Background:Endometrial cancer (EC) incidence and mortality have been steadily rising globally over recent decades. The introduction of advanced molecular technologies, such as next-generation sequencing (NGS) alongside the FIGO 2023 classification, presents opportunities for refined diagnostics and risk stratification. This study aimed to analyze differences in EC classification among oncology centers in southeastern Poland.Methods:Data were collected from 461 consecutive patients newly diagnosed with EC between 2022 and 2024 at four major oncology centers in southeastern Poland. Molecular and immunohistochemical (IHC) analyses were conducted on formalin-fixed paraffin-embedded (FFPE) tissues to identify key markers, including POLE mutations, MSI-H, and p53 status.Results:The application of the FIGO 2023 staging system revealed statistically significant inter-center differences, with Centers 1 and 4 diagnosing a higher proportion of early-stage cases. The most prevalent subtype was NSMP, observed in 51% of cases. MSI-H occurred in 13–36% of patients, depending on the center. p53 mutations ranged from 9% to 26%. POLE mutations were identified in 4% of patients overall. Significant variations in the molecular subtype distribution across centers highlight potential differences in diagnostic access or tumor biology.Conclusions:The findings demonstrate regional differences in EC staging and molecular profiles in Poland, potentially reflecting disparities in diagnostic resources, methodologies, or tumor characteristics. Addressing these variations through standardized diagnostic protocols and equitable access to molecular tools is critical for optimizing patient outcomes. Future research should focus on evaluating the impact of molecular markers on therapy response and prognosis to guide personalized treatment strategies.
背景：近几十年来，全球子宫内膜癌（EC）的发病率和死亡率持续上升。随着二代测序（NGS）等先进分子技术的引入以及FIGO 2023分期的应用，为精准诊断和风险分层提供了新的机遇。本研究旨在分析波兰东南部肿瘤中心在EC分类方面的差异。 方法：数据来源于2022年至2024年间在波兰东南部四家主要肿瘤中心连续收治的461例新诊断EC患者。对福尔马林固定石蜡包埋（FFPE）组织进行分子和免疫组化（IHC）分析，以检测关键标志物，包括POLE突变、MSI-H和p53状态。 结果：应用FIGO 2023分期系统显示出具有统计学意义的中心间差异，其中中心1和中心4诊断的早期病例比例较高。最常见的亚型为NSMP，占病例的51%。MSI-H的发生率在13%至36%之间，具体因中心而异。p53突变率为9%至26%。总体而言，POLE突变在患者中的检出率为4%。各中心分子亚型分布的显著差异，突显了诊断条件或肿瘤生物学特征方面可能存在的不同。 结论：研究结果表明，波兰EC的分期和分子特征存在地区差异，这可能反映了诊断资源、方法学或肿瘤特征的差异。通过标准化诊断方案和公平获取分子检测工具来解决这些差异，对于优化患者预后至关重要。未来的研究应侧重于评估分子标志物对治疗反应和预后的影响，以指导个体化治疗策略。
Analysis of Differences in the Classification of Endometrial Cancer Patients in Poland
肿瘤(癌症)患者之家