Gene Expression Signature-Based Prediction of Lymph Node Metastasis in Patients With Endometrioid Endometrial Cancer

    loading  Checking for direct PDF access through Ovid



This study aimed to develop a prediction model for lymph node metastasis using a gene expression signature in patients with endometrioid-type endometrial cancer.


Newly diagnosed endometrioid-type endometrial cancer cases in which the patients had undergone lymphadenectomy during a surgical staging procedure were identified from a national dataset (N = 330). Clinical and pathologic data were extracted from patient medical records, and gene expression datasets of their tumors were used to create a 12-gene predictive model for lymph node metastasis. We used principal components analysis on a training set (n = 110) to develop multivariate logistic models to predict low-risk patients having a probability of lymph node metastasis of less than 4%. The model with the highest prediction performance was selected for an evaluation set (n = 112), which, in turn, was validated in an independent validation set (n = 108).


The model applied to the evaluation set showed 100% sensitivity (90% confidence interval [CI], 74%–100%) and 42% specificity (90% CI, 34%–51%), which resulted in 100% negative predictive value (90% CI, 89%–100%). In the validation set, we confirmed that the model consistently showed 100% sensitivity (90% CI, 88%–100%), 42% specificity (90% CI, 32%–50%), and 100% negative predictive value (90% CI, 88%–100%).


Our 12-gene signature model is a useful tool for the identification of patients with endometrioid-type endometrial cancer at low risk of lymph node metastasis, particularly given that it can be used to analyze histologic tissue before surgery and used to tailor surgical options.

Related Topics

    loading  Loading Related Articles