Identification of a gene expression signature for survival prediction in type I endometrial carcinoma. Homo sapiens

Endometrial cancer is the most common malignancy of the female reproductive tract. In many cases the prognosis is favourable, but 22% of affected women die from the disease. We aimed to study potential differences in gene expression between endometrioid adenocarcinomas from survivors (5-year survival) and non-survivors. Forty-five patients were included in the investigation, of which 21 were survivors and 24 were non-survivors. The tumours were analysed with genome-wide expression array analysis, represented by 13526 genes. Distinct differences in gene expression were found between the groups. A t-test established that a set of 218 genes were significantly differentially expressed (P 2) was added the hierachical clustering yielded similar results. Overall design: Tumour cDNA from both groups (survivors vs. non-survivors) were hybridised together with the same reference, and we were able to calculate the relative expression level value for the sample Stage I tumours are expected to have a favourable prognosis. However, in our tumour material there were six non-survivors with stage I tumours. Five out of six stage I non-survivors clustered in the non-survival fraction. Our findings suggest that a subgroup of early stage endometroid adenocarcinomas can be correctly classified as potentially aggressive by using molecular biology in combination with conventional markers, thereby providing a tool for a more accurate classification and risk evaluation of the individual patient.