Expression of netrin‐1 in uterine serous carcinoma and its association with prognosis

• Published in: International journal of gynecology and obstetrics 2024-09, Vol.166 (3), p.1337-1344
• Main Authors: Ucuncu Kefeli, Aysegul, Yaprak Bayrak, Busra, Betul Tunce, Esra, Vural, Cigdem, Suyusal, Ibrahim Halil, Kefeli, Umut, Aksu, Maksut Gorkem
• Format: Article
• Language: English
• Subjects: biomarker; immunohistochemistry; netrin‐1; prognosis; uterine serous carcinoma
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.15513

Background/Objectives At present, there are few biomarkers used to predict the prognosis of uterine serous carcinoma (USC). Netrin‐1 may be a promising biomarker candidate. We investigated netrin‐1 expression in USC tissues and healthy endometrial tissues to determine its relevance to disease prognosis. Materials and Methods Netrin‐1 expression was examined in the tissues of 48 patients with USC and 30 patients with healthy benign endometrial tissues via immunohistochemistry. Results None of the healthy tissues were stained with netrin‐1. In tumor tissues, the overall positivity rate of netrin‐1 was 75%, detected as high expression in 17 patients (35%) and low in 19 (40%). Patients who had tumors with no netrin‐1 expression (n = 12) had a median overall survival (OS) of 60.0 months (95% confidence interval [CI], 47–98), whereas patients who had tumors with low to strong netrin‐1 expression (n = 33) had a lower median OS of 50 months, but the difference was not statistically significant (95% CI, 58–108; P = 0.531). Disease‐free survival (DFS) was not statistically significant between the groups (95% CI, 67.7–115.9; P = 0.566). Patients with a tumor diameter ≥2 cm had higher netrin‐1 expression than those with a tumor diameter of 2 cm (P = 0.027). We did not find any difference in overall and DFS when age, tumor stage, histology, tumor diameter, p53 status, lymphovascular space invasion, myometrial invasion, and lymph node metastasis were compared according to netrin‐1 expression (P > 0.05). Conclusion Netrin‐1 was expressed in USC but not in healthy tissues. Its expression was not associated with OS or DFS. Synopsis Netrin‐1 is highly expressed in uterine serous carcinoma but not in healthy tissues; however, its association with survival remains unknown.