The study included 364 formalin-fixed paraffin-embedded (FFPE) primary tumor samples retrospectively collected from a cohort of EC patients who were operated in the Department of Gynaecology, Gynaecological Oncology and Gynaecological Endocrinology, Medical University of Gdańsk (Gdańsk, Poland) between 2000 and 2010. Each patient was primarily treated by surgery, with the possible option of radiotherapy and/or chemotherapy administration. The inclusion criteria were operable
EC (stage IVB patients underwent cytoreductive surgery) confirmed by histologic examination and a signed consent form. The study was accepted by the Independent Ethics Committee of the Medical University of Gdańsk (NKEBN/269/2009, date: 14 September PARP inhibitor 2009). Procedures involving human subjects were in accordance with the Helsinki Declaration of 1975, as revised in 1983. The tumor samples included all stages of endometrial carcinoma, from stage IA to IVB, as distinguished by the International Federation of Gynecology and Obstetrics (FIGO) in 2009 [7]. We analyzed all primary carcinomas of the uterine corpus, separating them into endometrioid and non-endometrioid tumors. The latter included serous, clear GSK2126458 datasheet cell, mucinous, mixed, squamous cell, and undifferentiated carcinomas [8]. Metastases included lymph node and distant metastases. The patients’ characteristics are summarized in Table 1. The median age was 63 (range, 26-89 years). Patients
with a body mass index higher than 30 were classified as obese [9]. A survival analysis was performed for 362 (99.5%) patients. After a median follow-up of
72.5 months (range, 0-158), 107 (29.4%) patients had died. The last follow-up data were collected in September 2013. The study was performed in accordance with the REcommendations for Tumor MARKer Prognostic Studies (REMARK) criteria [10]. Samples were collected by surgical excision before any systemic treatment and were fixed in 10% (vol/vol) neutral buffered formalin for up to 24 hours, dehydrated in 70% ethanol, and embedded in paraffin. FFPE tissue blocks were stored at room temperature for up to 14 years. The percentage of tumor cells in each FFPE specimen was evaluated by hematoxylin and eosin staining reviewed by a certified pathologist. Tissue microarrays (TMAs) were constructed from FFPE surgical Orotidine 5′-phosphate decarboxylase resection tumor specimens and control samples. Four 1.5-mm-diameter cores from each tumor were obtained from the most representative areas (well-preserved fragments of invasive carcinoma, without necrosis, autolysis, and squamous metaplasia) using a tissue-arraying instrument (MTA-I; Beecher Instruments, Sun Prairie, WI), and then reembedded in microarray blocks. Punches of normal tissues were added to each array to introduce built-in internal controls to the system. Consecutive 4-μm-thick TMA sections were cut and placed on charged polylysine-coated slides (Superfrost Plus; BDH, Braunschweig, Germany) for subsequent IHC analysis.