Preoperative Risk Stratification of Endometrial Carcinoma : L1CAM as a Biomarker

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Pasanen , A , Loukovaara , M , Tuomi , T & Butzow , R 2017 , ' Preoperative Risk Stratification of Endometrial Carcinoma : L1CAM as a Biomarker ' , International Journal of Gynecological Cancer , vol. 27 , no. 7 , pp. 1318-1324 . https://doi.org/10.1097/IGC.0000000000001043

Title: Preoperative Risk Stratification of Endometrial Carcinoma : L1CAM as a Biomarker
Author: Pasanen, Annukka; Loukovaara, Mikko; Tuomi, Taru; Butzow, Ralf
Other contributor: University of Helsinki, Medicum
University of Helsinki, University of Helsinki
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Department of Pathology





Date: 2017-09
Language: eng
Number of pages: 7
Belongs to series: International Journal of Gynecological Cancer
ISSN: 1048-891X
DOI: https://doi.org/10.1097/IGC.0000000000001043
URI: http://hdl.handle.net/10138/311349
Abstract: Objective Preoperative or intraoperative risk assessment models are used to stratify patients with endometrial carcinoma to lymphadenectomy. Our aim was to determine whether preoperative analysis of L1 cell adhesion molecule (L1CAM) can improve risk assessment. Methods Immunohistochemical L1CAM staining was performed on endometrial biopsies of 241 patients and paired hysterectomy samples of 75 patients. Risk assessment models based on preoperative histologic type and grade, myometrial invasion, and/or tumor diameter and alternative models incorporating preoperative L1CAM were compared with regard to their capability of predicting lymph nodal or distant metastasis. Soluble L1 levels were measured by enzyme-linked immunosorbent assay in serum samples of 40 patients with endometrial carcinoma. Results The concordance rate between L1CAM staining results of preoperative and hysterectomy samples was moderate ( = 0.586, P <0.0001). Preoperative L1CAM expression was associated with nonendometrioid histology, lymph node involvement, advanced stage, and positive peritoneal cytology. Receiver operating characteristic curve analyses showed that L1CAM did not significantly improve risk stratification algorithms based on traditional risk factors. Intraoperative tumor diameter was an effective surrogate for myometrial invasion. There was no statistical difference between L1 serum levels of patients with an L1CAM-positive or L1CAM-negative endometrial carcinoma (P = 0.786). Conclusions L1 cell adhesion molecule expression in endometrial biopsy correlates with high-risk features of endometrial carcinoma but does not significantly improve risk stratification algorithms based on traditional factors. Soluble L1 detected in the serum of patients with endometrial carcinoma does not correlate with tumoral L1CAM expression.
Subject: Endometrial cancer
L1CAM
Lymphadenectomy
Risk stratification
Soluble L1CAM
INTRAOPERATIVE GROSS EXAMINATION
LYMPH-NODE METASTASIS
MYOMETRIAL INVASION
TUMOR DIAMETER
FROZEN-SECTION
CANCER
PREDICTOR
DISSEMINATION
SURVIVAL
L1
3122 Cancers
3123 Gynaecology and paediatrics
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