The Role of hCG Expression in Endometrial Cancer Prognosis

This study aims to investigate the expression pattern of human chorionic gonadotropin (hCG) in the tissue of endometrioid type endometrial cancer (EEC) using immunohistochemistry, and also to investigate the effect of hCG expression pattern on prognosis and survival in EEC. We evaluated patients who were operated between 2010 and 2020 in the obstetrics and gynecology clinic of our center due to EEC. In total, 194 women were determined to be in either the hCG-negative group (n=137) or the hCG-positive group (n=57). The detection rate of deep myometrial invasion (16.8% vs. 36.8%; P =0.002), lymphovascular space invasion (10.9% vs. 24.6%; P =0.015), and metastatic lymph node (6.7% vs. 21.8%; P = 0.003) in patients with hCG-positive staining were analyzed to be significantly higher. Five-year disease-free survival (DFS) ( P = 0.015) and overall survival (OS) ( P = 0.024) rates were found to be higher in the hCG-negative group. hCG expression was found to be an independent risk factor for recurrence, and DFS in grade I-II EEC was limited to the uterus and with superficial myometrial invasion (low risk). No independent risk factors for OS were analyzed. hCG positivity is a risk factor with poor prognostic factors in endometrial cancer. It was concluded that hCG expression in low-risk EEC is a valuable negative prognostic factor for recurrence and DFS.