Journal of International Obstetrics and Gynecology ›› 2023, Vol. 50 ›› Issue (4): 377-381.doi: 10.12280/gjfckx.20230211
• Research on Gynecological Malignancies: Original Article • Previous Articles Next Articles
LI Yuan-yuan, LI Qian, HE Lian, ZHU Yan-mei, ZHANG Xin()
Received:
2023-03-20
Published:
2023-08-15
Online:
2023-08-15
Contact:
ZHANG Xin, E-mail: LI Yuan-yuan, LI Qian, HE Lian, ZHU Yan-mei, ZHANG Xin. The Relationship between ProMisE Molecular Typing and Lymph Node Metastasis and Other Clinical Features in Endometrial Cancer[J]. Journal of International Obstetrics and Gynecology, 2023, 50(4): 377-381.
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指标 | n | MMR-D (n=20) | POLE EDM (n=2) | p53 abn (n=18) | p53 wt (n=34) | P |
---|---|---|---|---|---|---|
年龄(岁) | 0.395 | |||||
≤50 | 12 | 4(33.3) | 1(8.4) | 3(25.0) | 4(33.3) | |
>50 | 62 | 16(25.8) | 1(1.6) | 15(24.2) | 30(48.4) | |
绝经 | 0.781 | |||||
否 | 23 | 7(30.4) | 1(4.4) | 6(26.1) | 9(39.1) | |
是 | 51 | 13(25.5) | 1(2.0) | 12(23.5) | 25(49.0) | |
病理类型 | 0.907 | |||||
子宫内膜样 | 67 | 18(26.9) | 2(3.0) | 16(23.9) | 31(46.2) | |
浆液性 | 2 | 0(0.0) | 0(0.0) | 1(50.0) | 1(50.0) | |
混合型 | 5 | 2(40.0) | 0(0.0) | 1(20.0) | 2(40.0) | |
病理分级 | 0.036 | |||||
高分化 | 12 | 2(16.7) | 1(8.3) | 4(33.3) | 5(41.7) | |
中分化 | 44 | 8(18.2) | 1(2.3) | 10(22.7) | 25(56.8) | |
低分化 | 18 | 10(55.6) | 0(0.0) | 4(22.2) | 4(22.2) | |
肌层浸润 | 0.824 | |||||
<1/2 | 36 | 10(27.8) | 1(2.8) | 7(19.4) | 18(50.0) | |
≥1/2 | 38 | 10(26.3) | 1(2.6) | 11(29.0) | 16(42.1) | |
LVSI | 0.896 | |||||
阴性 | 57 | 15(26.3) | 2(3.5) | 13(22.8) | 27(47.4) | |
阳性 | 17 | 5(29.4) | 0(0) | 5(29.4) | 7(41.2) | |
FIGO分期 | 0.018 | |||||
Ⅰ~Ⅱ | 40 | 10(25.0) | 1(2.5) | 5(12.5) | 24(60.0) | |
Ⅲ~Ⅳ | 34 | 10(29.4) | 1(3.0) | 13(38.2) | 10(29.4) | |
肿瘤直径(cm) | 0.469 | |||||
<2 | 19 | 6(31.6) | 0(0.0) | 3(15.8) | 10(52.6) | |
2~5 | 36 | 7(19.4) | 2(5.6) | 12(33.3) | 15(41.7) | |
>5 | 19 | 7(36.8) | 0(0.0) | 3(15.8) | 9(47.4) | |
淋巴结转移 | 0.004 | |||||
否 | 42 | 10(23.8) | 1(2.4) | 5(11.9) | 26(61.9) | |
是 | 32 | 10(31.3) | 1(3.1) | 13(40.6) | 8(25.0) | |
CA125(U/mL) | 0.504 | |||||
≤35 | 46 | 15(32.6) | 1(2.2) | 11(23.9) | 19(41.3) | |
>35 | 28 | 5(17.8) | 1(3.6) | 7(25.0) | 15(53.6) | |
ER表达 | 0.747 | |||||
阳性 | 69 | 19(27.5) | 2(2.9) | 16(23.2) | 32(46.4) | |
阴性 | 5 | 1(20.0) | 0(0.0) | 2(40.0) | 2(40.0) | |
PR表达 | 0.350 | |||||
阳性 | 61 | 14(22.9) | 2(3.3) | 15(24.6) | 30(49.2) | |
阴性 | 13 | 6(46.2) | 0(0.0) | 3(23.1) | 4(30.7) |
指标 | n | MMR-D (n=20) | POLE EDM (n=2) | p53 abn (n=18) | p53 wt (n=34) | P |
---|---|---|---|---|---|---|
年龄(岁) | 0.395 | |||||
≤50 | 12 | 4(33.3) | 1(8.4) | 3(25.0) | 4(33.3) | |
