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Mismatch repair markers in preoperative and operative endometrial cancer samples; expression concordance and prognostic value.


ABSTRACT:

Background

The endometrial cancer mismatch repair (MMR) deficient subgroup is defined by loss of MSH6, MSH2, PMS2 or MLH1. We compare MMR status in paired preoperative and operative samples and investigate the prognostic impact of differential MMR protein expression levels.

Methods

Tumour lesions from 1058 endometrial cancer patients were immunohistochemically stained for MSH6, MSH2, PMS2 and MLH1. MMR protein expression was evaluated as loss or intact to determine MMR status, or by staining index to evaluate the prognostic potential of differential expression. Gene expression data from a local (n = 235) and the TCGA (n = 524) endometrial cancer cohorts was used for validation.

Results

We identified a substantial agreement in MMR status between paired curettage and hysterectomy samples. Individual high expression of all four MMR markers associated with non-endometrioid subtype, and high MSH6 or MSH2 strongly associated with several aggressive disease characteristics including high tumour grade and FIGO stage, and for MSH6, with lymph node metastasis. In multivariate Cox analysis, MSH6 remained an independent prognostic marker, also within the endometrioid low-grade subgroup (P < 0.001).

Conclusion

We demonstrate that in addition to determine MMR status, MMR protein expression levels, particularly MSH6, may add prognostic information in endometrial cancer.

SUBMITTER: Berg HF 

PROVIDER: S-EPMC9938259 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Mismatch repair markers in preoperative and operative endometrial cancer samples; expression concordance and prognostic value.

Berg Hege F HF   Engerud Hilde H   Myrvold Madeleine M   Lien Hilde E HE   Hjelmeland Marta Espevold ME   Halle Mari K MK   Woie Kathrine K   Hoivik Erling A EA   Haldorsen Ingfrid S IS   Vintermyr Olav O   Trovik Jone J   Krakstad Camilla C  

British journal of cancer 20221208 4


<h4>Background</h4>The endometrial cancer mismatch repair (MMR) deficient subgroup is defined by loss of MSH6, MSH2, PMS2 or MLH1. We compare MMR status in paired preoperative and operative samples and investigate the prognostic impact of differential MMR protein expression levels.<h4>Methods</h4>Tumour lesions from 1058 endometrial cancer patients were immunohistochemically stained for MSH6, MSH2, PMS2 and MLH1. MMR protein expression was evaluated as loss or intact to determine MMR status, or  ...[more]

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