Assessment of DNA Ploidy in the ProMisE molecular subgroups of endometrial cancer.

OBJECTIVE: We sought to determine whether DNA ploidy correlates with the four molecular subgroups of endometrial carcinoma (EC) as determined using ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer). METHODS: 90 cases of EC previously characterized by clinicopathological parameters, outcomes, and ProMisE molecular subgroup (POLE EDM, MMR-D, p53 wt or p53 abn) were assessed for DNA ploidy using image cytometry. Associations of ploidy with traditional clinicopathological parameters were also tested. RESULTS: Abnormal DNA ploidy status differed amongst the ProMisE groups (p<0.001) and was found in 80.9% (17/21) of p53 abn, 37.0% (10/27) of p53 wt, 28.6% (4/14) of POLE EDM and 14.3% (4/28) of MMR-D. Abnormal DNA content was significantly associated with lower BMI (p=0.034) and grade 3 tumors (p=0.001). In the entire cohort, abnormal DNA content was significantly associated with worse progression free survival (p=0.0094) but not disease specific survival (p=0.249) or overall survival (p=0.187). When examining ploidy within each of the ProMisE groups, abnormal DNA content correlated with worse overall survival (p=0.041) and progression free survival (p=0.011) in the MMR-D group. No statistically significant relationship was seen in the remaining 3 groups. CONCLUSION: Abnormal DNA ploidy status did correlate with the molecular subgroups of EC; abnormal DNA content was seen in the large majority of p53 abn cases. Abnormal ploidy however was also seen in smaller numbers in the p53 wt, POLE EDM and MMR-D groups; therefore abnormal DNA content was not a specific marker for any one molecular group. The addition of ploidy to the ProMisE molecular categories conferred additional prognostic value within the MMR-D group, which merits further study.

The association between third trimester multivitamin/mineral supplements and gestational length in uncomplicated pregnancies.

BACKGROUND: Widespread use of maternal micronutrient supplements have been correlated to gestational length and outcome in women predisposed to pre-eclampsia and preterm birth. However, research is yet to be conducted examining the influence of micronutrient supplements on outcomes at term in uncomplicated pregnancies. AIM: To analyse the relationship between third trimester micronutrient supplementation and gestation length at birth, demographics and maternal birthing outcomes in well women at term in a South East Queensland representative population. METHODS: This research retrospectively analysed existing data pertaining to 427 uncomplicated, pregnancies birthing at the Gold Coast and Logan Hospitals using information gathered through the Environments for Healthy Living Study and Queensland perinatal data collection. Data were analysed using SPSS v20 by Chi square, ANOVA and regression analysis. FINDINGS: Women in the third trimester taking individual zinc, folic acid or iron supplements in combination with a multivitamin were twice as likely to birth beyond 41 completed weeks (AOR 2.054, 95% CI 1.310-7.383, p=0.038) then those who did not take any supplement when controlled for established confounders. Non supplement users were found to experience a lower rate of post dates labour and requirements for induction (AOR 0.483, 95% CI 0.278-0.840, p=0.01). CONCLUSION: Length of gestation demonstrates significant associations with micronutrient supplementation practices. Well women consuming third trimester individual micronutrient supplements in addition to multivitamins experienced a longer gestation at term compared to women taking no micronutrients, increasing their risk for postdates induction of labour.