错配修复（MMR）状态对中高危险子宫内膜癌复发的影响

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-05-06 DOI:10.1016/j.ygyno.2025.04.588

Kelsey Jean Keverline, Breana Hill, Marianne Hom-Tedla, Marni Jacobs, Ramez N. Eskander

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引用次数: 0

摘要

大约25%的子宫内膜癌存在错配修复（dMMR）缺陷。这种分子畸变在高中危（HIR）子宫内膜癌患者中的临床影响尚不明确。方法：我们对2016年至2018年在南加州两家医院系统诊断为I期高中危子宫内膜样子宫内膜癌的女性进行了回顾性图表回顾。我们收集了人口统计信息、错配修复状态、病理报告和复发时间。结果244例患者符合纳入标准，其中86例（35%）为dMMR。与pMMR组相比，dMMR组淋巴血管间隙浸润的相对风险较高（相对风险1.63,95%可信区间1.26-2.10，p值0.0002），但深层肌层浸润的相对风险较低（相对风险0.81,95%可信区间0.66-0.99，p值0.047）。基于MMR状态的复发率或复发时间没有发现差异。在这项大型、多机构、队列研究中，在I期HIR、dMMR和pMMR子宫内膜样子宫内膜癌人群中，在复发率或其他癌症相关结局方面没有发现显著差异。

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Impact of mismatch repair (MMR) status on recurrence in high intermediate risk endometrial cancer

Background

Approximately 25 % of endometrial cancers harbor deficiencies in mismatch repair (dMMR). The clinical impact of this molecular aberration remains undefined in patients with high intermediate risk (HIR) endometrial cancer.

Methods

We conducted a retrospective chart review of women diagnosed with Stage I high-intermediate risk endometrioid endometrial cancer in two hospital systems in Southern California between 2016 and 2018. We collected demographic information, mismatch repair status, pathology reports, and time to recurrence.

Results

244 patients met inclusion criteria, of which 86 (35 %) were found to be dMMR. The dMMR patient population had higher relative risks of lymphovascular space invasion (relative risk 1.63, 95 % confidence interval 1.26–2.10, p-value 0.0002) but were less likely to have deep myometrial invasion (relative risk 0.81, 95 % confidence interval 0.66–0.99, p-value 0.047) when compared to the pMMR EC cohort. No differences were found in the rate of recurrence or time to recurrence based on MMR status.

Conclusions

In this large, multi-institution, cohort study there were no significant differences identified between Stage I HIR dMMR and pMMR endometrioid endometrial cancer populations with regards to recurrence rates or alternate cancer-related outcomes.

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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