Wang Hao, Xiao Yinbo, Cai Yumeng, Zhou Yang, Chen Longyun, Guo Jianbin, Shi Xiaohua, Liang Zhiyong
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100730, People's Republic of China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100730, People's Republic of China.
Int J Womens Health. 2024 Aug 14;16:1401-1411. doi: 10.2147/IJWH.S465255. eCollection 2024.
This study used single-center data to analyze the clinicopathological features of site-specific endometrial cancer.
Patients with endometrial carcinoma who had undergone surgery at Peking Union Medical College Hospital, China, between March 2016 and January 2022 were enrolled. Clinical information and pathological characteristics were summarized, and microsatellite status was analyzed using the immunohistochemical method. Patient prognoses were measured in terms of the rates of overall survival and progression-free survival.
The mean patient age was 49 years (ranging: from 25 to 76 years old), and there was no difference in clinicopathological features between endometrioid and type II endometrial carcinoma in LUSC. The ER and PR expression ratios were 80.4% and 64.3%, respectively, in this LUSC cohort, and the MMR deficiency ratio was 33.9%, including 39.6% in endometrioid carcinoma and 15.4% in type II endometrial carcinoma. Combined MSH2&MSH6 loss was more common than combined MLH1&PMS2 being unexpressed (16.1% vs 12.5%), and dMMR patients differed significantly from the pMMR group in terms of vascular invasion (=0.003). The combination of chemotherapy and radiotherapy did not provide a statistically significant improvement in prognosis compared to chemotherapy alone.
The results of this study showed that LUSC patients tended to be younger and their tumors had less expression of hormone markers. The biological behavior of both endometrioid cancer and type II EC may be similar when EC occurs in this area. Furthermore, this type of tumor also showed a higher incidence of vascular invasion, and the combination of chemotherapy and radiotherapy did not provide significant improvement. Thus, successful treatment of LUSC tumors requires aggressive surgical intervention and a more effective postoperative treatment approach.
本研究使用单中心数据来分析特定部位子宫内膜癌的临床病理特征。
纳入2016年3月至2022年1月在中国北京协和医院接受手术的子宫内膜癌患者。总结临床信息和病理特征，并采用免疫组化方法分析微卫星状态。通过总生存率和无进展生存率来衡量患者预后。
患者平均年龄为49岁（范围：25至76岁），肺鳞状细胞癌（LUSC）中子宫内膜样癌和II型子宫内膜癌的临床病理特征无差异。在该LUSC队列中，雌激素受体（ER）和孕激素受体（PR）表达率分别为80.4%和64.3%，错配修复（MMR）缺陷率为33.9%，其中子宫内膜样癌为39.6%，II型子宫内膜癌为15.4%。MSH2和MSH6联合缺失比MLH1和PMS2联合未表达更常见（16.1%对12.5%），错配修复缺陷（dMMR）患者在血管侵犯方面与错配修复功能正常（pMMR）组有显著差异（P = 0.003）。与单纯化疗相比，化疗联合放疗在预后方面未显示出统计学上的显著改善。
本研究结果表明，LUSC患者往往较年轻，其肿瘤激素标志物表达较少。当子宫内膜癌发生在该部位时，子宫内膜样癌和II型子宫内膜癌的生物学行为可能相似。此外，这类肿瘤血管侵犯发生率也较高，化疗联合放疗未带来显著改善。因此，成功治疗LUSC肿瘤需要积极的手术干预和更有效的术后治疗方法。
