Wayne State University School of Medicine, MI, USA.
Int J Gynecol Pathol. 2012 Jan;31(1):66-72. doi: 10.1097/PGP.0b013e318224329e.
Endometrial cancer is the most commonly diagnosed gynecologic malignancy in the United States and can be classified on the basis of various pathologic, molecular, and genetic features, including microsatellite instability (MSI). As MSI is generally associated with a more favorable outcome in colorectal cancers, it is feasible that microsatellite instability may also influence endometrial cancer survival. We examined MSI and survival in 45 African American and 31 white women diagnosed with endometrial cancer at a large, urban cancer center. Fifty-five tumors were classified as type I and 21 tumors were classified as type II. Unconditional logistic regression models found that microsatellite stable tumors were more frequently observed in white women compared with African American women (odds ratio, 8.61; 95% confidence interval, 1.01-73.69). Type I tumors with MSI were not found to be significantly associated with smoking status, tumor stage, or age. Only one type II tumor was classified as MSI. Neither race nor MSI status was a predictor of death from all causes or only endometrial cancer-related deaths were considered in univariate and multivariate survival models. The potential significance of a larger proportion of MSI tumors found in African American women with type I endometrial cancer should be assessed in a larger prospective study.
子宫内膜癌是美国最常见的妇科恶性肿瘤，可以根据各种病理、分子和遗传特征进行分类，包括微卫星不稳定性 (MSI)。由于 MSI 通常与结直肠癌的预后更有利相关，因此微卫星不稳定性也可能影响子宫内膜癌的生存。我们在一个大型城市癌症中心检查了 45 名非裔美国人和 31 名白人女性的 MSI 和生存情况，这些女性被诊断患有子宫内膜癌。55 个肿瘤被归类为 I 型，21 个肿瘤被归类为 II 型。非条件逻辑回归模型发现，与非裔美国女性相比，白人女性中更常观察到微卫星稳定的肿瘤（优势比，8.61；95%置信区间，1.01-73.69）。具有 MSI 的 I 型肿瘤与吸烟状况、肿瘤分期或年龄无关。仅发现一个 II 型肿瘤被归类为 MSI。无论种族还是 MSI 状态都不是单变量和多变量生存模型中所有原因导致的死亡或仅与子宫内膜癌相关的死亡的预测因子。在一项更大的前瞻性研究中，应评估非裔美国女性中更常见的 I 型子宫内膜癌中 MSI 肿瘤的更大比例的潜在意义。
