Deoxyribonucleic acid ploidy in endometrial carcinoma: A reproducible and valid prognostic marker in a routine diagnostic setting

Institute of Clinical Medicine, University of Bergen, and Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 10/2009; 201(6):603.e1-7. DOI: 10.1016/j.ajog.2009.07.029
Source: PubMed


The objective of the study was to investigate the prognostic impact of deoxyribonucleic acid (DNA) ploidy in endometrial carcinoma in a routine diagnostic series as compared with a research series.
We studied a population-based series of 363 endometrial carcinomas prospectively collected, with long and complete follow-up. The prognostic value of DNA ploidy was investigated in a routine diagnostic series (n=262) and compared with the results from a previous research series (n=101).
The proportion of DNA aneuploid tumors was 21% in the research series and 25% in the routine diagnostic series (P=NS). In both series, DNA aneuploidy was significantly correlated to higher age at diagnosis, nonendometrioid subtype, and high histologic grade. Patients with DNA aneuploid tumors had significantly poorer survival, adjusted for established clinicopathologic prognostic factors.
DNA ploidy estimation in endometrial carcinoma adds independent prognostic information in a routine diagnostic setting.

5 Reads
    • "However, results from multivariate analyses are conflicting (Terada, 2012;Mauland et al, 2014), where some studies demonstrate an independent effect on survival (Lundgren et al, 2004;Susini et al, 2007;Zaino et al, 1998), whereas others do not (Pfisterer et al, 1995;Larson et al, 1999). One prospective implementation study has shown an independent prognostic effect in a routine diagnostic setting (Wik et al, 2009). Furthermore, the vast majority of studies are performed on hysterectomy specimens, and only a few studies have assessed the value of DNA ploidy in curettage samples as a predictor of poor outcome (Mariani et al, 2000;Fredstorp-Lidebring et al, 2001;Steinbakk et al, 2011;Pradhan et al, 2012) or the relationship to lymph node status (Mariani et al, 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Preoperative risk stratification is essential in tailoring endometrial cancer treatment, and biomarkers predicting lymph node metastasis and aggressive disease are aspired in clinical practice. DNA ploidy assessment in hysterectomy specimens is a well-established prognostic marker. DNA ploidy assessment in preoperative curettage specimens is less studied, and in particular in relation to the occurrence of lymph node metastasis. Curettage image cytometry DNA ploidy in relation to established clinicopathological variables and outcome was investigated in 785 endometrial carcinoma patients prospectively included in the MoMaTEC multicentre trial. Diploid curettage status was found in 72.0%, whereas 28.0% were non-diploid. Non-diploid status significantly correlated with traditional aggressive postoperative clinicopathological features, and was an independent predictor of lymph node metastasis among FIGO stage I-III patients in multivariate analysis (OR 1.94, P=0.033). Non-diploid status was related to shorter disease-specific survival (5-year DSS of 74.4% vs 88.8% for diploid curettage, P<0.001). When stratifying by FIGO stage and lymph node status, the prognostic effect remained. However, in multivariate regression analysis, preoperative histological risk classification was a stronger predictor of DSS than DNA ploidy. Non-diploid curettage is significantly associated with aggressive clinicopathological phenotype, lymph node metastasis, and poor survival in endometrial cancer. The prognostic effect was also observed among subgroups with (presumably) less aggressive traits, such as low FIGO stage and negative lymph node status. Our results indicate curettage DNA ploidy as a possible supplement to existing parameters used to tailor surgical treatment.British Journal of Cancer advance online publication 21 April 2015. doi:10.1038/bjc.2015.123
    No preview · Article · Apr 2015 · British Journal of Cancer
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper introduces an efficient technique for designing a parameterized family of one- and multi-dimensional filters by regarding it as a single multi-dimensional filter. The new design technique is very fast since it reduces the design of a large set of filters to the design of a complex or real one-dimensional filter which is then mapped to produce the desired set of filters. It has the additional advantage that the one- and multi-dimensional filters in the set can be designed and realized efficiently without having to explicitly compute the coefficients of the separate filters. Among the types of filters which can be designed with this technique are seismic migration filters and linear-phase filters
    Preview · Conference Paper · Jun 1996
  • [Show abstract] [Hide abstract]
    ABSTRACT: DNA ploidy has been reported to be a prognostic marker for patients with endometrial carcinoma. In this study, DNA ploidy and histologic heterogeneity were evaluated by comparing curettage and hysterectomy specimens in 99 consecutive patients diagnosed with endometrial carcinoma. High-resolution DNA ploidy image analysis and review of histologic specimens were performed. The histologic subtypes were identical in 77 (78%) and differed in 22 (22%) cases. The DNA ploidy results were concordant in the curettage and hysterectomy specimens in 72 (72.7%) and discordant in 27 (27.3%) cases. Histologic heterogeneity was significantly associated with DNA ploidy heterogeneity (P=0.03). On the basis of histologic heterogeneity, DNA ploidy-discordant cases were divided into 2 groups. One group (16.2% of cases) consisted of specimens with similar histology in curettage and hysterectomy, all belonging to the endometrioid subtype. This group showed DNA ploidy discordance because of a DNA diploid peak in 1 specimen and an aneuploid peak (DI=1.05-1.2) in the other. The other group (11.1% of cases) consisted of cases with different histologic subtype or grade and showed a more pronounced DNA ploidy difference (diploid vs. aneuploid with DI>1.2). Our results suggest that the DNA ploidy results of the hysterectomy and curettage specimens are not identical. The difference observed, which we believe reflects the intratumoral heterogeneity, should be taken into account when applying DNA ploidy to endometrial carcinoma specimens.
    No preview · Article · Sep 2010 · International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists
Show more