摘要
目的探讨WHO(2020)女性生殖系统肿瘤分子分型在子宫内膜癌(endometrial cancer,EC)中的临床应用及其意义。方法收集62例EC临床资料,根据WHO(2020)女性生殖系统分子分型标准,采用免疫组化法和PCR法将EC分为4种亚型,即POLE突变型、错配修复缺陷型(mismatch repair deficient,MMRd)、无特异性分子谱型(no specific molecular profile,NMSP)和p53突变型,分析其与临床病理特征的关系。结果POLE突变型3例(4.8%),MMRd型15例(24.2%),NSMP型36例(58.1%),p53突变型8例(12.9%)。POLE基因突变与浸润深度、组织学分级、脉管侵犯、淋巴结转移和FIGO分期,差异均无统计学意义(P>0.05)。15例MMRd型患者中,FIGOⅡ+Ⅲ期患者的比例明显增加,其中1例p53蛋白过表达,2例均完全失表达。36例NSMP型患者与组织学低级别(Grade I+Ⅱ)有关(P<0.05),与其它临床病理特征均无关(P>0.05);8例p53突变型患者与组织学高级别(GradeⅢ级)有关(P<0.05);淋巴结转移、FIGOⅡ+Ⅲ期明显增加,差异均无统计学意义(P>0.05)。结论分子分型在EC的治疗中具有重要应用价值,与POLE基因突变型和NSMP型相比,MMRd型和p53突变型患者预后较差。
Purpose To explore the application and clinicopathological significance of molecular classification in endometrial cancer(EC)of WHO(2020)tumors of the female reproductive system.Methods Sixty-two EC patients were collected and categorized into four subgroups,namely POLE mutation type,mismatch repair deficient(MMRd)type,non-specific molecular spectrum(NMSP)type,and p53 mutation type,based on WHO molecular classification tested by PCR and immunohistochemistry.The correlation among four molecular subgroups and their clinicopathological features were analyzed.Results The molecular classification was distributed as follows:3(4.8%)cases were POLE-mutated,15(24.2%)cases MMRd,36(58.1%)cases NSMP and 8(12.9%)cases p53 abnormal expression.There were no significant differences among POLE-mutated and infiltration depth,grade,lymph vascular space invasion and other pathological factors such as lymph node metastasis and FIGO stage(P>0.05).Among 15 patients with MMRd,the proportion of FIGO stageⅡ+Ⅲsignificantly increased.One case showed abnormal overexpression of p53 protein,while two cases showed complete loss of expression in MMRd subgroup.36 cases of NSMP were associated with low histopathological grade(GradeⅠ+Ⅱ)(P<0.05),and no significant differences were observed among NSMP and other clinicopathological factors(P>0.05).The p53 abnormal expression in 8 cases was related to high histopathological grade(GradeⅢ)(P<0.05),and the rate of lymph node metastasis and FIGO stageⅡ+Ⅲsignificantly increased in patients with p53 abnormal expression,and although the difference was not statistically significant(P>0.05).Conclusion The molecular subgroups of EC have certain clinical application value,the cases with MMRd and p53 abnormal expression may have poor prognosis than these with POLE-mutated and NSMP.
作者
曹立宇
田壮壮
祝利利
白真真
张聪
CAO Liyu;TIAN Zhuangzhuang;ZHU Lili;BAI Zhenzhen;ZHANG Cong(Department of Pathology,Fuyang Hospital of Anhui Medical University,Fuyang 236000,China;Department of Pathology,Anhui Medical University,Hefei 230032,China)
出处
《临床与实验病理学杂志》
CAS
北大核心
2024年第3期279-284,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
安徽省卫生健康科研项目基金(AHWJ20222a024)
阜阳市级临床重点专科经费[阜卫医函(2023)41号]。
关键词
子宫内膜肿瘤
分子分型
错配修复
免疫组织化学
聚合酶链反应
endometrial neoplasm
molecular classification
mismatch repair
immunohistochemistry
polymerase chain reaction