>50 | 62 | 16(25.8) | 1(1.6) | 15(24.2) | 30(48.4) | |
绝经 | 0.781 | |||||
否 | 23 | 7(30.4) | 1(4.4) | 6(26.1) | 9(39.1) | |
是 | 51 | 13(25.5) | 1(2.0) | 12(23.5) | 25(49.0) | |
病理类型 | 0.907 | |||||
子宫内膜样 | 67 | 18(26.9) | 2(3.0) | 16(23.9) | 31(46.2) | |
浆液性 | 2 | 0(0.0) | 0(0.0) | 1(50.0) | 1(50.0) | |
混合型 | 5 | 2(40.0) | 0(0.0) | 1(20.0) | 2(40.0) | |
病理分级 | 0.036 | |||||
高分化 | 12 | 2(16.7) | 1(8.3) | 4(33.3) | 5(41.7) | |
中分化 | 44 | 8(18.2) | 1(2.3) | 10(22.7) | 25(56.8) | |
低分化 | 18 | 10(55.6) | 0(0.0) | 4(22.2) | 4(22.2) | |
肌层浸润 | 0.824 | |||||
<1/2 | 36 | 10(27.8) | 1(2.8) | 7(19.4) | 18(50.0) | |
≥1/2 | 38 | 10(26.3) | 1(2.6) | 11(29.0) | 16(42.1) | |
LVSI | 0.896 | |||||
阴性 | 57 | 15(26.3) | 2(3.5) | 13(22.8) | 27(47.4) | |
阳性 | 17 | 5(29.4) | 0(0) | 5(29.4) | 7(41.2) | |
FIGO分期 | 0.018 | |||||
Ⅰ~Ⅱ | 40 | 10(25.0) | 1(2.5) | 5(12.5) | 24(60.0) | |
Ⅲ~Ⅳ | 34 | 10(29.4) | 1(3.0) | 13(38.2) | 10(29.4) | |
肿瘤直径(cm) | 0.469 | |||||
<2 | 19 | 6(31.6) | 0(0.0) | 3(15.8) | 10(52.6) | |
2~5 | 36 | 7(19.4) | 2(5.6) | 12(33.3) | 15(41.7) | |
>5 | 19 | 7(36.8) | 0(0.0) | 3(15.8) | 9(47.4) | |
淋巴结转移 | 0.004 | |||||
否 | 42 | 10(23.8) | 1(2.4) | 5(11.9) | 26(61.9) | |
是 | 32 | 10(31.3) | 1(3.1) | 13(40.6) | 8(25.0) | |
CA125(U/mL) | 0.504 | |||||
≤35 | 46 | 15(32.6) | 1(2.2) | 11(23.9) | 19(41.3) | |
>35 | 28 | 5(17.8) | 1(3.6) | 7(25.0) | 15(53.6) | |
ER表达 | 0.747 | |||||
阳性 | 69 | 19(27.5) | 2(2.9) | 16(23.2) | 32(46.4) | |
阴性 | 5 | 1(20.0) | 0(0.0) | 2(40.0) | 2(40.0) | |
PR表达 | 0.350 | |||||
阳性 | 61 | 14(22.9) | 2(3.3) | 15(24.6) | 30(49.2) | |
阴性 | 13 | 6(46.2) | 0(0.0) | 3(23.1) | 4(30.7) |
分子亚型 | 淋巴结转移 | χ2 | P | |
---|---|---|---|---|
是(n=32) | 否(n=42) | |||
MMR-D | 0.510 | 0.475 | ||
是(n=20) | 10(50.0) | 10(50.0) | ||
否(n=54) | 22(40.7) | 32(59.3) | ||
POLE EDM | - | 0.854a | ||
是(n=2) | 1(50.0) | 1(50.0) | ||
否(n=72) | 31(43.1) | 41(56.9) | ||
p53 | 11.591 | 0.001 | ||
abn(n=18) | 13(72.2) | 5(27.8) | ||
wt(n=34) | 8(23.5) | 26(76.5) |
分子亚型 | 淋巴结转移 | χ2 | P | |
---|---|---|---|---|
是(n=32) | 否(n=42) | |||
MMR-D | 0.510 | 0.475 | ||
是(n=20) | 10(50.0) | 10(50.0) | ||
否(n=54) | 22(40.7) | 32(59.3) | ||
POLE EDM | - | 0.854a | ||
是(n=2) | 1(50.0) | 1(50.0) | ||
否(n=72) | 31(43.1) | 41(56.9) | ||
p53 | 11.591 | 0.001 | ||
abn(n=18) | 13(72.2) | 5(27.8) | ||
wt(n=34) | 8(23.5) | 26(76.5) |
因素 | β | SE | Wald χ2 | P | OR | 95%CI |
---|---|---|---|---|---|---|
绝经 | -1.688 | 0.874 | 3.726 | 0.054 | 0.185 | 0.033~1.026 |
病理分级 (对照:高分化) | ||||||
中分化 | 2.391 | 1.558 | 2.355 | 0.125 | 10.926 | 0.515~231.630 |
低分化 | 3.199 | 1.721 | 3.456 | 0.063 | 24.513 | 0.841~714.722 |
