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High AGR2 protein is a feature of low grade endometrial cancer cells.

ABSTRACT: Background:Biomarkers for identification of endometrial cancers (ECs) with high risk of recurrence are required to reduce the rising EC-related mortality. AGR2 is a prognostic marker in several hormonally-regulated cancers. Aim:To assess the utility of AGR2 as a prognostic marker in EC. Methods:AGR2 immunoexpression was evaluated in 163 human endometrial samples. Change in AGR2 mRNA levels in response to oestrogen and dihydrotestosterone was studied in vitro. Results:Upregulation of AGR2 (protein and mRNA) was seen in low grade EC, compared to the postmenopausal endometrium (P = 0.013) and to the high-grade EC (P < 0.0001). Elevated AGR2 protein expression-scores were associated with a high expression of estrogen alpha (ER?), progesterone, androgen receptors and early clinical stages. Metastatic lesions maintained higher AGR2 expression relative to matched-primary tumors. High-AGR2 protein levels were associated with better overall survival (P = 0.02) in all ECs, but in highly-ER?-expressing ECs, AGR2 associated with unfavourable patient outcome. Androgen through its receptor, downregulated AGR2 mRNA in the Ishikawa cells. Conclusions:AGR2 is overexpressed in low grade ECs and positively associated with hormone receptors. The association between high AGR2 and progressive disease within the high-ER?-expressing ECs suggests that in this group of patients, AGR2 might be a potential biomarker of poor prognosis.

SUBMITTER: Kamal A

PROVIDER: S-EPMC6101135 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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High AGR2 protein is a feature of low grade endometrial cancer cells.

Kamal Areege A Valentijn Anthony A Barraclough Roger R Rudland Philip P Rahmatalla Nihad N Martin-Hirsch Pierre P Stringfellow Helen H Decruze Shandya B SB Hapangama Dharani K DK

Oncotarget 20180731 59

<h4>Background</h4>Biomarkers for identification of endometrial cancers (ECs) with high risk of recurrence are required to reduce the rising EC-related mortality. AGR2 is a prognostic marker in several hormonally-regulated cancers.<h4>Aim</h4>To assess the utility of AGR2 as a prognostic marker in EC.<h4>Methods</h4><i>AGR2</i> immunoexpression was evaluated in 163 human endometrial samples. Change in <i>AGR2</i> mRNA levels in response to oestrogen and dihydrotestosterone was studied <i>in vitr ...[more]

PMID: 30140383

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Project description:ObjectivesThis review examines how response rates to progestin treatment of low-grade endometrial cancer can be improved. In addition to providing a brief overview of the pathogenesis of low-grade endometrial cancer, we discuss limitations in the current classification of endometrial cancer and how stratification may be refined using molecular markers to reproducibly identify 'low-risk' cancers which may represent the best candidates for progestin therapy. We also discuss constraints in current approaches to progestin treatment of low-grade endometrial cancer and perform a systematic review of predictive biomarkers.MethodsPubMed, ClinicalTrials.gov, and Cochrane Library were searched for studies reporting pre-treatment biomarkers associated with outcome in women with low-grade endometrial cancer or endometrial hyperplasia with an intact uterus who received progestin treatment. Studies of fewer than 50 women were excluded. The study protocol was registered in PROSPERO (ID 152374). A descriptive synthesis of pre-treatment predictive biomarkers reported in the included studies was conducted.ResultsOf 1908 records reviewed, 19 studies were included. Clinical features such as age or body mass index cannot predict progestin response. Lesions defined as 'low-risk' by FIGO criteria (stage 1A, grade 1) can respond well; however, the reproducibility and prognostic ability of the current histopathological classification system is suboptimal. Molecular markers can be reproducibly assessed, have been validated as prognostic biomarkers, and may inform patient selection for progestin treatment. DNA polymerase epsilon (POLE)-ultramutated tumors and a subset of p53 wild-type or DNA mismatch repair (MMR)-deficient tumors with 'low-risk' features (eg, progesterone and estrogen receptor-positive) may have improved response rates, though this needs to be validated.DiscussionMolecular markers can identify cases which may be candidates for progestin treatment. More work is needed to validate these biomarkers and potentially identify new ones. Predictive biomarkers are anticipated to inform future research into progestin treatment of low-grade endometrial cancer and ultimately improve patient outcomes.

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High AGR2 protein is a feature of low grade endometrial cancer cells.

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High AGR2 protein is a feature of low grade endometrial cancer cells.

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