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POLE Mutation Characteristics in a Chinese Cohort with Endometrial Carcinoma

Authors Li Y, He Q, Li S, Wen X, Ye L, Wang K, Wan X

Received 17 April 2020

Accepted for publication 15 July 2020

Published 28 July 2020 Volume 2020:13 Pages 7305—7316

DOI https://doi.org/10.2147/OTT.S258642

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Cho


Yiran Li1 *, Qizhi He2 *, Shuangdi Li,1 Xiaoli Wen,3 Lei Ye,1 Kai Wang,3 Xiaoping Wan1

1Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Pathology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 3Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Kai Wang Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Shanghai 200040, People’s Republic of China
Tel +86 (021)-5403-7438
Email kaiwangcn@yahoo.com
Xiaoping Wan Department of Gynecology, Shanghai First Maternity and Infant Hospital, Shanghai 200040, People’s Republic of China
Tel +86 136-5191-7177
Email wanxiaoping62@126.com

Objective: To study the characteristics of polymerase epsilon (POLE) exonuclease domain mutations in Chinese patients with endometrial carcinoma (EC).
Methods: This study analyzed data from 529 patients with EC in The Cancer Genome Atlas (TCGA) and 467 EC patients evaluated at the Shanghai First Maternity and Infant Hospital (SFMIH). POLE mutation heterogeneity was analyzed in paired curettage and hysterectomy samples from 120 SFMIH patients. Sanger sequencing identified mutations in the POLE exonuclease domain, and correlations between POLE mutation status and various clinicopathological features were determined by chi-squared testing and Cohen’s kappa analysis, with Kaplan–Meier survival curves generated to assess correlations between POLE mutation status and overall survival (OS).
Results: Thirty-five mutations were identified in 467 samples (7.5%), and novel mutations were detected in the SFMIH cohort. Compared to the TCGA cohort, the SFMIH cohort had fewer POLE mutations when matched by age (< 60) and histology (endometrioid) (p < 0.001 and p = 0.010, respectively). In our study cohort, POLE mutations were significantly associated with adjuvant treatment (p = 0.029), and patients with POLE mutations who underwent chemoradiotherapy had a poor OS (p < 0.0001). Notably, shorter OS was significantly associated with POLE mutations in hysterectomy samples from patients aged > 60 years or with stage I disease in the paired curettage-hysterectomy group.
Conclusion: The significant difference in POLE mutation profiles between the TCGA and SFMIH cohorts, as well as the poor consistency between the curettage and hysterectomy samples, suggests that different parameters need to be applied to determine the prognosis of patients with EC in China.

Keywords: endometrial carcinoma, polymerase epsilon mutation, POLE mutation, Chinese cohort, hysterectomy, curettage specimens

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