Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
Arch Gynecol Obstet. 2021 Jun;303(6):1393-1400. doi: 10.1007/s00404-021-06028-4. Epub 2021 Mar 23.
The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) groups has identified four molecular prognostic groups of endometrial cancer (EC): POLE-mutated (POLE-mt), mismatch repair-deficient (MMR-d), p53-abnormal (p53-abn), p53-wild-type (p53-wt). These groups might have different pathogenesis and risk factors, and might occur in different phenotypes of patients. However, these data are still lacking.
To provide a clinical characterization of the ProMisE groups of EC.
A systematic review and meta-analysis was performed by searching seven electronic databases from their inception to December 2020, for all studies reporting clinical characteristics of EC patients in each ProMisE group. Pooled means of age and BMI and pooled prevalence of FIGO stage I and adjuvant treatment in each ProMisE group were calculated.
Six studies with 1, 879 women were included in the systematic review. Pooled means (with standard error) and prevalence values were: in the MMR-d group, age = 66.5 ± 0.6; BMI = 30.6 ± 1.2; stage I = 72.6%; adjuvant treatment = 47.3%; in the POLE-mt group, age = 58.6 ± 2.7; BMI = 27.2 ± 0.9; stage I = 93.7%; adjuvant treatment = 53.6%; in the p53-wt group, age = 64.2 ± 1.9; BMI = 32.3 ± 1.4; stage I = 80.5%; adjuvant treatment = 45.3%; in the p53-abn group, age = 71.1 ± 0.5; BMI = 29.1 ± 0.5; stage I = 50.8%; adjuvant treatment = 64.4%.
The ProMisE groups identify different phenotypes of patients. The POLE-mt group included the youngest women, with the lower BMI and the highest prevalence of stage I. The p53-wt group included patients with the highest BMI. The p53-abn group included the oldest women, with the highest prevalence of adjuvant treatment and the lowest prevalence of stage I. The MMR-d group showed intermediate values among the ProMisE groups for all clinical features.
主动分子风险分类器预测子宫内膜癌(ProMisE)将子宫内膜癌(EC)分为四个分子预后组:错配修复缺陷(MMR-d)、p53 异常(p53-abn)、p53 野生型(p53-wt)和 POLE 突变(POLE-mt)。这些组可能具有不同的发病机制和危险因素,并且可能发生在不同表型的患者中。然而,这些数据仍然缺乏。
提供 ProMisE 组 EC 的临床特征。
通过检索从成立到 2020 年 12 月的七个电子数据库,对所有报告 EC 患者在每个 ProMisE 组临床特征的研究进行系统回顾和荟萃分析。计算每个 ProMisE 组中年龄和 BMI 的平均值和患病率,以及 FIGO Ⅰ期和辅助治疗的患病率。
本系统综述纳入了 6 项研究,共 1879 名女性。汇总平均值(标准误差)和患病率值为:MMR-d 组年龄=66.5±0.6;BMI=30.6±1.2;Ⅰ期=72.6%;辅助治疗=47.3%;POLE-mt 组年龄=58.6±2.7;BMI=27.2±0.9;Ⅰ期=93.7%;辅助治疗=53.6%;p53-wt 组年龄=64.2±1.9;BMI=32.3±1.4;Ⅰ期=80.5%;辅助治疗=45.3%;p53-abn 组年龄=71.1±0.5;BMI=29.1±0.5;Ⅰ期=50.8%;辅助治疗=64.4%。
ProMisE 组鉴定出不同表型的患者。POLE-mt 组包括最年轻的女性,BMI 最低,Ⅰ期比例最高。p53-wt 组包括 BMI 最高的患者。p53-abn 组包括年龄最大的女性,辅助治疗率最高,Ⅰ期比例最低。MMR-d 组在所有临床特征方面在 ProMisE 组中均表现出中间值。