Abstract
Purpose To study the prognostic value of CD47 in endometrial carcinoma (EC) and its correlation with clinicopathological variables. Methods Next-generation sequencing data from The Cancer Genome Atlas was analyzed with the Kaplan–Meier curve, Cox's regression model, and ROC curve. A cohort of 544 specimens, including 344 cases of endometrial cancer, 92 cases of endometrial hyperplasia (EH), and 118 cases of normal endometrium (NE), were evaluated with immunohistochemistry and analyzed with statistical methods. Results For TCGA data, CD47 expression in EC was considerably greater than in NE tissues. CD47 expression correlated significantly with age, clinical stage, histological grade, histological type, and menopause status. Kaplan–Meier analysis and Cox's regression model revealed that elevated CD47 expression was positively correlated with a poorer prognosis. ROC curve showed that CD47 had high specificity and sensitivity as an independent prognosis factor. In our cohort, CD47 expression was significantly stronger in EC than in NE. The strongly positive expression of CD47 could be observed in EC, but none was observed in NE. The CD47 expression rate ranked in descending order: atypical endometrium hyperplasia, complex endometrium hyperplasia, and simple endometrium hyperplasia. Atypical endometrium hyperplasia CD47 expression rate was much greater than either simple endometrium hyperplasia or complex endometrium hyperplasia. A substantial connection existed amongst CD47 expression and the clinical stage. Kaplan–Meier survival analysis demonstrated that CD47 expression was connected with overall survival (OS). Univariate analysis instead of the multivariate analysis revealed that CD47 expression was associated significantly with prognosis. Conclusions CD47 is a critical part of the progress of pathogenesis in EC. CD47 expression correlates with multiple clinicopathological variables and is a potential prognostic risk factor.
Highlights
Endometrial cancer (EC) is one of the most common female reproductive system malignant tumors with distinct biological behavior
About 30% of advanced stage endometrial cancer diagnosed patients do not improve long-term survival even with recommended treatment strategy including surgery, platinumbased chemotherapy, and radiotherapy [3, 4]. e application of CA-125 in clinical practice may be useful in advanced stages and serous carcinoma [5]; there is no biomarker with special sensitivity and specificity to predict prognosis and therapeutic effects. us, exploring the pathological mechanism and looking for desirable Journal of Oncology biomarkers to increase the rate of early diagnosis of EC are the key to ameliorate prognosis
CD47 expression correlated significantly with histological grade (p < 0.001), histological type (p < 0.001), age (≤60 vs. >60, p < 0.001), clinical stages, and menopause status (p 0.002, Table 2). ere were no significant differences in weight, height, BMI, tumor invasion, and hormones therapy between the low and high CD47 expression group (p > 0.05, Table 2)
Summary
Endometrial cancer (EC) is one of the most common female reproductive system malignant tumors with distinct biological behavior. About 30% of advanced stage endometrial cancer diagnosed patients do not improve long-term survival even with recommended treatment strategy including surgery, platinumbased chemotherapy, and radiotherapy [3, 4]. E application of CA-125 in clinical practice may be useful in advanced stages and serous carcinoma [5]; there is no biomarker with special sensitivity and specificity to predict prognosis and therapeutic effects. On the contrary, inhibiting CD47 expression could increase the ability of macrophages to eradicate different types of cancer [13]. Is study explored CD47 expression and available clinical variables from e Cancer Genome Atlas (TCGA) data and detected CD47 expression in EC, EH, and NE with our collected samples to provide a theoretical basis for screening a potential biomarker to evaluate prognosis and promote new drug development
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