ProMisE分子分型 (对照:p53 wt) | ||||||
POLE EDM | 2.532 | 4.468 | 0.321 | 0.571 | 12.578 | 0.002~79 919.494 |
MMR-D | 1.318 | 0.936 | 1.981 | 0.159 | 3.734 | 0.596~23.394 |
p53 abn | 3.320 | 1.097 | 9.164 | 0.002 | 27.669 | 3.224~237.480 |
肌层浸润≥1/2 | 3.093 | 0.848 | 13.310 | <0.001 | 22.046 | 4.185~116.146 |
因素 | β | SE | Wald χ2 | P | OR | 95%CI |
---|---|---|---|---|---|---|
绝经 | -1.688 | 0.874 | 3.726 | 0.054 | 0.185 | 0.033~1.026 |
病理分级 (对照:高分化) | ||||||
中分化 | 2.391 | 1.558 | 2.355 | 0.125 | 10.926 | 0.515~231.630 |
低分化 | 3.199 | 1.721 | 3.456 | 0.063 | 24.513 | 0.841~714.722 |
ProMisE分子分型 (对照:p53 wt) | ||||||
POLE EDM | 2.532 | 4.468 | 0.321 | 0.571 | 12.578 | 0.002~79 919.494 |
MMR-D | 1.318 | 0.936 | 1.981 | 0.159 | 3.734 | 0.596~23.394 |
p53 abn | 3.320 | 1.097 | 9.164 | 0.002 | 27.669 | 3.224~237.480 |
肌层浸润≥1/2 | 3.093 | 0.848 | 13.310 | <0.001 | 22.046 | 4.185~116.146 |
[1] |
Siegel RL, Miller KD, Fuchs HE, et al. Cancer Statistics, 2021[J]. CA Cancer J Clin, 2021, 71(1):7-33. doi: 10.3322/caac.21654.
doi: 10.3322/caac.21654 |
[2] |
Carlson JW, Nastic D. High-Grade Endometrial Carcinomas: Classification with Molecular Insights[J]. Surg Pathol Clin, 2019, 12(2):343-362. doi: 10.1016/j.path.2019.02.003.
doi: S1875-9181(19)30014-5 pmid: 31097108 |
[3] |
Rossi EC, Kowalski LD, Scalici J, et al. A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study[J]. Lancet Oncol, 2017, 18(3):384-392. doi: 10.1016/S1470-2045(17)30068-2.
doi: S1470-2045(17)30068-2 pmid: 28159465 |
[4] |
Cancer Genome Atlas Research Network, Kandoth C, Schultz N, et al. Integrated genomic characterization of endometrial carcinoma[J]. Nature, 2013, 497(7447):67-73. doi: 10.1038/nature12113.
doi: 10.1038/nature12113 |
[5] |
Talhouk A, McConechy MK, Leung S, et al. Confirmation of ProMisE: A simple, genomics-based clinical classifier for endometrial cancer[J]. Cancer, 2017, 123(5):802-813. doi: 10.1002/cncr.30496.
doi: 10.1002/cncr.30496 pmid: 28061006 |
[6] |
Singh N, Piskorz AM, Bosse T, et al. p53 immunohistochemistry is an accurate surrogate for TP53 mutational analysis in endometrial carcinoma biopsies[J]. J Pathol, 2020, 250(3):336-345. doi: 10.1002/path.5375.
doi: 10.1002/path.5375 |
[7] |
支文雪, 刘红刚. 子宫内膜癌分子分型的研究进展[J]. 临床与实验病理学杂志, 2021, 37(3):321-323,326. doi: 10.13315/j.cnki.cjcep.2021.03.015.
doi: 10.13315/j.cnki.cjcep.2021.03.015 |
[8] |
Parra-Herran C, Lerner-Ellis J, Xu B, et al. Molecular-based classification algorithm for endometrial carcinoma categorizes ovarian endometrioid carcinoma into prognostically significant groups[J]. Mod Pathol, 2017, 30(12):1748-1759. doi: 10.1038/modpathol.2017.81.
