一种简便实用的子宫内膜癌分子分型方法应用分析  

Application analysis of a simple and practical molecular typing method of endometrial cancer

作　　者：栗三东 钱文平 王金桃 张蕾 刘敏 LI Sandong;QIAN Wenping;WANG Jintao;ZHANG Lei;LIU Min(Pathology Center,Youyi Clinical Laboratories of Shaanxi,Shaanxi Xi'an 710065,China;Basic Laboratory of Pathology,Shaanxi Provincial Cancer Hospital,Shaanxi Xi'an 710061,China)

机构地区：[1]陕西友谊医学检验实验室病理中心,陕西西安710065 [2]陕西省肿瘤医院病理科基础研究室,陕西西安710061

出　　处：《现代肿瘤医学》2024年第21期4115-4120,共6页Journal of Modern Oncology

摘　　要：目的:探讨一种简化实用的子宫内膜癌(endometrial cancer,EC)分子分型方法及其与患者临床病理特征的关系。方法:收集2020年01月至2023年05月该病理中心收集的行病理检查的手术切除子宫内膜癌标本110例,手术方式为全子宫和双侧附件切除及盆腔淋巴结清扫,采用免疫组织化学染色技术,明确子宫内膜癌分子亚型,并分析各分子亚型的临床病理特征。结果:110例子宫内膜癌中,根据免疫组化染色结果进行免疫表型分组,分为三组:MSI-H组58例(52.73%),p53abn组4例(3.64%),p53wt组48例(43.64%)。三组分子分型中,MSI-H及p53wt与子宫内膜癌患者的年龄、FIGO病理分级、FIGO分期、肌层浸润深度、脉管浸润情况和淋巴结转移均无关(均P>0.05)。p53abn与子宫内膜癌患者年龄、FIGO分期、肿瘤肌层浸润深度、脉管浸润情况和淋巴结转移均有关(均P<0.05),而与子宫内膜癌的FIGO病理分级无关(P>0.05)。综合比较分析,三组免疫组化的分子分型与子宫内膜癌患者年龄、FIGO病理分级、FIGO分期、脉管浸润情况和淋巴结转移均有关(均P<0.05),而与子宫内膜癌的肿瘤肌层浸润深度无关(P>0.05)。结论:免疫组化简化分型法是一种有效的子宫内膜癌分子分型方法。该简化的分子分型客观、重复性强,能够给临床提供更准确的信息,为子宫内膜癌分子亚型诊断提供同等的信息,为子宫内膜癌患者治疗方案的选择提供科学依据。Objective:To explore a simplified and practical molecular typing method for endometrial cancer(EC),and its relationship with the clinicalpathological features.Methods:110 cases of EC diagnosed in our pathology center from January 2020 to May 2023 were collected for analysis,using immunohistochemical staining to clarify molecular classification,and analyzing the clinicopathological characteristics of each molecular subtype.The surgical methods included total hysterectomy with double appendages and pelvic lymph node dissection.Results:Among the 110 cases of EC,immunophenotypes were divided into three groups based on immunohistochemical results.There were 58 cases(52.73%)in the MSI-H group,and 4 cases(3.64%)in the p53abn group,and 48 cases(43.64%)in the p53wt group.Among the three molecular subtypes,MSI-H and p53wt were not associated with age,FIGO pathological grading,FIGO staging,depth of muscular infiltration,vascular infiltration,and lymph node metastasis in EC patients(all P>0.05).p53abn was associated with age,FIGO staging,depth of tumor muscle invasion,vascular infiltration,and lymph node metastasis in EC patients(all P<0.05),but not with FIGO pathological grading of EC(P>0.05).Comparative analysis showed that the molecular typing of the three groups was related to the age,FIGO pathological grading,FIGO staging,vascular infiltration,and lymph node metastasis in EC patients(all P<0.05),and not to the depth of tumor muscle invasion of EC(P>0.05).Conclusion:The simplified method of immunohistochemistry can serve as an effective approach for molecular typing of endometrial cancer.And it's objectivity and repeatability can provide more precise information to clinical practice and can also provide equivalently important information for the diagnosis of molecular subtypes,and at the same time,providing scientific basis for the selection of treatment plans for EC patients.

关 键 词：子宫内膜癌 分子分型 免疫组化 临床病理特征 

分 类 号：R737.33[医药卫生—肿瘤]