Vegter, M.E. (Margit Eelbren) (2015) De prognostische waarde van L1 cell adhesion molecule (L1CAM) voor het cervixcarcinoom. thesis, Medicine.
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Abstract
Introduction L1 cell adhesion molecule (L1CAM) has been discovered as an important independent prognostic predictor for different malignant tumours such as colon carcinoma, ovarian carcinoma and endometrial carcinoma. The presence of L1CAM in tumour cells leads to greater cell motility, more aggressive disease and worse survival. The presence of L1CAM in cervical carcinoma has been demonstrated in one earlier study, but the relation between L1CAM and prognosis had not been studied yet. Aim of the study The aim of this study is to determine the prognostic value of L1CAM in patients with cervical carcinoma to be able to make a better selection of patients with a higher risk of death of recurrence of disease. Method 179 tissue preparations of tumours patients treated with surgery in the LUMC between 2006 and 2011 for cervical carcinoma were immunohistochemical examined for L1CAM. Subsequently these preparations were scored based on percentage of tumour surface with L1CAM presence, by two blinded researchers. The outcome was linked to a database with follow up data of the patients and used for statistical analysis. Results Of the 179 examined tumours, 60 tumours had L1CAM presence (33.5%). L1CAM presence was not related to the presence of lymph node metastasis. L1CAM presence did have a relation to worse survival (≥50% L1CAM presence; P = 0.036), worse disease specific survival (≥50% L1CAM presence; P = 0.040) and increased recurrence (>0% L1CAM presence; P = 0.016). Multivariate Cox regression analysis with age, histology, FIGO stage, lymph vascular space invasion and lymph node metastasis as covariates showed ≥50% L1CAM presence as an important independent predictor of worse survival with a hazard ratio (HR) of 5.2 (confidence interval (CI) 1.8-14.8) and a worse disease specific survival with a HR of 4.5 (CI 1.4-14.5). >0% L1CAM presence was an important independent predictor for recurrence with a HR of 2.4 (CI 1.3-4.6). Conclusion L1CAM is probably an important prognostic predictor for progress of disease of cervical carcinoma. L1CAM might play an important role in the future in the decision making of the optimal treatment of the patient. The results of this study have to be repeated in a validation set.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Smit, drs. S. Sicco |
| Supervisor name: | Kroon, dr. C. D. de and Afdeling gynaecologische oncologie and Leidsch Univeristair Medisch Centrum |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/421 |
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