TCGA 分子分类在子宫癌肉瘤中的预后价值。
Prognostic value of the TCGA molecular classification in uterine carcinosarcoma.
机构信息
Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy.
Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
出版信息
Int J Gynaecol Obstet. 2022 Jul;158(1):13-20. doi: 10.1002/ijgo.13937. Epub 2021 Oct 11.
BACKGROUND
The TCGA molecular groups of endometrial carcinoma are "POLE-mutated" (POLEmut), "microsatellite-instable/mismatch repair-deficient" (MSI/MMRd), "TP53-mutated/p53-abnormal" (TP53mut/p53abn), and "no specific molecular profile" (NSMP).
OBJECTIVE
Prognostic assessment of the TCGA groups in uterine carcinosarcoma (UCS).
SEARCH STRATEGY
Systematic review from January 2000 to January 2021.
SELECTION CRITERIA
Studies assessing the TCGA groups in UCS.
DATA COLLECTION AND ANALYSIS
Progression-free survival (PFS) and overall survival (OS) were assessed by Kaplan-Meier and Cox analyses (reference: TP53mut/p53abn group) and compared with endometrioid and serous carcinomas (original TCGA cohort), with a significant P < 0.050.
MAIN RESULTS
Five studies with 263 UCS were included. Compared with TP53mut/p53abn UCS, MSI/MMRd UCS showed significantly better PFS (P < 0.001) but similar OS (P = 0.788), whereas NSMP UCS showed similar PFS (P = 0.936) and OS (P = 0.240). Compared with their endometrioid/serous counterparts, NSMP and TP53mut/p53abn UCS showed significantly worse PFS (P < 0.001 and P = 0.004) and OS (P < 0.001 and P < 0.001), while MSI/MMRd UCS showed similar PFS (P = 0.595) but significantly worse OS (P < 0.001). The POLEmut group showed neither recurrences nor deaths in both the UCS and the endometrioid/serous carcinoma cohorts.
CONCLUSION
POLEmut UCS show excellent prognosis, whereas TP53mut/p53abn and NSMP UCS show a prognosis even worse than that of TP53mut/p53abn endometrioid/serous carcinomas. The prognosis of MSI/MMRd UCS remains to be defined.
背景
子宫内膜癌的 TCGA 分子分组为“POLE 突变”（POLEmut）、“微卫星不稳定/错配修复缺陷”（MSI/MMRd）、“TP53 突变/p53 异常”（TP53mut/p53abn）和“无特定分子特征”（NSMP）。
目的
评估 TCGA 分组在子宫癌肉瘤（UCS）中的预后作用。
检索策略
系统检索 2000 年 1 月至 2021 年 1 月期间的文献。
选择标准
评估 UCS 中 TCGA 分组的研究。
数据收集和分析
通过 Kaplan-Meier 和 Cox 分析评估无进展生存期（PFS）和总生存期（OS）（参考：TP53mut/p53abn 组），并与子宫内膜样癌和浆液性癌（原始 TCGA 队列）进行比较，P<0.050 具有统计学意义。
主要结果
纳入了 5 项研究，共 263 例 UCS。与 TP53mut/p53abn UCS 相比，MSI/MMRd UCS 的 PFS 显著更好（P<0.001），但 OS 无显著差异（P=0.788），而 NSMP UCS 的 PFS 相似（P=0.936），OS 无显著差异（P=0.240）。与相应的子宫内膜样癌和浆液性癌相比，NSMP 和 TP53mut/p53abn UCS 的 PFS 和 OS 均显著更差（P<0.001 和 P=0.004），而 MSI/MMRd UCS 的 PFS 相似（P=0.595），但 OS 显著更差（P<0.001）。POLEmut 组在 UCS 和子宫内膜样癌/浆液性癌队列中均未出现复发或死亡。
结论
POLEmut UCS 预后良好，而 TP53mut/p53abn 和 NSMP UCS 的预后甚至比 TP53mut/p53abn 子宫内膜样癌和浆液性癌更差。MSI/MMRd UCS 的预后仍有待确定。
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