Jumaah Alaa Salah, Al-Haddad Hawraa Sahib, Salem Mais Muhammed, McAllister Katherine Ann, Yasseen Akeel Abed
Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq.
Al-Furat Al-Awsat Hospital, Kufa, Iraq.
J Pathol Transl Med. 2021 May;55(3):202-211. doi: 10.4132/jptm.2021.02.19. Epub 2021 Apr 14.
Loss of mismatch repair (MMR) occurs frequently in endometrial carcinoma (EC) and is an important prognostic marker. However, the frequency of MMR deficiency (D-MMR) in EC remains inconclusive. This systematic review and meta-analysis addressed this inconsistency and evaluated related clinicopathology.
Electronic databases were searched for articles: PubMed, Science Direct, Web of Science, EMBASE, and the Wiley Online Library. Data were extracted from 25 EC studies of D-MMR to generate a clinical dataset of 7,459 patients. A random-effects model produced pooled estimates of D-MMR EC frequency with 95% confidence interval (CI) for meta-analysis.
The overall pooled proportion of D-MMR was 24.477% (95% CI, 21.022 to 28.106) in EC. The Lynch syndrome subgroup had 22.907% pooled D-MMR (95% CI, 14.852 to 32.116). D-MMR was highest in type I EC (25.810) (95% CI, 22.503 to 29.261) compared to type II (13.736) (95% CI, 8.392 to 20.144). Pooled D-MMR was highest at EC stage and grades I-II (79.430% and 65.718%, respectively) and lowest in stages III-IV and grade III (20.168% and 21.529%). The pooled odd ratios comparing D-MMR to proficient MMR favored low-stage EC disease (1.565; 0.894 to 2.740), lymphovascular invasion (1.765; 1.293 to 2.409), and myometrial invasion >50% (1.271; 0.871 to 1.853).
Almost one-quarter of EC patients present with D-MMR tumors. The majority has less aggressive endometrioid histology. D-MMR presents at lower tumor stages compared to MMR-proficient cases in EC. However other metastatic parameters are comparatively higher in the D-MMR disease setting.
错配修复（MMR）功能缺失在子宫内膜癌（EC）中频繁发生，是一项重要的预后标志物。然而，EC中错配修复缺陷（D-MMR）的发生率仍无定论。本系统评价和荟萃分析解决了这一不一致性问题，并评估了相关的临床病理学特征。
检索电子数据库中的文章：PubMed、Science Direct、Web of Science、EMBASE和Wiley Online Library。从25项关于D-MMR的EC研究中提取数据，以生成一个包含7459例患者的临床数据集。采用随机效应模型对D-MMR EC发生率进行汇总估计，并计算95%置信区间（CI）用于荟萃分析。
EC中D-MMR的总体汇总比例为24.477%（95%CI，21.022至28.106）。林奇综合征亚组的D-MMR汇总比例为22.907%（95%CI，14.852至32.116）。与II型EC（13.736）（95%CI，8.392至20.144）相比，I型EC中D-MMR最高（25.810）（95%CI，22.
