包括雌激素受体在内的分子亚型在子宫内膜样卵巢癌中的预后潜力

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-04-09 DOI:10.1016/j.ygyno.2025.03.050

Hein S. Zelisse , Malou L.H. Snijders , Floris H. Groenendijk , Johannes B.G. Halfwerk , Gerrit K.J. Hooijer , Willemien J. van Driel , Alicia León-Castillo , Christianne A.R. Lok , Loes F.S. Kooreman , Sandrina Lambrechts , Eva-Maria Roes , Roy J. Reinten , Marlou Heeling , Noah J. Sandel , Ronald van Marion , Frederike Dijk , Marc J. van de Vijver , Constantijne H. Mom , Mignon D.J.M. van Gent

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引用次数: 0

摘要

前瞻性子宫内膜癌分子风险分类器（ProMisE）已被证明适用于子宫内膜样卵巢癌（ENOC），将肿瘤分为四个分子亚组：POLE突变（POLEmut），错配修复缺陷（MMRd）， p53异常（p53abn）和无特异性分子谱（NSMP）。然而，ENOC中较大的NSMP亚组限制了其临床适用性。结合雌激素受体（ER）状态可提高NSMP子宫内膜癌的预后准确性。因此，本研究探讨了内质网状态在ENOC分子亚群中的预后价值。方法在这项多中心、回顾性队列研究中，使用1994-2021年手术治疗的ENOC患者石蜡包埋肿瘤组织进行分子分类。免疫组化法检测内质网状态。采用log-rank检验和Cox比例风险模型进行生存分析。结果167例纳入的患者中，1.2%为POLEmut肿瘤，6.6%为MMRd肿瘤，11.4%为p53abn肿瘤，80.8%为NSMP肿瘤。12%的肿瘤ER状态为阴性，与ER阳性肿瘤相比，其10年总生存率显著降低(HR 3.51, 95% CI 1.75-7.01, p <；措施)。POLEmut和MMRd亚组中未发现ER阴性肿瘤，p53abn亚组中ER状态不影响预后。在NSMP亚组中，11.1%的肿瘤为er阴性，显示出较差的10年总生存率（HR 3.92, 95% CI 1.67-9.21, p = 0.002）。结论：在ENOC的NSMP亚组中，er状态改善了预后分层，er阴性肿瘤的预后较差。这些发现可能会为ENOC提供更个性化的治疗策略。

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The prognostic potential of molecular subtypes including estrogen receptor status in endometrioid ovarian cancer

Background

The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) has been shown to be applicable to endometrioid ovarian cancer (ENOC), classifying tumors into four molecular subgroups: POLE mutated (POLEmut), mismatch repair deficient (MMRd), p53 abnormal (p53abn), and no specific molecular profile (NSMP). However, the large NSMP subgroup in ENOC limits its clinical applicability. Incorporating estrogen receptor (ER) status has improved prognostic accuracy in NSMP endometrial cancer. Therefore, this study investigated the prognostic value of ER status in the molecular subgroups of ENOC.

Methods

In this multicenter, retrospective cohort study, paraffin-embedded tumor tissue from surgically treated ENOC patients (1994–2021) was used for molecular classification. ER status was determined by immunohistochemistry. Survival analysis was performed using the log-rank test and Cox proportional hazards model.

Results

Of the 167 included patients, 1.2 % had a POLEmut tumor, 6.6 % an MMRd tumor, 11.4 % a p53abn tumor, and 80.8 % an NSMP tumor. ER status was negative in 12 % of tumors, correlating with a significantly lower 10-year overall survival rate compared to ER-positive tumors (HR 3.51, 95 % CI 1.75–7.01, p < .001). No ER-negative tumors were found in the POLEmut and MMRd subgroups, and ER status was not prognostic in the p53abn subgroup. In the NSMP subgroup, 11.1 % of tumors were ER-negative, showing a worse 10-year overall survival rate (HR 3.92, 95 % CI 1.67–9.21, p = .002).

Conclusion

ER status improves prognostic stratification within the NSMP subgroup in ENOC, with ER-negative tumors associated with a worse prognosis. These findings may lead to more personalized treatment strategies for ENOC.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy