Combined ASRGL1 and p53 immunohistochemistry as an independent predictor of survival in endometrioid endometrial carcinoma
Journal article, 2018

Objective: In clinical practise, prognostication of endometrial cancer is based on clinicopathological risk factors. The use of immunohistochemistry-based markers as prognostic tools is generally not recommended and a systematic analysis of their utility as a panel is lacking. We evaluated whether an immunohistochemical marker panel could reliably assess endometrioid endometrial cancer (EEC) outcome independent of clinicopathological information. Methods: A cohort of 306 EEC specimens was profiled using tissue microarray (TMA). Cost- and time-efficient immunohistochemical analysis of well-established tissue biomarkers (ER, PR, HER2, Ki-67, MLH1 and p53) and two new biomarkers (L1CAM and ASRGL1) was carried out. Statistical modelling with embedded variable selection was applied on the staining results to identify minimal prognostic panels with maximal prognostic accuracy without compromising generalizability. Results: A panel including p53 and ASRGL1 immunohistochemistry was identified as the most accurate predictor of relapse-free and disease-specific survival. Within this panel, patients were allocated into high- (5.9%), intermediate- (29.5%) and low- (64.6%) risk groups where high-risk patients had a 30-fold risk (P < 0.001) of dying of EEC compared to the low-risk group. Conclusions: P53 and ASRGL1 immunoprofiling stratifies EEC patients into three risk groups with significantly different outcomes. This simple and easily applicable panel could provide a useful tool in EEC risk stratification and guiding the allocation of treatment modalities.

Risk stratification

Endometrial cancer






Jutta Huvila

University of Turku

Teemu D. Laajala

University of Helsinki

University of Turku

P. H. Edqvist

Uppsala University

Adil Mardinoglu

Chalmers, Biology and Biological Engineering, Systems and Synthetic Biology

Royal Institute of Technology (KTH)

Lauri Talve

University of Turku

F. Ponten

Uppsala University

Seija Grénman

University of Turku

Olli Carpén

University of Helsinki

University of Turku

Finland HUSLAB

Tero Aittokallio

University of Turku

University of Helsinki

Annika Auranen

University of Tampere

Gynecologic Oncology

0090-8258 (ISSN) 1095-6859 (eISSN)

Vol. 149 1 173-180

Subject Categories

Clinical Laboratory Medicine

Urology and Nephrology

Cancer and Oncology



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