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Clinicopathologic and protein markers distinguishing the "polymerase epsilon exonuclease" from the "copy number low" subtype of endometrial cancer.


ABSTRACT:

Objective

The need to perform genetic sequencing to diagnose the polymerase epsilon exonuclease (POLE) subtype of endometrial cancer (EC) hinders the adoption of molecular classification. We investigated clinicopathologic and protein markers that distinguish the POLE from the copy number (CN)-low subtype in EC.

Methods

Ninety-one samples (15 POLE, 76 CN-low) were selected from The Cancer Genome Atlas EC dataset. Clinicopathologic and normalized reverse phase protein array expression data were analyzed for associations with the subtypes. A logistic model including selected markers was constructed by stepwise selection using area under the curve (AUC) from 5-fold cross-validation (CV). The selected markers were validated using immunohistochemistry (IHC) in a separate cohort.

Results

Body mass index (BMI) and tumor grade were significantly associated with the POLE subtype. With BMI and tumor grade as covariates, 5 proteins were associated with the EC subtypes. The stepwise selection method identified BMI, cyclin B1, caspase 8, and X-box binding protein 1 (XBP1) as markers distinguishing the POLE from the CN-low subtype. The mean of CV AUC, sensitivity, specificity, and balanced accuracy of the selected model were 0.97, 0.91, 0.87, and 0.89, respectively. IHC validation showed that cyclin B1 expression was significantly higher in the POLE than in the CN-low subtype and receiver operating characteristic curve of cyclin B1 expression in IHC revealed AUC of 0.683.

Conclusion

BMI and expression of cyclin B1, caspase 8, and XBP1 are candidate markers distinguishing the POLE from the CN-low subtype. Cyclin B1 IHC may replace POLE sequencing in molecular classification of EC.

SUBMITTER: Kim K 

PROVIDER: S-EPMC9024182 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Clinicopathologic and protein markers distinguishing the "polymerase epsilon exonuclease" from the "copy number low" subtype of endometrial cancer.

Kim Kidong K   Hwangbo Suhyun S   Kim Hyojin H   Kim Yong Beom YB   No Jae Hong JH   Suh Dong Hoon DH   Park Taesung T  

Journal of gynecologic oncology 20220117 3


<h4>Objective</h4>The need to perform genetic sequencing to diagnose the polymerase epsilon exonuclease (<i>POLE</i>) subtype of endometrial cancer (EC) hinders the adoption of molecular classification. We investigated clinicopathologic and protein markers that distinguish the <i>POLE</i> from the copy number (CN)-low subtype in EC.<h4>Methods</h4>Ninety-one samples (15 <i>POLE</i>, 76 CN-low) were selected from The Cancer Genome Atlas EC dataset. Clinicopathologic and normalized reverse phase p  ...[more]

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