子宫内膜癌ProMisE分子分型与临床病理特征及预后的相关性分析  

Correlation analysis of ProMisE molecular classification with clinical pathological features and prognosis in endometrial cancer

作　　者：刘红[1] 罗敏 彭春蓉 樊英 何静[1] 罗古坡 王登凤 张国楠 Liu Hong;Luo Min;Peng Chunrong(Departments of Gynecological Oncology,Sichuan Cancer Hospital Affiliated to University of Electronic Science and Technology,Chengdu 610041;Departments of Oncology,Chengdu Sixth People's Hospital,Chengdu 610051)

机构地区：[1]电子科技大学附属肿瘤医院妇瘤科,成都610041 [2]成都市第六人民医院肿瘤科,成都610051

出　　处：《现代妇产科进展》2024年第4期255-263,共9页Progress in Obstetrics and Gynecology

基　　金：北京康华中西医发展基金会2021年度第一批“妇科肿瘤专项研究基金”项目(No:KH-2021-LLZX-009)

摘　　要：目的:探讨子宫内膜癌(EC)ProMisE分子分型与临床病理特征的相关性及其对患者预后的影响。方法:回顾分析81例EC患者的临床病理资料,进行ProMisE分子分型。用非参数检验检测ProMisE分子亚型与临床病理特征的相关性。卡帕系数(Kappa)进行ESMO风险分层与ProMisE分型的一致性检验。Kaplan-Meier法绘制生存曲线,单因素及多因素Cox回归分析法探讨影响EC患者预后的危险因素。结果:ProMisE分子分型与各临床病理因素不存在统计学意义的相关性。ProMisE分子分型与ESMO风险分层一致性不佳(Kappa=0.005,P=0.922)。多因素Cox回归分析显示,腹水细胞学阳性(HR=19.471,P=0.001)和宫颈间质侵犯(HR=9.662,P=0.032)是PFS下降的独立预后影响因素,且腹水细胞学阳性(HR=20.641,P=0.012)是OS的独立预后影响因素。ESGO-ESTRO-ESP模型和ESMO2016模型对比ProMisE模型对PFS的预测能力更好(P<0.05)。结论:ProMisE分子分型与ESMO风险分层系统一致性不佳,结合了分子分型和临床病理参数的ESGO-ESTRO-ESP预后分层模型对预测EC患者PFS能力更强。腹水细胞学阳性是影响EC患者PFS及OS的独立预后因素。Objective:To explore the correlation between ProMisE molecular classification and clinical pathological features and its impact on the prognosis of endometrial cancer patients.Methods:Retrospectively analyze clinical and pathological data of 81 patients with endometrial cancer undergoing surgery and perform ProMisE molecular classification of them.The correlations of ProMisE molecular classification with clinicopathological characteristics were examined by non-parametric tests.Cross analysis was conducted on the consistency between ProMisE molecular typing and 2016 ESMO risk stratification using Kappa consistency test.The Kaplan-Meier method was used to plot survival curves,univariate and multivariate factor Cox regression analysis were used to explore the risk factors affecting the prognosis of patients with endometrial cancer.Results:There was no statistically significant correlation between ProMisE molecular classification and various clinical pathological factors.The consistency between ProMisE molecular classification and ESMO risk stratification was poor(Kappa=0.005,P=0.922).Multivariate Cox regression analysis showed that positive ascitic cytology(HR=19.471,P=0.001)and cervical interstitial invasion(HR=9.662,P=0.032)were independent prognostic factors for decreased PFS,and positive ascitic cytology(HR=20.641,P=0.012)was also an independent prognostic factor for OS.ESMO risk stratification and ESGO-ESTRO-ESP risk stratification model has a better predictive ability for PFS compared to ProMisE molecular classification(P<0.05).Conclusion:The consistency between ProMisE molecular classification and ESMO risk stratification is poor.The ESGO-ESTRO-ESP prognostic stratification model,which combines molecular classification and clinical pathological parameters,has a stronger ability to predict patient PFS.Positive ascitic cytology is an independent prognostic factor affecting PFS and OS in patients.

关 键 词：子宫内膜癌 ProMisE分子分型 ESMO风险分层 治疗 预后 

分 类 号：R737.33[医药卫生—肿瘤]