Smith DuPreez, Young Kang Eun, Nelson Gregg S, Lee Cheng-Han, Köbel Martin, Aubrey Christa
Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Aberta, Canada.
Gynecol Oncol Rep. 2024 Jul 1;54:101447. doi: 10.1016/j.gore.2024.101447. eCollection 2024 Aug.
This study aims to investigate the relationship between body mass index (BMI) and molecular subtypes of endometrial carcinoma using an immunohistochemistry (IHC)-based classification approach.
We analyzed a consecutive series of endometrial cancer cases undergoing surgical staging in southern Alberta (2019-2021). Molecular classification was determined through IHC-based molecular typing, incorporating p53 and mismatch repair (MMR), and further characterized with the addition of ER and PR. BMI associations with molecular classification were assessed using t-tests. Hormone receptor status was further examined in a separate cohort of MMRd endometrial cancer patients undergoing surgical staging at Foothills Medical Centre (Alberta, Canada).
Among 289 cases, comprising various histological subtypes, the pNSMP subtype exhibited the highest average BMI (33.93 kg/m) compared to the p53 abnormal subtype (30.40 kg/m, p = 0.02). The MMRd subtype had an average BMI of 33.22 kg/m. While there were no significant BMI differences between FIGO grade 1 and grade 2/3 tumours in the pNSMP or MMRd, a trend toward higher BMI in grade 1 tumours versus grade 2/3 tumours in the MMRd was observed (p = 0.13). A separate cohort of 53 MMRd endometrial carcinomas revealed that FIGO grade 1 tumours were associated with higher BMI (p < 0.05) and more frequent ER/PR expression compared to grade 2/3 tumours (p < 0.05).
This study suggests an association between obesity and NSMP endometrial carcinoma. The relationship between BMI and low-grade MMRd endometrial carcinomas with increased ER/PR expression warrants further exploration.
本研究旨在采用基于免疫组织化学（IHC）的分类方法，探讨体重指数（BMI）与子宫内膜癌分子亚型之间的关系。
我们分析了艾伯塔省南部（2019 - 2021年）连续一系列接受手术分期的子宫内膜癌病例。通过基于IHC的分子分型确定分子分类，纳入p53和错配修复（MMR），并通过添加雌激素受体（ER）和孕激素受体（PR）进一步进行特征描述。使用t检验评估BMI与分子分类之间的关联。在山麓医疗中心（加拿大艾伯塔省）接受手术分期的另一组错配修复缺陷（MMRd）子宫内膜癌患者中，进一步检查激素受体状态。
在289例包含各种组织学亚型的病例中，与p53异常亚型（30.40kg/m²，p = 0.02）相比，pNSMP亚型的平均BMI最高（33.93kg/m²）。MMRd亚型的平均BMI为33.22kg/m²。虽然在pNSMP或MMRd中，国际妇产科联盟（FIGO）1级和2/3级肿瘤之间的BMI没有显著差异，但在MMRd中观察到1级肿瘤的BMI有高于2/3级肿瘤的趋势（p = 0.13）。另一组53例MMRd子宫内膜癌显示，与2/3级肿瘤相比，FIGO 1级肿瘤与更高的BMI相关（p < 0.05），且雌激素受体/孕激素受体表达更频繁（p < 0.05）。
本研究提示肥胖与非特异性分子谱（NSMP）子宫内膜癌之间存在关联。BMI与雌激素受体/孕激素受体表达增加的低级别MMRd子宫内膜癌之间的关系值得进一步探索。
