Background
Synuclein-γ (SNCG) is highly expressed in advanced solid tumors, including in uterine serous carcinoma (USC). The goal was to determine if SNCG protein was associated with survival and clinical covariates using the largest existing collection of USC from the Gynecologic Oncology Group (GOG-8023).
Methods
High-density tissue microarrays (TMAs) of tumor tissues of 313 patients with USC were stained by immunohistochemistry (IHC) for SNCG, p53, p16, FOLR1, pERK, pAKT, ER, PR, and HER2/neu. Association of SNCG and other tumor markers with overall and progression-free survival was assessed using Logrank tests and Cox proportional hazards models including adjustment for age, race, and stage.
Results
Overall survival at 5 years was 46% for high and 62% for low SNCG expression groups (logrank p=0.021, hazard ratio [HR]=1.31, 95% confidence interval [CI]= 0.91-1.9 in adjusted Cox model). Progression free survival at 5 years was worse for high SNCG at 40% compared to 56% for low SNCG (logrank p=0.0081, [HR]=1.36, 95% [CI]= 0.96-1.92 in adjusted Cox model). High levels of both p53 and p16 were significantly associated with worse overall survival (p53: [HR]=4.20, 95% [CI]=1.54-11.45; p16: [HR]= 1.95, 95% [CI]=1.01-3.75) and progression-free survival (p53: [HR]= 2.16, 95% [CI]=1.09-4.27; p16: ([HR]= 1.53, 95% [CI]=0.87-2.69) compared to low levels.
Conclusions
This is the largest collection of USC cases to date demonstrating that SNCG was associated with poor survival in USC in univariate analyses. SNCG does not predict survival outcome independently of p53 and p16 in models that jointly consider multiple markers.