Clinical implications and prognostic value of five biomarkers in endometrial carcinoma

Objective

The aim was to identify the relationship between ER, PR, P53, Ki-67, PTEN, the association with clinicopathological parameters and the correlation with survival.

Methods

We studied 190 cases of primary endometrial carcinoma in which ER, PR, Ki-67, P53, PTEN antigens were investigated with the use of immunohistochemical methods. To evaluate the correlations among immunohistochemical staining and the age, menopause status, histological type, FIGO stage, grading, depth of invasion, lymph nodes involvement and serum tumor marker. Survival analysis was assessed within single and combined biomarkers types.

Results

The percentage of Ki-67 and P53 positive endometrial tumors was significantly higher in ER negative vs ER positive tumors (both P = 0.000). The same trend was evident in PR positive and negative group. The percentage of PTEN positive tumors was significantly higher in PR positive versus PR negative tumors (P = 0.021) but was no difference in different ER status. ER and PR status were significant predictors with FIGO staging, grading and recurrence. There was no clear association between PTEN positivity and clinicopathological parameters except more relevance with endometrioid histotype (P = 0.013). Positive Ki-67 or P53 was found to be strictly related to more aggressive features. There was statistically significant difference in different status of P53 and Ki-67 in survival time.

Conclusion

ER and PR positive tumors showed a statistically significant association with better clinical outcome, PR has more significant influence on prognosis. The percentage of positive Ki-67 or P53 was significantly higher in hormone-independent group versus in hormone-dependent group and combined Ki-67 and P53 may have more effect on prognosis in former group.