploidy discordance because of a DNA diploid peak in 1 specimen and an aneuploid peak (DI=1.05-1.2) in the other. The other group (11.1% of cases) consisted of cases with different histologic subtype or grade and showed a more pronounced DNA ploidy difference (diploid vs. aneuploid with DI>1.2). Our results suggest that the DNA ploidy results of the hysterectomy and curettage specimens are not identical. The difference observed, which we believe reflects the intratumoral heterogeneity, should be taken into account when applying DNA ploidy to endometrial carcinoma specimens.

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Deoxyribonucleic acid ploidy in endometrial carcinoma: a reproducible and valid prognostic marker in a routine diagnostic setting

Abstract: DNA ploidy estimation in endometrial carcinoma adds independent prognostic information in a routine diagnostic setting.

Cited by 25 publications

References 355 publications

Microsatellite instability and ploidy status define three categories with distinctive prognostic impact in endometrioid endometrial cancer

Microsatellite instability and ploidy status define three categories with distinctive prognostic impact in endometrioid endometrial cancer

Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective

DNA Ploidy Heterogeneity in Endometrial Carcinoma

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