• Tarjei S Hveem, Tormund S Njølstad, Birgitte Nielsen, Rolf Anders Syvertsen, John Arne Nesheim, Marna L Kjæreng, Wanja Kildal, Manohar Pradhan, Janusz Marcickiewicz, Solveig Tingulstad, Anne C Staff, Hans K Haugland, Runar Eraker, Klaus Oddenes, Jan A Rokne, Jostein Tjugum, Margaret S Lode, Frederic Amant, Henrica M J Werner, Line Bjørge, Fritz Albregtsen, Knut Liestøl, Helga B Salvesen, Jone Trovik, Håvard E Danielsen, and ENITEC network/MoMaTEC study group.
• Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.
• Cancer Epidemiol. Biomarkers Prev. 2017 Jan 1; 26 (1): 61-67.

BackgroundMost endometrial carcinoma patients are diagnosed at an early stage with a good prognosis. However, a relatively low fraction with lethal disease constitutes a substantial number of patients due to the high incidence rate. Preoperative identification of patients with high risk and low risk for poor outcome is necessary to tailor treatment. Nucleotyping refers to characterization of cell nuclei by image cytometry, including the assessment of chromatin structure by nuclear texture analysis. This method is a strong prognostic marker in many cancers but has not been evaluated in preoperative curettage specimens from endometrial carcinoma.MethodsThe prognostic impact of changes in chromatin structure quantified with Nucleotyping was evaluated in preoperative curettage specimens from 791 endometrial carcinoma patients prospectively included in the MoMaTEC multicenter trial.ResultsNucleotyping was an independent prognostic marker of disease-specific survival in preoperative curettage specimens among patients with Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage I-II disease (HR=2.9; 95% CI, 1.2-6.5; P = 0.013) and significantly associated with age, FIGO stage, histologic type, histologic grade, myometrial infiltration, lymph node status, curettage histology type, and DNA ploidy.ConclusionsNucleotyping in preoperative curettage specimens is an independent prognostic marker for disease-specific survival, with potential to supplement existing parameters for risk stratification to tailor treatment.ImpactThis is the first study to evaluate the prognostic impact of Nucleotyping in curettage specimens from endometrial carcinoma and shows that this may be a clinically useful prognostic marker in endometrial cancer. External validation is warranted. Cancer Epidemiol Biomarkers Prev; 26(1); 61-67. ©2016 AACR.©2016 American Association for Cancer Research.

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