doi: 10.1038/modpathol.2017.81 |
[9] |
Kommoss S, McConechy MK, Kommoss F, et al. Final validation of the ProMisE molecular classifier for endometrial carcinoma in a large population-based case series[J]. Ann Oncol, 2018, 29(5):1180-1188. doi: 10.1093/annonc/mdy058.
doi: S0923-7534(19)34532-6 pmid: 29432521 |
[10] |
孙丽丽, 刘格丹, 贾楠, 等. 不同分子分型的子宫内膜癌临床病理特征分析[J]. 肿瘤预防与治疗, 2022, 35(5):435-441. doi: 10.3969/j.issn.1674-0904.2022.05.007.
doi: 10.3969/j.issn.1674-0904.2022.05.007 |
[11] |
杜宁宁, 刘岩, 任彩霞, 等. 癌症基因组图谱子宫内膜癌分子分型在子宫内膜样癌中的临床应用探索[J]. 中华病理学杂志, 2019, 48(8):596-603. doi: 10.3760/cma.j.issn.0529?5807.2019.08.003.
doi: 10.3760/cma.j.issn.0529?5807.2019.08.003 |
[12] | 何亚. 分子分型在子宫内膜癌中的应用价值[D]. 天津: 天津医科大学, 2020. |
[13] | 聂禹菲, 郭红燕, 高妍, 等. 子宫内膜癌分子分型与肥胖及代谢异常合并症的关系[J]. 实用妇产科杂志, 2022, 38(7):555-558. |
[14] |
Stelloo E, Nout RA, Osse EM, et al. Improved Risk Assessment by Integrating Molecular and Clinicopathological Factors in Early-stage Endometrial Cancer-Combined Analysis of the PORTEC Cohorts[J]. Clin Cancer Res, 2016, 22(16):4215-4224. doi: 10.1158/1078-0432.CCR-15-2878.
doi: 10.1158/1078-0432.CCR-15-2878 pmid: 27006490 |
[15] |
León-Castillo A, Gilvazquez E, Nout R, et al. Clinicopathological and molecular characterisation of ′multiple-classifier′ endometrial carcinomas[J]. J Pathol, 2020, 250(3):312-322. doi: 10.1002/path.5373.
doi: 10.1002/path.5373 |
[16] |
Köbel M, Kang EY. The Many Uses of p53 Immunohistochemistry in Gynecological Pathology: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual9 Meeting[J]. Int J Gynecol Pathol, 2021, 40(1):32-40. doi: 10.1097/PGP.0000000000000725.
doi: 10.1097/PGP.0000000000000725 pmid: 33290354 |
[17] |
Ignatov A, Ivros S, Bozukova M, et al. Systematic lymphadenectomy in early stage endometrial cancer[J]. Arch Gynecol Obstet, 2020, 302(1):231-239. doi: 10.1007/s00404-020-05600-8.
doi: 10.1007/s00404-020-05600-8 pmid: 32430757 |
[18] |
Jamieson A, Thompson EF, Huvila J, et al. Endometrial carcinoma molecular subtype correlates with the presence of lymph node metastases[J]. Gynecol Oncol, 2022, 165(2):376-384. doi: 10.1016/j.ygyno.2022.01.025.
doi: 10.1016/j.ygyno.2022.01.025 pmid: 35504673 |
[19] |
Mariani A, Sebo TJ, Katzmann JA, et al. Endometrial cancer: can nodal status be predicted with curettage?[J]. Gynecol Oncol, 2005, 96(3):594-600. doi: 10.1016/j.ygyno.2004.11.030.
doi: 10.1016/j.ygyno.2004.11.030 pmid: 15721399 |
[20] |
Widschwendter P, Bauer E, De Gregorio N, et al. Influence of Prognostic Factors on Lymph Node Involvement in Endometrial Cancer: A Single-Center Experience[J]. Int J Gynecol Cancer, 2018, 28(6):1145-1152. doi: 10.1097/IGC.0000000000001290.
doi: 10.1097/IGC.0000000000001290 pmid: 29757871 |
[21] |
Li Y, Cong P, Wang P, et al. Risk factors for pelvic lymph node metastasis in endometrial cancer[J]. Arch Gynecol Obstet, 2019, 300(4):1007-1013. doi: 10.1007/s00404-019-05276-9.
doi: 10.1007/s00404-019-05276-9 pmid: 31435773 |
[22] |
王晶, 袁江静, 王玉东. 2022欧洲肿瘤内科学会《子宫内膜癌临床实践指南》解读[J]. 中国实用妇科与产科杂志, 2022, 38(8):827-829. doi: 10.19538/j.fk2022080115.
doi: 10.19538/j.fk2022080115 |
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