University of Hawaii School of Medicine, Department of Obstetrics and Gynecology, Honolulu, Hawaii, USA.
Gynecol Oncol. 2013 Apr;129(1):188-92. doi: 10.1016/j.ygyno.2013.01.028. Epub 2013 Feb 4.
This study examines patients under the age of 70 with endometrial cancer and lymphatic invasion or lymph node metastases. Survival of patients with loss of tumor mismatch repair expression is compared to survival of patients with normal mismatch repair expression.
This is a retrospective review of patients treated from 1998-2009 for carcinoma of the endometrium. All patients with lymphatic invasion, including lymph node metastases, had immunohistochemical staining of the primary tumor for loss of expression of the mismatch repair genes MLH1, PMS2, MSH6, and MSH2. Overall survival and disease specific survival were compared using Kaplan-Meier plots.
Sixty-six patients were identified for inclusion; 26 demonstrated loss of mismatch repair expression and 40 demonstrated normal mismatch repair expression. Overall survival and disease specific survival were significantly better in the group with defective mismatch repair expression. Subgroup analysis of FIGO stage 3C patients also showed significantly better survival in patients with deficient mismatch repair expression.
For patients with endometrial cancer and lymphatic invasion, patients demonstrating loss of mismatch repair expression in the primary tumor appear to have a significantly better survival than patients with normal mismatch repair expression. Further investigation appears warranted to examine a possible role of mismatch repair expression as a prognostic marker for high risk patients with endometrial cancer.
本研究探讨了年龄在 70 岁以下、患有子宫内膜癌且存在淋巴管浸润或淋巴结转移的患者。比较肿瘤错配修复表达缺失患者与正常错配修复表达患者的生存情况。
这是一项对 1998 年至 2009 年间治疗的子宫内膜癌患者进行的回顾性研究。所有存在淋巴管浸润（包括淋巴结转移）的患者均对原发肿瘤进行错配修复基因 MLH1、PMS2、MSH6 和 MSH2 表达缺失的免疫组织化学染色。使用 Kaplan-Meier 图比较总生存率和疾病特异性生存率。
共纳入 66 例患者；26 例显示错配修复表达缺失，40 例显示正常错配修复表达。在错配修复表达缺失组，总生存率和疾病特异性生存率显著提高。FIGO 分期为 3C 期的亚组分析也显示，错配修复表达缺失的患者生存情况明显更好。
对于患有子宫内膜癌且存在淋巴管浸润的患者，原发肿瘤中存在错配修复表达缺失的患者似乎比正常错配修复表达的患者具有更好的生存情况。进一步的研究似乎有必要探究错配修复表达作为子宫内膜癌高危患者的预后标志物的可能作用。
