子宫内膜癌ProMisE分子分型与脉管浸润和淋巴结转移的相关性研究  

Relationship between ProMisE molecular typing and vascular invasion and lymph node metastasis in endo⁃metrial carcinoma

作　　者：戴仕芬[1] 谢玉珍 陈秋燕 陈启城 DAI Shi-fen;XIE Yu-zhen;CHEN Qiu-yan;CHEN Qi-cheng(The People's Hospital of Meizhou,Department of Gynecology,Meizhou,Guangdong Province 514031,China)

机构地区：[1]梅州市人民医院妇科,广东梅州514031

出　　处：《解剖学研究》2024年第4期370-374,383,共6页Anatomy Research

基　　金：梅州市科技计划项目(231127172058878)。

摘　　要：目的 探讨子宫内膜癌ProMisE分子分型与脉管浸润和淋巴结转移的相关性。方法 选取2021年1月-2023年11月梅州市人民医院收治的子宫内膜癌患者60例,同时纳入相应的癌旁组织为对照,收集患者的临床资料,采用ProMisE分子分型方法进行分子分型,比较组别间ProMisE分子分型情况以及后者对子宫内膜癌脉管浸润和淋巴结转移的影响。结果 子宫内膜癌患者中POLE突变型16例(26.67%),dMMR共17例(28.33%)、p53 wt型51例(85.00%),p53 abn亚型9例(15.00%)。4种分子分型患者中,只有P53表达状态与淋巴结转移有关(P=0.010),而dMMR状态与脉管浸润有关(P=0.000),4种分子分型与浸润深度(P=0.037)、分化程度(P=0.010)、临床分期(P=0.016)有较大相关,但与年龄、肿瘤大小等无关(P>0.05)。二分类Logistic回归分析dMMR型(OR=15.112,95%CI:6.233~47.120,P=0.001)、p53突变型(OR=10.631,95%CI:8.164~48.121,P=0.003)、浸润深度(OR=6.633,95%CI:1.699~10.122,P=0.001)是淋巴结转移的危险因素。结论 对于子宫内膜癌ProMisE分子分型为p53突变型和dMMR型者患者,具有较高的脉管浸润和淋巴结转移的风险,临床应参考ProMisE分子分型制定相应的治疗方案。Objective To investigate the relationship between ProMisE molecular typing and vascular inva-sion and lymph node metastasis of endometrial carcinoma.Methods A total of 60 patients with endometrial cancer admitted to Meizhou People's Hospital from January 2021 to November 2023 were selected,and corresponding adja-cent tissues were included as controls.Clinical data of the patients were collected,and ProMisE molecular typing method was used for molecular typing.To compare the ProMisE molecular typing between groups and the effect of PROMISE on vascular invasion and lymph node metastasis of endometrial carcinoma.Results Among the patients with endometrial carcinoma,there were 16 cases of POLE mutation(26.67%),17 cases of dMMR(28.33%),51 cases of p53 wt type(85.00%),and 9 cases of p53 abn subtype(15.00%).Among the four molecular types,only P53 expression was correlated with lymph node metastasis(P=0.010),while dMMR expression was correlated with vascular invasion(P=0.000),and the four molecular types were significantly correlated with depth of invasion(P=0.037),degree of differentiation(P=0.010),and clinical stage(P=0.016).However,there was no correlation with age or tumor size(P>0.05).Binary Logistic regression analysis of dMMR type(OR=15.112,95%CI:6.233-47.120,P=0.001)and p53 mutant type(OR=10.631,95%CI:8.164-48.121,P=0.003),depth of invasion(OR=6.633,95%CI:1.699-10.122,P=0.001)were risk factors for lymph node metastasis.Conclusion For patients with endo-metrial carcinoma with ProMisE molecular typing of p53 mutation and dMMR type,there is a high risk of vascular in-vasion and lymph node metastasis,and the corresponding treatment plan should be made according to ProMisE mo-lecular typing.

关 键 词：子宫内膜癌 ProMisE分子分型 脉管浸润 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]