不同分子分型子宫内膜癌患者的临床病理特征分析

Clinicopathological Characteristics of Endometrial Cancer Patients with Different Molecular Subtypes

目的探讨不同分子分型子宫内膜癌(RC)的临床病理特征。方法选取收治的85例EC手术患者作为研究对象,所有患者均行手术治疗,采用免疫组织化学染色法检测,包括错配修复(MMR)蛋白检测、p53、孕激素受体(PR)、雌激素受体(ER);并按照ProMisE分子分型流程进行不同分子分型EC区分;统计不同分子分型在传统病理类型内占比,分析不同分子分型病理特征的关系。结果85例RC患者中MMRd亚型26例(30.59%)、NSMP亚型36例(42.35%)、POLE突变型2例(2.35%)、p53abn型21例(24.71%);64例子宫内膜炎腺癌中MMRd亚型22例(34.38%)、NSMP亚型30例(46.88%)、POLE突变型2例(3.13%)、p53abn型10例(15.63%);11例浆液性癌中NSMP亚型4例(36.36%)、p53abn型7例(63.64%);4例透明细胞癌中MMRd亚型3例(75.00%)、p53abn型1例(25.00%);3例癌肉瘤中p53abn型3例(100%);3例其他中MMRd亚型1例(33.33%)、NSMP亚型2例(66.67%);不同分子分型EC间肿瘤分期、病理类型、病理分级相比,差异有统计学意义(P<0.05)。结论EC的4种分子分型对疾病区分更为真实、客观,且不同分型在肿瘤分期、病理分级及病理类型方面存在一定差异,有助于临床制定个体化精准治疗,改善患者预后。

Objective To explore the clinicopathological characteristics of endometrial cancer(RC)with different molecular subtypes.Methods 85 patients undergoing EC surgery were selected as the study subjects,and all patients underwent surgical treatment.Immunohistochemical staining was used to detect mismatch repair(MMR)protein,p53,progesterone receptor(PR),and estrogen receptor(ER);And distinguish different molecular typing EC according to the ProMisE molecular typing process;Calculate the proportion of different molecular subtypes within traditional pathological types and analyze the relationship between pathological features of different molecular subtypes.Results Among the 85 RC patients,there were 26 MMRd subtypes(30.59%),36 NSMP subtypes(42.35%),2 POLE mutations(2.35%),and 21 p53 abn subtypes(24.71%);Among 64 cases of endometritis adenocarcinoma,there were 22 cases of MMRd subtype(34.38%),30 cases of NSMP subtype(46.88%),2 cases of POLE mutation(3.13%),and 10 cases of p53 abn subtype(15.63%);Among the 11 cases of serous carcinoma,4 cases(36.36%)had NSMP subtypes and 7 cases(63.64%)had p53 abn subtypes;Among the 4 cases of clear cell carcinoma,there were 3 cases of MMRd subtype(75.00%)and 1 case of p53 abn subtype(25.00%);Among the 3 cases of carcinosarcoma,3 cases(100%)had p53 abn type;Among the other 3 cases,there was 1 MMRd subtype(33.33%)and 2 NSMP subtypes(66.67%);There was a statistically significant difference in tumor staging,pathological type,and pathological grade among different molecular subtypes of EC(P<0.05).Conclusion The four molecular subtypes of EC are more realistic and objective in distinguishing diseases,and there are certain differences in tumor staging,pathological grading,and pathological types among different subtypes,which helps to develop personalized and precise treatment in clinical practice and improve patient prognosis.