ER and PR expression and survival after endometrial cancer

作者：Smith, Deborah; Stewart, Colin J. R.; Clarke, Edward M.; Lose, Felicity; Davies, Claire; Armes, Jane; Obermair, Andreas; Brennan, Donal; Webb, Penelope M.; Nagle, Christina M.; Spurdle, Amanda B.^*

来源：Gynecologic Oncology, 2018, 148(2): 258-266.

DOI：10.1016/j.ygyno.2017.11.027

• Endometrial cancer
• Survival
• Hormone receptor status
• ER
• PR

Objective. To measure association between endometrial carcinoma ER and PR status and endometrial cancer (EC) survival, accounting for inter-observer variation. @@@ Methods. The intensity and proportion of tumor cell expression of ER and PR in ECs were assessed independently and semi-quantitatively by two pathologists using digital images of duplicate tumor tissue microarrays (TMAs). Cases with inconsistent initial assessment were reviewed and final scoring agreed. The association between overall and EC-specific survival and hormone receptor expression (intensity, proportion and combined) was assessed using Cox regression analysis. The C-index was used to evaluate model discrimination with addition of ER and PR status. @@@ Results. Tumor ER and PR analysis was possible in 659 TMAs from 255 patients, and in 459 TMAs from 243 patients, respectively. Initial ER and PR scoring was consistent in 82% and 80% of cases, respectively. In multivariate analyses decreased ER and PR expression was associated with increased tumor-related mortality. Associations reached statistical significance for ER proportion score (P = 0.05), ER intensity score (P = 0.003), and PR combined score (P = 0.04). Decreased expression of combined ER/PR expression was associated with poorer EC-specific survival than decreased expression of either hormone receptor alone (P = 0.005). However, hormone receptor status did not significantly improve mortality prediction in individual cases. @@@ Conclusion. ER and PR expression combined, using cut-points that capture variation in scoring and across cores, is significantly associated with EC-specific survival in analyses adjusting for known prognostic factors. However, at the individual level, ER and PR expression does not improve mortality prediction.

• 出版日期2018-2