Department of Gynecology and Obstetrics, University of Greifswald, Greifswald, Germany.
Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany.
BMC Cancer. 2024 Mar 25;24(1):380. doi: 10.1186/s12885-024-12127-7.
Accurate preoperative molecular and histological risk stratification is essential for effective treatment planning in endometrial cancer. However, inconsistencies between pre- and postoperative tumor histology have been reported in previous studies. To address this issue and identify risk factors related to inaccurate histologic diagnosis after preoperative endometrial evaluation, we conducted this retrospective analysis.
We conducted a retrospective analysis involving 375 patients treated for primary endometrial cancer in five different gynaecological departments in Germany. Histological assessments of curettage and hysterectomy specimens were collected and evaluated.
Preoperative histologic subtype was confirmed in 89.5% of cases and preoperative tumor grading in 75.2% of cases. Higher rates of histologic subtype variations (36.84%) were observed for non-endometrioid carcinomas. Non-endometrioid (OR 4.41) histology and high-grade (OR 8.37) carcinomas were identified as predictors of diverging histologic subtypes, while intermediate (OR 5.04) and high grading (OR 3.94) predicted diverging tumor grading.
When planning therapy for endometrial cancer, the limited accuracy of endometrial sampling, especially in case of non-endometrioid histology or high tumor grading, should be carefully considered.
准确的术前分子和组织学风险分层对于子宫内膜癌的有效治疗计划至关重要。然而，之前的研究报告显示术前和术后肿瘤组织学之间存在不一致性。为了解决这个问题，并确定与术前子宫内膜评估后组织学诊断不准确相关的风险因素，我们进行了这项回顾性分析。
我们对德国五个不同妇科部门治疗的 375 名原发性子宫内膜癌患者进行了回顾性分析。收集并评估刮宫和子宫切除术标本的组织学评估。
89.5%的病例确认了术前组织学亚型，75.2%的病例确认了术前肿瘤分级。非子宫内膜样癌的组织学亚型变化率更高（36.84%）。非子宫内膜样（OR 4.41）组织学和高级别（OR 8.37）癌被确定为组织学亚型差异的预测因素，而中级别（OR 5.04）和高级别（OR 3.94）则预测肿瘤分级差异。
在计划子宫内膜癌的治疗时，应仔细考虑子宫内膜取样的有限准确性，尤其是在非子宫内膜样组织学或高肿瘤分级的情况下。
