Department of Obstetric & Gynaecology, Oncology Division, Airlangga University, Surabaya, Indonesia.
Department of Pathology Anatomy, Airlangga University, Surabaya, Indonesia.
Asian Pac J Cancer Prev. 2023 Sep 1;24(9):3229-3234. doi: 10.31557/APJCP.2023.24.9.3229.
This study aimed to analyze the correlation between the 3-year disease-free survival (DFS) and mismatch repair (MMR) protein levels in patients with type 1 endometrial carcinoma. Many studies have reported different results regarding the role of MMR in the prognosis of endometrial carcinoma; therefore, we aimed to identify this association in our hospital.
This observational study employed a historical cohort design and included patients with type 1 endometrial carcinoma who underwent surgery at Dr. Soetomo Hospital between January 2017 and December 2019. Medical records and paraffin blocks meeting these criteria were obtained. MMR proteins (MLH1 and MSH2) were assessed using immunohistochemistry.
A total of 46 patients with type 1 endometrial carcinoma were analyzed. We observed MMR deficiency (dMMR) in 12 patients (26.1%) and MMR proficiency (pMMR) in 34 patients (73.9%). Of the 12 patients with dMMR, nine cases (75%) were diagnosed as stage I and 7 (58.33%) as low grade. The 3-year DFS in patients with dMMR and pMMR was 83.3% and 67.6%, respectively (Hazard Ratio 2.31, 95% CI 0.5135-10.475, p=0.27). Higher stages had a 5.42 times increased risk of recurrence (95% CI 1.3378-21.9358, p=0.018). Higher histopathological grades were also associated with 8.65 times increased risk of recurrence (95% CI 2.5020-29.8738, p=0.001).
Patients with dMMR had a better DFS compared to those with pMMR; however, the difference was not statistically significant. The tumor stage and histopathological grade were independent risk factors for recurrence.
本研究旨在分析 1 型子宫内膜癌患者 3 年无病生存率（DFS）与错配修复（MMR）蛋白水平的相关性。许多研究报告了 MMR 在子宫内膜癌预后中的作用的不同结果；因此，我们旨在在我院确定这种相关性。
本观察性研究采用历史队列设计，纳入 2017 年 1 月至 2019 年 12 月在苏托莫医院接受手术的 1 型子宫内膜癌患者。获取符合这些标准的病历和石蜡块。使用免疫组织化学法评估 MMR 蛋白（MLH1 和 MSH2）。
共分析了 46 例 1 型子宫内膜癌患者。我们观察到 12 例（26.1%）存在 MMR 缺陷（dMMR），34 例（73.9%）存在 MMR 功能正常（pMMR）。在 12 例 dMMR 患者中，9 例（75%）诊断为 I 期，7 例（58.33%）为低级别。dMMR 和 pMMR 患者的 3 年 DFS 分别为 83.3%和 67.6%（风险比 2.31，95%CI 0.5135-10.475，p=0.27）。较高的分期复发风险增加 5.42 倍（95%CI 1.3378-21.9358，p=0.018）。较高的组织病理学分级也与 8.65 倍的复发风险相关（95%CI 2.5020-29.8738，p=0.001）。
dMMR 患者的 DFS 优于 pMMR 患者，但差异无统计学意义。肿瘤分期和组织病理学分级是复发的独立危险因素。
