Department of Obstetrics and Gynecology Faculty of Medicine, Çukurova University, 01330, Adana, Turkey.
Department of Pathology, Division of Gynecologic Pathology, Faculty of Medicine, Çukurova University, 01330, Adana, Turkey.
Pathol Oncol Res. 2020 Oct;26(4):2351-2356. doi: 10.1007/s12253-020-00836-w. Epub 2020 Jun 2.
Although the prognostic significance of grade in endometrial cancer is well known, grade 2 cases have not been evaluated separately in most of the previous studies. In this study, we aim to investigate whether the oncologic outcomes of grade 2 endometrioid endometrial carcinomas trend towards grade 1 or 3 tumors. Patients' records and pathological reports were reviewed retrospectively and eligible patients with endometrioid endometrial carcinoma were determined and distributed into 3 groups according to their 1988 International Federation of Gynecology and Obstetrics (FIGO) grade. Groups' characteristics and oncologic outcomes were compared. Differences between grades were tested with z-test and adjusted by Bonferroni method. Kaplan-Meier method was performed for the survival analysis. In total, 776 patients of endometrioid endometrial carcinoma were included in this study. Mean follow-up time was 52 ± 14 months. Patients' mean age was 56.3 ± 10.8 years. Even though grade 2 endometrioid endometrial carcinomas were different from both grade 1 and 3 in terms of the pathological features, survival analyses demonstrated that their oncologic outcomes trended towards grade 1. The grade was determined as an independent prognostic factor for overall survival (OS). The interobserver reproducibility will be improved among pathologists by combining FIGO grade 1 and 2 endometrioid endometrial carcinomas, while prognosis prediction is not likely to be affected.
虽然子宫内膜癌的分级预后意义已经明确，但在大多数先前的研究中，并未单独评估 2 级病例。在这项研究中，我们旨在研究 2 级子宫内膜样腺癌的肿瘤学结局是否倾向于 1 级或 3 级肿瘤。回顾性地审查了患者的记录和病理报告，并确定了符合条件的子宫内膜样腺癌患者，并根据其 1988 年国际妇产科联合会（FIGO）分级将其分为 3 组。比较了各组的特征和肿瘤学结局。使用 z 检验测试等级之间的差异，并通过 Bonferroni 方法进行调整。使用 Kaplan-Meier 方法进行生存分析。总共纳入了 776 例子宫内膜样腺癌患者。中位随访时间为 52±14 个月。患者的平均年龄为 56.3±10.8 岁。尽管 2 级子宫内膜样腺癌在病理特征方面与 1 级和 3 级不同，但生存分析表明其肿瘤学结局倾向于 1 级。分级被确定为总生存（OS）的独立预后因素。通过将 FIGO 1 级和 2 级子宫内膜样腺癌合并，将提高病理学家之间的观察者间可重复性，而预后预测不太可能受到影响。
