Optimum risk stratification in an early stage of endometrial cancer (EC) combines molecular and clinicopathological features. The purpose of the study was to determine the prognostic value of molecular classification and traditional pathological factors in a sample group of patients with stage I EC according to the FIGO 2023 criteria, to achieve a more personalized approach to patient care and treatment. The immunohistochemistry for p53 and mismatch repair (MMR) proteins, and DNA sequencing forPOLEexonuclease domain and clinicopathological parameters, including disease disease-free survival (DFS) and overall survival (OS) in 139 patients, were analyzed. It has been shown that the independent recurrence risk factors are stage IC (p< 0.001), aggressive histological types EC (p< 0.001), and the presence of p53abn protein immunoexpression (p= 0.009). Stage IC (p= 0.018), aggressive histological types EC (p= 0.025) and the presence of p53abn protein immunoexpression (p= 0.010) were all significantly associated with lower 5-year OS rates. Our research studies confirm that the molecular category corresponds to a different prognosis in clinical stage I EC according to the new 2023 FIGO classification, withPOLEmut cases presenting the best outcomes and p53abn cases showing the worst outcomes. Beyond the previous routine clinicopathological assessment, the new EC staging system represents an important step toward improving our ability to stratify IC stage EC risk.
子宫内膜癌（EC）早期的最佳风险分层需结合分子特征与临床病理学特征。本研究旨在依据FIGO 2023标准，分析I期EC患者样本中分子分型与传统病理因素的预后价值，以实现更个体化的患者护理与治疗方案。研究对139例患者进行了p53和错配修复（MMR）蛋白的免疫组化检测、POLE核酸外切酶结构域DNA测序及临床病理参数分析，包括无病生存期（DFS）和总生存期（OS）。结果显示：IC期（p<0.001）、侵袭性组织学类型EC（p<0.001）以及p53蛋白异常免疫表达（p=0.009）是独立的复发风险因素。IC期（p=0.018）、侵袭性组织学类型EC（p=0.025）和p53蛋白异常免疫表达（p=0.010）均与较低的5年OS率显著相关。我们的研究证实，根据2023年新版FIGO分期标准，分子分型对应着临床I期EC的不同预后，其中POLE突变型预后最佳，p53异常型预后最差。相较于既往常规临床病理评估，新版EC分期系统在提升IC期EC风险分层能力方面迈出了重要一步。
肿瘤(癌症)患者之家