Transformed Follicular Lymphoma (TFL) Predicts Outcome in Advanced Endometrial Cancer
Transformed Follicular Lymphoma (TFL) Predicts Outcome in Advanced Endometrial Cancer
复制标题
DOI：
10.1158/1055-9965.epi-17-0762
复制
发表时间：
2018-08-01
影响因子：
3.8
通讯作者：
Sudo, Tamotsu
中科院分区：
文献类型：
--
作者：
Wakahashi, Senn;Kawakami, Fumi;Sudo, Tamotsu
背景：转化型滤泡性淋巴瘤(TFL，ZC3H12D)是一种候选抑癌基因，通过调节Rb的磷酸化而导致细胞周期停滞，但其临床影响尚不清楚。本研究的目的是评价TFL表达在晚期子宫内膜癌中的预后意义。方法：收集103例国际妇产科联合会III-IV期子宫内膜癌患者的组织标本。结果：TFL低表达24例(23.3%)，单因素分析10年无进展生存期(PFS)和总生存期(OS)均低于TFL表达正常者(PFS，P=0.003；OS，P=0.106)。在多变量分析中，调整协变量后，TFL状态是PFS[HR=2.76；95%可信区间(CI)1.45~5.28；P=0.002]和OS(HR=1.94；95%CI=0.91~4.11；P=0.085)的显著预测因素。TFL基因定位于人类染色体6q25.1，雌激素受体α基因ESR1也位于该染色体上。ERα表达缺失是早期子宫内膜癌预后较差的因素。在41例ERα低的患者中，15例TFL低的患者10年生存率显著降低(单因素分析，P=0.055；多因素分析，HR=4.7；95%CI，1.68-13.20；P=0.003)。结论：无论ERα状态如何，TFL都是一个很强的独立预后因素。(C)2018年AACR。
Background: Transformed follicular lymphoma (TFL, ZC3H12D) was identified as a candidate tumor suppressor gene that contributes to cell-cycle arrest through regulation of Rb phosphorylation, but the clinical impact of TFL is unknown. The goal of this study was to evaluate the prognostic significance of TFL expression in advanced endometrial cancer.Methods: Tissue samples were obtained from 103 patients with Federation Internationale des Gynaecologistes et Obstetristes stage III-IV endometrial cancer. Associations between TFL expression and outcomes were evaluated using the Kaplan-Meier method and multivariate Cox proportional hazards regression models.Results: There were 24 TFL-low cases (23.3%) and the 10-year progression-free survival (PFS) and overall survival (OS) in these cases were lower than those for patients with normal TFL expression in univariate analysis (PFS, P = 0.003; OS, P = 0.106). In multivariate analysis, TFL status was a significant predictor for PFS [HR = 2.76; 95% confidence interval (CI), 1.45-5.28; P = 0.002] and OS (HR = 1.94; 95% CI, 0.91-4.11; P = 0.085), adjusted for covariates. The TFL gene maps to human chromosome 6q25.1, where estrogen receptor alpha (ER alpha) gene ESR1 is also located. Lack of ER alpha expression is a poor prognostic factor in early endometrial cancer. Among 41 ER alpha-low patients, 10-year PFS was significantly lower in 15 TFL-low cases (univariate analysis, P = 0.055; multivariate analysis, HR = 4.70; 95% CI, 1.68-13.20; P = 0.003).Conclusions: We identified TFL as a strong independent prognostic factor, regardless of ER alpha status.Impact: An investigation of the mechanism underlying tumor suppression by TFL may lead to new thderapies for patients with advanced endometrial cancer. (C) 2018 AACR.