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The Korean Journal of Pathology 2011;45(6): 596-603.
doi: https://doi.org/10.4132/KoreanJPathol.2011.45.6.596
Prognostic Significance of Amplification of the c-MYC Gene in Surgically Treated Stage IB-IIB Cervical Cancer.
Tae Jung Kim, Ahwon Lee, Sung Jong Lee, Won Chul Lee, Yeong Jin Choi, Kyo Young Lee, Chang Suk Kang
1Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea. klee@catholic.ac.kr
2Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, Seoul, Korea.
3Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
BACKGROUND: Mutations of c-MYC have been described in cervical cancer. However, association between c-MYC gene status and its prognostic significance have not been clarified. METHODS: Tissue microarray sections from 144 patients with stage IB-IIB cervical cancer treated by radical hysterectomy were analyzed by fluorescence in situ hybridization using a region-specific probe for c-MYC and a centromere-specific probe for chromosome 8. RESULTS: Seventy five percent (108/144) of c-MYC gain and 6.9% (10/144) of c-MYC gene amplification were observed. c-MYC gene alteration was more frequently observed in squamous cell carcinoma than adenocarcinoma or adenosquamous carcinoma and were associated with low Ki67 labeling index (p=0.013). c-MYC amplification was not associated with clinicopathologic parameters except absence of bcl2 expression (p=0.048). Survival analysis revealed that patients with c-MYC amplification were significantly associated with higher risk of disease recurrence (p=0.007) and cancer related death (p=0.020). However, c-MYC gain was not associated with unfavorable outcome. Multivariate analysis proved c-MYC amplification as independent prognostic factors of shorter disease free survival and cancer-related death (p=0.028 and p=0.025, respectively). CONCLUSIONS: c-MYC amplification, not gain, is an independent prognostic marker for shorter disease free and cancer specific survival in cervical cancer treated by radical hysterectomy.
Key Words: Uterine cervical neoplasms; In situ hybridization, fluorescence; MYC; Hysterectomy; Prognosis