Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.

<h4>Background</h4>Uterine Carcinosarcomas (UCS) are a rare type of cancer composed of an admixture of high-grade carcinomatous and sarcomatous elements. Clinicopathological prognostic factors in UCS are well established, but studies that approach the impact of biomarkers in this unusual...

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Main Authors: Jesse Lopes da Silva, Lucas Zanetti de Albuquerque, Fabiana Resende Rodrigues, Nina Carrossini Bastos, Isabele Avila Small, Elisa Bouret Campos Barroso, Fernando Lopes Cordero, Daniel de Souza Fernandes, Eduardo Paulino, Andreia Cristina de Melo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0285447
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author Jesse Lopes da Silva
Lucas Zanetti de Albuquerque
Fabiana Resende Rodrigues
Nina Carrossini Bastos
Isabele Avila Small
Elisa Bouret Campos Barroso
Fernando Lopes Cordero
Daniel de Souza Fernandes
Eduardo Paulino
Andreia Cristina de Melo
author_facet Jesse Lopes da Silva
Lucas Zanetti de Albuquerque
Fabiana Resende Rodrigues
Nina Carrossini Bastos
Isabele Avila Small
Elisa Bouret Campos Barroso
Fernando Lopes Cordero
Daniel de Souza Fernandes
Eduardo Paulino
Andreia Cristina de Melo
author_sort Jesse Lopes da Silva
collection DOAJ
description <h4>Background</h4>Uterine Carcinosarcomas (UCS) are a rare type of cancer composed of an admixture of high-grade carcinomatous and sarcomatous elements. Clinicopathological prognostic factors in UCS are well established, but studies that approach the impact of biomarkers in this unusual disease are scarce. The study objective was to evaluate the prevalence and prognostic impact of a panel of prominent biomarkers in uterine carcinosarcoma (UCS) using an immunohistochemical characterization with four biomarkers.<h4>Methods and findings</h4>The internal database of a single Brazilian institution was carefully explored to select women diagnosed with UCS who were submitted to surgery and postoperative chemotherapy with carboplatin and paclitaxel between January 2012 and December 2017. Tissue microarrays containing UCS samples were evaluated by immunohistochemistry for L1CAM, CDX2, p53 and microsatellite instability markers. A total of 57 cases were included. The mean age was 65.3 years (standard deviation, SD 7.0). L1CAM was negative (score 0, no staining) in 27 (47.4%) patients. Of L1CAM-positive, 10 (17.5%) showed weak (score 1, <10%), 6 (10.5%) showed moderate (score 2, between 10-50%), and 14 (24.6%) showed strong L1CAM staining (score 3, ≧50%). dMMR occurred in 3 (5.3%) cases. The p53 was aberrantly expressed in 15 (26.3%) tumors. CDX2 was positive in 3 (5.3%) patients. The three-year progression-free survival (PFS) rate in the general population of the study was 21.2% (95% CI: 11.7-38.1) and the three-year overall survival (OS) rate was 29.4% (95% CI: 18.1-47.6). By multivariate analysis, the presence of metastases and CDX2-positive were significantly associated with poorer PFS (p < 0.001 and p = 0.002, respectively) and OS (p < 0.001 and p = 0.009, respectively).<h4>Conclusion</h4>The strong influence of CDX2 on prognosis requires further investigation. Biological or molecular variability may have impaired the assessment of the impact of the other markers on survival.
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spelling doaj.art-4c5c48e7eba54a699c10f0f2e6399c6d2023-06-16T05:31:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01185e028544710.1371/journal.pone.0285447Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.Jesse Lopes da SilvaLucas Zanetti de AlbuquerqueFabiana Resende RodriguesNina Carrossini BastosIsabele Avila SmallElisa Bouret Campos BarrosoFernando Lopes CorderoDaniel de Souza FernandesEduardo PaulinoAndreia Cristina de Melo<h4>Background</h4>Uterine Carcinosarcomas (UCS) are a rare type of cancer composed of an admixture of high-grade carcinomatous and sarcomatous elements. Clinicopathological prognostic factors in UCS are well established, but studies that approach the impact of biomarkers in this unusual disease are scarce. The study objective was to evaluate the prevalence and prognostic impact of a panel of prominent biomarkers in uterine carcinosarcoma (UCS) using an immunohistochemical characterization with four biomarkers.<h4>Methods and findings</h4>The internal database of a single Brazilian institution was carefully explored to select women diagnosed with UCS who were submitted to surgery and postoperative chemotherapy with carboplatin and paclitaxel between January 2012 and December 2017. Tissue microarrays containing UCS samples were evaluated by immunohistochemistry for L1CAM, CDX2, p53 and microsatellite instability markers. A total of 57 cases were included. The mean age was 65.3 years (standard deviation, SD 7.0). L1CAM was negative (score 0, no staining) in 27 (47.4%) patients. Of L1CAM-positive, 10 (17.5%) showed weak (score 1, <10%), 6 (10.5%) showed moderate (score 2, between 10-50%), and 14 (24.6%) showed strong L1CAM staining (score 3, ≧50%). dMMR occurred in 3 (5.3%) cases. The p53 was aberrantly expressed in 15 (26.3%) tumors. CDX2 was positive in 3 (5.3%) patients. The three-year progression-free survival (PFS) rate in the general population of the study was 21.2% (95% CI: 11.7-38.1) and the three-year overall survival (OS) rate was 29.4% (95% CI: 18.1-47.6). By multivariate analysis, the presence of metastases and CDX2-positive were significantly associated with poorer PFS (p < 0.001 and p = 0.002, respectively) and OS (p < 0.001 and p = 0.009, respectively).<h4>Conclusion</h4>The strong influence of CDX2 on prognosis requires further investigation. Biological or molecular variability may have impaired the assessment of the impact of the other markers on survival.https://doi.org/10.1371/journal.pone.0285447
spellingShingle Jesse Lopes da Silva
Lucas Zanetti de Albuquerque
Fabiana Resende Rodrigues
Nina Carrossini Bastos
Isabele Avila Small
Elisa Bouret Campos Barroso
Fernando Lopes Cordero
Daniel de Souza Fernandes
Eduardo Paulino
Andreia Cristina de Melo
Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.
PLoS ONE
title Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.
title_full Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.
title_fullStr Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.
title_full_unstemmed Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.
title_short Exploring biomarkers and prognostic factors in uterine carcinosarcoma: An insight into L1CAM, CDX2, p53, and MSI status.
title_sort exploring biomarkers and prognostic factors in uterine carcinosarcoma an insight into l1cam cdx2 p53 and msi status
url https://doi.org/10.1371/journal.pone.0285447
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