Indoleamine 2,3-dioxygenase Is a Novel Prognostic Indicator for Endometrial Cancer

Br J Cancer. 2006 Dec 4;95(11):1555-61. doi: 10.1038/sj.bjc.6603477. Epub 2006 Nov 21.

Abstract

Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-catabolising enzyme inducing immune tolerance. The present study aimed to investigate IDO expression and its prognostic significance in endometrial cancer. Indoleamine 2,3-dioxygenase expression in endometrial cancer tissues (n = 80) was immunohistochemically scored as four groups (IDO-, 1+, 2+, and 3+). The high IDO expression (IDO2+ or 3+) in tumour cells was found in 37 (46.3%) of the 80 cases, and was positively correlated with surgical stage, myometrial invasion, lymph-vascular space involvement, and lymph node metastasis, but not with the histological grade. Patients with high IDO expression had significantly impaired overall survival and progression-free survival (PFS) (P = 0.002 and P = 0.001, respectively) compared to patients with no or weak expression of IDO (IDO- or 1+). The 5-year PFS for IDO-/1+, 2+, and 3+ were 97.7, 72.9, and 36.4%, respectively. Even in patients with early-stage disease (International Federation of Gynecology and Obstetrics I/II, n = 64), the PFS for IDO2+/3+ was significantly poor (P = 0.001) compared to that for IDO-/1+. On multivariate analysis, IDO expression was an independent prognostic factor for PFS (P = 0.020). These results indicated that the high IDO expression was involved in the progression of endometrial cancer and correlated with the impaired clinical outcome, suggesting that IDO is a novel and reliable prognostic indicator for endometrial cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / analysis*
  • Blotting, Western
  • Carcinoma, Endometrioid / metabolism*
  • Carcinoma, Endometrioid / mortality
  • Carcinoma, Endometrioid / pathology*
  • Disease-Free Survival
  • Endometrial Neoplasms / metabolism*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology*
  • Female
  • Humans
  • Immunohistochemistry
  • Indoleamine-Pyrrole 2,3,-Dioxygenase / biosynthesis*
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • Indoleamine-Pyrrole 2,3,-Dioxygenase