Protein Biomarker Discovered for Uterine Cancer

A new biomarker has been discovered which makes it possible to identify women with uterine cancer who have a high risk of recurrence.

Endometrial cancer of the uterus is the most common form of gynecologic cancer in Europe and North America and the treatment primarily consists of removing the uterus and in some cases offering chemotherapy if the risk of recurrence is deemed high.

Scientists at Uppsala University (Sweden) and their colleagues conducted a study based on samples collected from 500 women who were diagnosed with uterine cancer between the years 1981 and 2007. Tissue microarrays (TMA) were constructed from formalin-fixed, paraffin-embedded (FFPE) primary tumors derived from hysterectomy specimens. Duplicate 1.0 mm diameter cores from each donor block were assembled into a recipient TMA block using the Beecher Manual Tissue Arrayer MTA-1 (Estigen OÜ; Tartu, Estonia).

Automated immunohistochemistry (IHC) was performed using a LabVision Autostainer 480S (Thermo Fisher Scientific; Runcorn, UK). Stained slides were scanned using an Aperio ScanScope XT Slide Scanner (Aperio Technologies; Vista, CA, USA). The l-asparaginase (ASRGL1) protein was identified as an endometrial carcinoma biomarker candidate. ASRGL1 expression was immunohistochemically evaluated. The protein ASRGL1 is an enzyme that normally exists in healthy cells of the uterus.

The investigators found that patients who had entirely or partially lost ASRGL1 in the tumor cells had a much higher risk of the cancer recurring and dying from the disease, while patients with sustained high levels of ASRGL1 had a much lower risk of recurrence. The study also shows that ASRGL1 is an independent prognostic factor, even after compensating for other risk factors such as tumor stage and tumor grade.

Per-Henrik Edqvist, PhD, the lead author of the study, said, “'I view the results as a first step towards personal treatment of uterine cancer. Today, 10% to 15% of the patients suffer recurrences, even though they were considered low risk patients according to classic diagnostics. By using ASRGL1, the chance of identifying such hidden high-risk patients and offer them more aggressive treatment after their operation increases.” The study was published on April 6, 2015, in the journal Gynecologic Oncology.

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Uppsala University
Estigen
Thermo Fisher Scientific
Aperio Technologies