The relationship between lymph node metastasis and immunohistochemical molecular subtypes in endometrial cancer: A cohort study of 339 patients

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2025-09-01 DOI:10.1111/jog.70065

Hande Nur Öncü, Gökçen Ege, Neslihan Öztürk, Oğuz Kaan Köksal, Büşra Körpe, Candost Hanedan, Çağanay Soysal, Vakkas Korkmaz

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Abstract

Aim

This study evaluated the association between immunohistochemically (IHC) molecular subtypes and lymph node metastasis (LNM) in endometrial cancer.

Methods

The study included 339 patients diagnosed with endometrial cancer (EC) confined to the uterus and treated with pelvic ± para-aortic lymph node dissection (LND), who were included in the study. Patients were divided into two groups: LNM-negative (Group 1, n = 289) and LNM-positive (Group 2, n = 50). All patients underwent IHC-based molecular subtype analysis. Demographic, clinical, and histopathological characteristics were evaluated.

Results

The median age was 62 years (34–79) in Group 1 and 64 years (48–79) in Group 2 (p = 0.022). Body mass index (BMI) and parity were similar between the groups (p > 0.05). LNM was detected in 14.7% of patients (50/339). Among Group 1, 64.4% (186/289) had a non-specific molecular profile (NSMP), 20.1% (58/289) had mismatch repair deficiency (MMRd), and 15.5% (45/289) had the p53 abnormal (p53abn) subtype. In contrast, in Group 2, 44% (22/50) were NSMP, 24% (12/50) were MMRd, and 32% (16/50) were p53abn (p = 0.008). A statistically significant association was observed between LNM and the p53abn subtype. LNM was present in 26% (16/61) of patients with the p53abn subtype, compared to 17% (12/70) in the MMRd group and 11% (22/208) in the NSMP group.

Conclusion

While our study identified an association between the p53abn subtype and lymph node metastasis, this finding alone does not support using p53 status in isolation to determine lymphatic staging; instead, it should be considered a complementary marker alongside established clinicopathologic factors.

Abstract Image

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339例子宫内膜癌患者淋巴结转移与免疫组织化学分子亚型的关系

目的探讨免疫组织化学（IHC）分子亚型与子宫内膜癌淋巴结转移（LNM）的关系。方法对339例诊断为子宫内膜癌（EC）并行盆腔±主动脉旁淋巴结清扫术（LND）的患者进行研究。患者分为两组：lnm阴性（1组，n = 289）和lnm阳性（2组，n = 50）。所有患者均进行基于免疫组化的分子亚型分析。评估了人口统计学、临床和组织病理学特征。结果1组患者中位年龄为62岁（34 ~ 79岁），2组患者中位年龄为64岁（48 ~ 79岁）（p = 0.022）。体重指数（BMI）和胎次组间差异无统计学意义（p > 0.05）。14.7%的患者（50/339）检出LNM。1组中，64.4%（186/289）存在非特异性分子谱（NSMP）， 20.1%（58/289）存在错配修复缺陷（MMRd）， 15.5%（45/289）存在p53异常（p53abn）亚型。第2组中，44%（22/50）为NSMP， 24%（12/50）为MMRd， 32%（16/50）为p53abn （p = 0.008）。在LNM和p53abn亚型之间观察到统计学上显著的关联。p53abn亚型患者中有26%（16/61）存在LNM，而MMRd组为17% (12/70)，NSMP组为11%（22/208）。结论：虽然我们的研究确定了p53abn亚型与淋巴结转移之间的关联，但这一发现本身并不支持单独使用p53状态来确定淋巴分期；相反，它应被视为与已确定的临床病理因素相辅相成的标志物。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.