Asparaginase‐like protein 1 expression in curettage independently predicts lymph node metastasis in endometrial carcinoma: a multicentre study

• Published in: BJOG : an international journal of obstetrics and gynaecology 2018-12, Vol.125 (13), p.1695-1703
• Main Authors: Fonnes, T, Trovik, J, Edqvist, P‐HD, Fasmer, KE, Marcickiewicz, J, Tingulstad, S, Staff, AC, Bjørge, L, Amant, F, Haldorsen, IS, Werner, HMJ, Akslen, LA, Tangen, IL, Krakstad, C
• Format: Article
• Language: English
• Subjects: Aged; Asparaginase; Asparaginase - metabolism; Asparaginase-like protein 1; Autoantigens - metabolism; biomarker; biomarkers; Biopsy; Cancer and Oncology; Cancer och onkologi; cancer-patients; Carcinoma; Carcinoma - metabolism; Carcinoma - secondary; Carcinoma - surgery; Clinical trials; Curettage; Endometrial cancer; endometrial carcinoma; Endometrial Neoplasms - metabolism; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Endometrium; f-18-fdg pet/ct; Female; Humans; Immunohistochemistry; l1cam; Lymph nodes; Lymphatic Metastasis; Lymphatic system; markers; Metastases; Metastasis; Obstetrics & Gynecology; Obstetrics, Gynecology and Reproductive Medicine; ovarian-cancer; Patients; Predictive Value of Tests; Prognosis; Progression-Free Survival; Proportional Hazards Models; Reproduktionsmedicin och gynekologi; risk; Risk Assessment - methods; specimens; stage; Survival; Survival Rate; tumors; Uterine cancer
• ISSN: 1470-0328; 1471-0528; 1471-0528
• DOI: 10.1111/1471-0528.15403

Objective Correct preoperative identification of high‐risk patients is important to optimise surgical treatment and improve survival. We wanted to explore if asparaginase‐like protein 1 (ASRGL1) expression in curettage could predict lymph node metastases and poor outcome, potentially improving preoperative risk stratification. Design Multicentre study. Setting Ten hospitals in Norway, Sweden and Belgium. Population Women diagnosed with endometrial carcinoma. Methods ASRGL1 expression in curettage specimens from 1144 women was determined by immunohistochemistry. Main outcome measures ASRGL1 status related to disease‐specific survival, lymph node status, preoperative imaging parameters and clinicopathological data. Results ASRGL1 expression had independent prognostic value in multivariate survival analyses, both in the whole patient population (hazard ratio (HR) 1.63, 95% CI 1.11–2.37, P = 0.012) and in the low‐risk curettage histology subgroup (HR 2.54, 95% CI 1.44–4.47, P = 0.001). Lymph node metastases were more frequent in women with low expression of ASRGL1 compared with women with high ASRGL1 levels (23% versus 10%, P