Prognostic factors and survival outcomes of immunohistochemically detection based-molecular subtypes of endometrial cancer-analysis of 576 clinical cases.

IF 2.4 3区 医学 Q2 PATHOLOGY
Xiaohui Wang, Aziz Ur Rehman Aziz, Dandan Wang, Yaping Wang, Ming Liu, Xiaohui Yu, Daqing Wang
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引用次数: 0

Abstract

Objective: The study aimed to identify distinct molecular subtypes of endometrial cancer (EC) by immunohistochemistry and to analyze their pathological characteristics, independent prognostic factors, and patient survival outcomes for potential clinical applications.

Method: 576 patients with preoperative EC confined to the uterus were divided into three subgroups based on the immunohistochemical detection method: MMR-deficiency (MMRd), P53 wild type (P53wt) and P53 abnormal (P53abn). These subgroups were retrospectively analyzed, and their pathological characteristics, prognostic factors and survival outcomes were compared.

Results: We identified 401 (69.6%), 123 (21.4%), and 52 (9%) cases of P53wt, MMRd, and P53abn subgroups, respectively. A significant difference was observed in the median age of onset, tumor stage, high-grade tumor differentiation, non-endometrioid carcinoma, myometrial invasion, lymphovascular invasion, the incidence of lymph node metastasis postoperative, and expression of ER and PR receptors among the three groups. Pathological type, lymphovascular invasion, ER and PR expression were identified as independent prognostic factors for disease-free survival (DFS). Additionally, pathological type, lymphovascular invasion, myometrial invasion, and PR expression were recognized as independent prognostic factors for overall survival (OS) in the study cohort. However, the survival outcome for P53abn was the worst, with lymphovascular invasion identified as an independent prognostic factor for DFS. Lymph node status, FIGO stage, and ER expression were identified as independent prognostic factors for OS.

Conclusion: The study concludes that immunohistochemical detection-based subtyping of EC holds clinical practicality and can be employed to explore both pathological and clinical prognoses for EC patients.

基于免疫组织化学检测的子宫内膜癌分子亚型预后因素及生存结局——576例临床病例分析
目的:本研究旨在通过免疫组织化学方法鉴定子宫内膜癌(EC)的不同分子亚型,并分析其病理特征、独立预后因素和患者生存结局,为潜在的临床应用提供依据。方法:采用免疫组化检测方法将576例术前局限于子宫的EC患者分为mmr缺失(MMRd)、P53野生型(P53wt)和P53异常(P53abn) 3个亚组。对这些亚组进行回顾性分析,比较其病理特征、预后因素和生存结局。结果:我们分别确定了401例(69.6%)、123例(21.4%)和52例(9%)P53wt、MMRd和P53abn亚组。三组患者在发病中位年龄、肿瘤分期、肿瘤分化程度、非子宫内膜样癌、子宫肌层浸润、淋巴血管浸润、术后淋巴结转移发生率、ER和PR受体表达等方面差异均有统计学意义。病理类型、淋巴血管侵袭、ER和PR表达被确定为无病生存(DFS)的独立预后因素。此外,病理类型、淋巴血管浸润、肌层浸润和PR表达被认为是研究队列中总生存(OS)的独立预后因素。然而,P53abn的生存结果是最差的,淋巴血管侵袭被确定为DFS的独立预后因素。淋巴结状态、FIGO分期和ER表达被确定为OS的独立预后因素。结论:基于免疫组化检测的EC分型具有临床实用性,可用于探讨EC患者的病理和临床预后。
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来源期刊
Diagnostic Pathology
Diagnostic Pathology 医学-病理学
CiteScore
4.60
自引率
0.00%
发文量
93
审稿时长
1 months
期刊介绍: Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).
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