妇科癌症中的间利素表达：临床病理学意义和与HER2表达的相关性
Mesothelin expression in gynecologic carcinosarcoma: clinicopathological significance and correlation with HER2 expression
影响因子:3.70000
分区:医学2区 / 妇产科学3区 肿瘤学3区
发表日期:2024 Mar
作者:
Rui Kitadai, Tadaaki Nishikawa, Hiroshi Yoshida, Chiharu Mizoguchi, Kasumi Yamamoto, Tomoyasu Kato, Kan Yonemori
摘要
这项研究旨在评估间皮素（MSLN）的表达，并确定其临床意义以及与人类表皮生长因子受体2（HER2）表达在妇科癌症中的表达。我们追溯评估了子宫癌（UCS）和卵巢癌（UCS）和卵巢癌（ovarian Carcinosarcoma and ocs and Ocs）的患者，其中199777名均可进行良好的疗法。还进行了福尔马林固定的，石蜡包裹的标本（克隆SP74）和HER2（克隆4A5）。使用H得分和4型评分系统（0-3+）对MSLN进行评分。 MSLN的阳性在任何强度下定义为任何正细胞，而高MSLN表达被定义为≥30％的肿瘤细胞中的强度≥2+。 HER2表达根据2018年修改后的美国临床肿瘤学会/美国病理学家学院标准进行评分。总共招募了128名患者，其中包括119例使用UCS和9例OCS。 UCS中的所有病例均表现出MSLN阳性，33.9％的MSLN表达较高。临床病理学特征与高或低MSLN表达没有显着相关。但是，高MSLN组的总生存率（OS）比低MSLN组的延长（未评估，而36.8个月；危险比= 0.48，95％置信区间= 0.26-0.89，p = 0.016）。 HER2高患者的MSLN表达高于HER2阴性患者。在高-MSLN和低MSLN表达组中，HER2状态不影响OS。 OCS显示100％MSLN阳性，在妇科癌中广泛观察到66.6％的高MSLN.MSLN表达。此外，高-MSLN表达是UCS的一个有利的预后因素。即使在抗HER2治疗时代，MSLN也可能是UCS的有前途的治疗靶标。
Abstract
This study aimed to evaluate mesothelin (MSLN) expression and determine its clinical significance and correlation with human epidermal growth factor receptor 2 (HER2) expression in gynecological carcinosarcoma.We retrospectively evaluated patients with uterine carcinosarcoma (UCS) and ovarian carcinosarcoma (OCS) who underwent surgery between 1997 and 2019. Immunohistochemical staining of formalin-fixed, paraffin-embedded specimens for MSLN (clone SP74) and HER2 (clone 4A5) was also performed. MSLN was scored using the H-score and 4-tired scoring system (0-3+). MSLN positivity was defined as any positive cell at any intensity, while high MSLN expression was defined as an intensity of ≥2+ in ≥30% of tumor cells. HER2 expression was scored according to modified 2018 American Society of Clinical Oncology/College of American Pathologists criteria.A total of 128 patients were recruited, including 119 with UCS and 9 with OCS. All cases in UCS exhibited MSLN positivity, and 33.9% showed high-MSLN expression. Clinicopathological characteristics were not significantly associated with high or low-MSLN expression. However, the high-MSLN group showed more prolonged overall survival (OS) than the low-MSLN group (not assessed vs. 36.8 months; hazard ratio=0.48, 95% confidence interval=0.26-0.89, p=0.016). HER2-high patients had higher MSLN expression than HER2-negative patients. In high-MSLN and low-MSLN expression groups, HER2 status did not affect OS. OCS showed 100% MSLN positivity, with 66.6% high-MSLN.MSLN expression is widely observed in gynecological carcinosarcomas. Moreover, high-MSLN expression is a favorable prognostic factor for UCS. MSLN could be a promising therapeutic target for UCS, even in the era of anti-HER2 therapy.