Evaluation of prognostic predictive factor of fertility preserving hormone therapy for young patients with endometrial cancer

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K09607
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Keio University
• Principal Investigator: Wataru Yamagami 慶應義塾大学, 医学部(信濃町), 教授 (30348718)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 妊孕性温存療法 / 子宮体癌 / 子宮内膜異型増殖症 / 黄体ホルモン / 遺伝子パネル検査 / 免疫組織化学

Outline of Final Research Achievements

The aim of this study was to comprehensively clarify clinicopathological and molecular genetic factors in young-onset endometrial cancer/ atypical endometrial hyperplasia (AEH). In 35 cases of endometrial cancer/ AEH, gene expression and copy number were analyzed using the gene panel test "PleSSision-Rapid", and immunohistochemical staining was performed on FFPE specimens.
Patients with PTEN pathological valiant had significantly lower tumor disappearance rates, and those with PIK3CA pathological valiant had significantly poorer recurrence-free survival rates. In addition, p53 partially-positive cases tended to have a lower tumor disappearance rate.
Only histological type was extracted as a significant factor in the multivariate analysis of clinicopathological factors, gene panel sequencing and immunohistochemistry.

Free Research Field

婦人科腫瘍学

Academic Significance and Societal Importance of the Research Achievements

子宮体癌や子宮内膜異型増殖症に対する妊孕性温存療法の病変消失率や無再発生存期間を予測するマーカー遺伝子変異やタンパク変異を同定することができた。治療前の子宮内膜組織を用いて、治療効果を予測可能であることが示されたことで、妊孕性温存療法の選択の適否やその後の不妊治療の要否などが部分的ではあるものの、治療前に予測可能となったといえる。また、治療成績が良好である子宮全摘を含む標準治療を施行するべきかどうかの意志決定にも利用可能と考えられた。