子宫内膜癌分子分型应用及临床意义

Application and clinical significance of molecular subtyping in endometrial cancer

目的分析子宫内膜癌分子分型的应用与临床意义。方法选取本院40例子宫内膜癌患者为研究对象。对其开展常规病理与免疫组织化学染色切片,分析分子分型分布情况。结果40例患者中,高拷贝型、低拷贝型、MSI-H型、POLE超突变型各占11例、20例、7例、2例,其中子宫内膜样腺癌共计33例,而高拷贝型、低拷贝型、MSI-H型、POLE超突变型各占6例、19例、6例、2例。非子宫内膜样腺癌共计7例,低拷贝型、MSI-H型、POLE超突变型各有5例、1例、1例。40例患者分子分型p53状态、MMR蛋白表达、淋巴结转移、脉管浸润、FIGO分期、肿瘤病理类型、恶性肿瘤家族史比较,差异有统计学意义(P<0.05)。在3年随访期间未出现患者死亡事件,复发例数共计11例,复发率为22.50%,其中高拷贝型、低拷贝型、MSI-H型复发率各为55.56%、22.22%、22.22%。在无进展生存率分布情况中,高拷贝型为52.50%,低拷贝型为92.50%,MSI-H型为77.50%,POLE超突变型为100%。结论子宫内膜癌分子分型能够为病情预后与治疗提供参考依据,确保患者得到更有效的治疗,值得临床应用。

Objective To analyze the application and clinical significance of molecular typing in endometrial cancer.Methods 4o patients with endometrial cancer in our hospital were selected as the research subjects.Perform routine pathological and immunohistochemical staining sections on it to analyze the distribution of molecular subtypes.Among the 40 patients,11,20,7,and 2 were high copy type,low copy type,MSI-H type,and POLE super mutation type,respectively.Results Among them,there were a total of 33 cases of endometrioid adenocarcinoma,while 6,19,6,and 2 were high copy type,low copy type,MSI-H type,and POLE super mutation type,respectively.There are a total of 7 cases of non-endometrial adenocarcinoma,including 5 cases of low copy type,1 case of MSI-H type,and 1 case of POLE super mutation type.There were statistically significant differences in molecular subtype p53 status,MMR protein expression,lymph node metastasis,vascular infiltration,FIGO staging,tumor pathological type,and family history of malignant tumors among 40 patients(P<0.05).During the 3-year follow-up period,there were no patient deaths,with a total of 1l relapses and a recurrence rate of 22.50%.The recurrence rates for high copy,low copy,and MSI-H types were 55.56%,22.22%,and 22.22%,respectively.In the distribution of progression free survival rate,the high copy type was 52.50%,the low copy type was 92.50%,the MSI-H type was 77.50%,and the POLE super mutant type was 100%.Conclusion Molecular subtyping of endometrial cancer can provide reference for prognosis and treatment,ensuring that patients receive more effective treatment,and is worthy of clinical application.