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Published on: April 21, 2022
IMP3 as a prognostic biomarker in patients with malignant peritoneal mesothelioma
Song Hui1, Zheng Guo-Qi1, Guo Xiao-Zhong2
1Department of Gastroenterology, Cangzhou Central Hospital, Cangzhou, Hebei 061001, China.
Abstract:
Malignant peritoneal mesothelioma (MPeM) is an incurable cancer with poor prognosis, and several biomarkers have been suggested for screening of MPeM. The aim of our study was to evaluate the prognostic significances of IMP3 and Fli-1 in MPeM. Diagnostic biopsies of 44 MPeM patients were centrally collected and were immunohistochemically analyzed for expression of IMP3, Fli-1, and Ki-67. Labeling was assessed by 2 pathologists. Complete clinical information and follow-up were obtained from patients' records. Carcinomas expressed Fli-1 in 42 (95.5%) of 44 specimens, and IMP3 in 23 (52.3%) of 44 specimens. Spearman ρ analysis revealed that Fli-1 expression was related to both histologic type and Ki-67 labeling index (Ki-67LI; r = -0.500, P < .05; r = 0.358, P < .05), and IMP3 expression was related to Ki-67LI (r = 0.401, P < .05). A Kaplan-Meier analysis and univariate Cox regression analysis showed that tumor-directed treatment, a lower peritoneal carcinomatosis index, stage I, lower Ki-67LI, and lower level of IMP3 expression had a statistically significantly positive effect on overall survival; Fli-1 did not affect overall survival in the univariate analysis (hazard ratio [HR], 1.026; P = .904). A Kaplan-Meier analysis showed the correlation between IMP3-Fli-1 and overall survival, whereas univariate and multivariate Cox regression analyses did not confirm the correlation. Cox regression analysis revealed that IMP3 expression (HR, 2.311 [95% confidence interval, 1.190-4.486]; P = .013) and no tumor-directed treatment (HR, 0.189 [95% confidence interval, 0.086-0.416]; P = .000) retained independent prognostic significance, both with negative effect on OS. IMP3, along with tumor-directed treatment protocols, is a powerful prognosticator in patients with MPeM.
Insights
This study investigated IMP3 and Fli-1 as biomarkers for malignant peritoneal mesothelioma (MPeM). IMP3 expression, along with tumor-directed treatment, significantly impacts patient survival, making IMP3 a powerful prognosticator for MPeM.
Area of Science:
- Oncology
- Pathology
- Biomarker Research
Background:
- Malignant peritoneal mesothelioma (MPeM) is an aggressive cancer with limited treatment options and poor prognosis.
- Identifying reliable biomarkers is crucial for MPeM screening and prognostic assessment.
Purpose of the Study:
- To evaluate the prognostic significance of Insulinoma-Associated Protein 1 (IMP3) and Friend Leukemia Integration 1 (Fli-1) expression in MPeM.
- To determine the correlation of these biomarkers with clinical parameters and patient survival.
Main Methods:
- Immunohistochemical analysis of IMP3, Fli-1, and Ki-67 expression in 44 MPeM patient biopsies.
- Assessment of labeling by two pathologists.
- Correlation analysis with clinical data, including peritoneal carcinomatosis index, stage, and overall survival (OS) using Spearman, Kaplan-Meier, and Cox regression models.
Main Results:
- Fli-1 was expressed in 95.5% of MPeM specimens, while IMP3 was expressed in 52.3%.
- IMP3 expression correlated with Ki-67 labeling index (Ki-67LI).
- Lower Ki-67LI and lower IMP3 expression were associated with improved OS. IMP3 expression (HR, 2.311) and lack of tumor-directed treatment (HR, 0.189) were independent negative prognostic factors for OS.
Conclusions:
- IMP3 expression is a significant independent negative prognosticator in MPeM.
- IMP3, in conjunction with tumor-directed treatment, serves as a powerful tool for predicting outcomes in MPeM patients.
- Fli-1 expression did not demonstrate independent prognostic significance in this cohort.
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