Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study

Abstract Background This study analyzed the changes of serum and pathological biomarkers during fertility-sparing therapy of endometrial cancer (EC) or endometrial atypical hyperplasia (EAH), to investigate their implications for early prediction of treatment efficacy. Methods A retrospective analys...

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Main Authors: Yiqin Wang, Rong Zhou, Xiaobo Zhang, Huixin Liu, Danhua Shen, Jianliu Wang
Format: Article
Language:English
Published: BMC 2021-06-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-021-01383-5
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author Yiqin Wang
Rong Zhou
Xiaobo Zhang
Huixin Liu
Danhua Shen
Jianliu Wang
author_facet Yiqin Wang
Rong Zhou
Xiaobo Zhang
Huixin Liu
Danhua Shen
Jianliu Wang
author_sort Yiqin Wang
collection DOAJ
description Abstract Background This study analyzed the changes of serum and pathological biomarkers during fertility-sparing therapy of endometrial cancer (EC) or endometrial atypical hyperplasia (EAH), to investigate their implications for early prediction of treatment efficacy. Methods A retrospective analysis of EC or EAH patients who received fertility-sparing therapy between 2012 and 2016 was performed. Serum and endometrium sampling were obtained for each patient at three time points: at baseline, at 3–6 months' treatment and at the end of conservative treatment. Serum biomarkers including insulin resistance (HbA1c, HOMA-IR), sex hormones and thyroid hormones were measured. Meanwhile expression of endometrial pathological biomarkers including ER, PR, PRB and Ki-67 was also assessed by immunohistochemistry. Results For the 53 recruited patients, overall complete response, recurrence and pregnancy rates were 94%, 26% and 36.4%. During the treatment, the serum biomarkers of HOMA-IR remained stable, while pathological markers including PR, PRB and Ki67 diminished significantly. Patients who achieved remission faster had significant lower HOMA-IR level and higher PRB expression at baseline. We also found a more remarkable down-regulation of PRB related with faster remission. Further multivariate analysis confirmed that baseline HOMA-IR ≥ 2.5 negatively affected treatment time to remission (OR 0.206; p = 0.017). While marked reduction of PRB (≥ 30%) at 3–6 months' treatment correlated with faster remission (OR 5.788; p = 0.010). Conclusion For EC and EAH patients who received fertility-sparing therapy, baseline status of insulin resistance predicted poor response to progestin, while marked reduction of PRB following the initial 3–6 months' treatment predicted fast remission.
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spelling doaj.art-dd94b4b056b9479fa68af4fe389a58a52022-12-21T18:59:37ZengBMCBMC Women's Health1472-68742021-06-012111910.1186/s12905-021-01383-5Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort studyYiqin Wang0Rong Zhou1Xiaobo Zhang2Huixin Liu3Danhua Shen4Jianliu Wang5Department of Obstetrics and Gynecology, Peking University People’s HospitalDepartment of Obstetrics and Gynecology, Peking University People’s HospitalDepartment of Pathology, Peking University People’s HospitalDepartment of Clinical Epidemiology, Peking University People’s HospitalDepartment of Pathology, Peking University People’s HospitalDepartment of Obstetrics and Gynecology, Peking University People’s HospitalAbstract Background This study analyzed the changes of serum and pathological biomarkers during fertility-sparing therapy of endometrial cancer (EC) or endometrial atypical hyperplasia (EAH), to investigate their implications for early prediction of treatment efficacy. Methods A retrospective analysis of EC or EAH patients who received fertility-sparing therapy between 2012 and 2016 was performed. Serum and endometrium sampling were obtained for each patient at three time points: at baseline, at 3–6 months' treatment and at the end of conservative treatment. Serum biomarkers including insulin resistance (HbA1c, HOMA-IR), sex hormones and thyroid hormones were measured. Meanwhile expression of endometrial pathological biomarkers including ER, PR, PRB and Ki-67 was also assessed by immunohistochemistry. Results For the 53 recruited patients, overall complete response, recurrence and pregnancy rates were 94%, 26% and 36.4%. During the treatment, the serum biomarkers of HOMA-IR remained stable, while pathological markers including PR, PRB and Ki67 diminished significantly. Patients who achieved remission faster had significant lower HOMA-IR level and higher PRB expression at baseline. We also found a more remarkable down-regulation of PRB related with faster remission. Further multivariate analysis confirmed that baseline HOMA-IR ≥ 2.5 negatively affected treatment time to remission (OR 0.206; p = 0.017). While marked reduction of PRB (≥ 30%) at 3–6 months' treatment correlated with faster remission (OR 5.788; p = 0.010). Conclusion For EC and EAH patients who received fertility-sparing therapy, baseline status of insulin resistance predicted poor response to progestin, while marked reduction of PRB following the initial 3–6 months' treatment predicted fast remission.https://doi.org/10.1186/s12905-021-01383-5Endometrial cancerEndometrial atypical hyperplasiaFertility-sparingInsulin resistanceProgesterone receptorTreatment efficacy
spellingShingle Yiqin Wang
Rong Zhou
Xiaobo Zhang
Huixin Liu
Danhua Shen
Jianliu Wang
Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study
BMC Women's Health
Endometrial cancer
Endometrial atypical hyperplasia
Fertility-sparing
Insulin resistance
Progesterone receptor
Treatment efficacy
title Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study
title_full Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study
title_fullStr Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study
title_full_unstemmed Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study
title_short Significance of serum and pathological biomarkers in fertility-sparing treatment for endometrial cancer or atypical hyperplasia: a retrospective cohort study
title_sort significance of serum and pathological biomarkers in fertility sparing treatment for endometrial cancer or atypical hyperplasia a retrospective cohort study
topic Endometrial cancer
Endometrial atypical hyperplasia
Fertility-sparing
Insulin resistance
Progesterone receptor
Treatment efficacy
url https://doi.org/10.1186/s12905-021-01383-5
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