Alexa Matthias, Hasenburg Annette, Battista Marco Johannes
Department of Gynecology and Obstetrics, University Medical Center Mainz, 55131 Mainz, Germany.
Cancers (Basel). 2021 Mar 23;13(6):1478. doi: 10.3390/cancers13061478.
Adjuvant treatment decisions for endometrial cancer (EC) are based on stage, the histological grade of differentiation, histological subtype, and few histopathological markers. The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) identified four risk groups of EC patients using a combination of immunohistochemistry and mutation analysis: Polymerase Epsilon exonuclease domain mutated (POLE EDM), mismatch repair deficient (MMRd), p53 wild-type/copy-number-low (p53 wt), and p53-mutated/copy-number-high (p53 abn). Patients allocated to the POLE or abnormal p53 expression subtype are faced with a significantly altered outcome possibly requiring a modified adjuvant treatment decision. Within this review, we summarize the development of ProMisE, characterize the four molecular subtypes, and finally discuss its value in terms of a patient-tailored therapy in order to prevent significant under or overtreatment.
子宫内膜癌（EC）的辅助治疗决策基于分期、组织学分化程度、组织学亚型以及少数组织病理学标志物。子宫内膜癌主动分子风险分类器（ProMisE）通过免疫组织化学和突变分析相结合的方法，确定了EC患者的四个风险组：聚合酶ε外切酶结构域突变（POLE EDM）、错配修复缺陷（MMRd）、p53野生型/拷贝数低（p53 wt）和p53突变/拷贝数高（p53 abn）。被分配到POLE或p53异常表达亚型的患者面临着显著改变的预后，可能需要修改辅助治疗决策。在本综述中，我们总结了ProMisE的发展，描述了四种分子亚型，最后讨论了其在个体化治疗方面的价值，以防止严重的治疗不足或过度治疗。
