Clinical and pathologic features of young endometrial cancer patients with loss of mismatch repair expression
Clinical and pathologic features of young endometrial cancer patients with loss of mismatch repair expression
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DOI：
10.1016/j.ygyno.2012.05.019
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发表时间：
2012-09-01
影响因子：
4.7
通讯作者：
Terada, Keith Y.
中科院分区：
文献类型：
--
作者：
Grzankowski, Kassondra S.;Shimizu, David M.;Terada, Keith Y.
目标。本研究检查绝经前和早期绝经患者在一个独特的人群与子宫内膜癌和失配修复（MMR）基因表达丢失。目的是比较表达丧失（LOE）患者与正常表达（NE）患者的临床和病理差异。在1998年至2008年间，60岁以下的子宫内膜癌患者从单一肿瘤登记处确定。从病历中提取临床和病理资料。在存档的组织块上染色检测MSH6、MSH2、MLH1和PMS2的表达。进行统计学分析。分析158例患者；58%为亚洲人，34%为太平洋岛民，8%为高加索人。127保留网元。50%的高加索人，21.9%的亚洲人和12.5%的太平洋岛屿人群有一个或多个MMR基因的爱。LOE在III级（p= 0.0013）和3-4期肿瘤（p= 0.0079）、平均肌层浸润深度（p= 0.0019）、淋巴血管间隙浸润（p=0.0020）、淋巴结转移（p= 0.0157）的发生率较高，而1级（p=0.0020）和1A期肿瘤（p= 0.0085）的发生率较低。LOE组的平均BMI明显较低（p = 0.0001）。NE组35%的患者BMI大于40，而LOE组为零。年轻的LOE子宫内膜癌患者似乎代表了一个具有临床意义的亚组，这些患者没有典型1型子宫内膜癌的特征，通常表现为较低的BMI和与预后差相关的肿瘤特征。目前尚不清楚在夏威夷发现的独特种族是否对结果有重大影响。需要进一步调查以确定适当的治疗策略。(C) 2012年Elsevier Inc.出版。
Objective. This study examines premenopausal and early menopause patients in a unique population with endometrial cancer and loss of mismatch repair (MMR) gene expression. The purpose is to compare clinical and pathologic differences in patients with loss of expression (LOE) to those with normal expression (NE).Methods. Endometrial cancer patients under age 60 in-between 1998 and 2008 were identified from a single tumor registry. Clinical and pathologic data were abstracted from records. Staining for expression of MSH6, MSH2, MLH1, and PMS2 were performed on archived tissue blocks. Statistical analysis was performed.Results. 158 patients were analyzed; 58% Asian, 34% Pacific Islander, and 8% Caucasian. 31 demonstrated LOE of at least one MMR gene; 127 retained NE. 50% Caucasian, 21.9% Asian, and 12.5% Pacific Island populations had LOE of one or more MMR genes. LOE was found to have a higher incidence of Grade III (p = 0.0013) and stage 3-4 tumors (p = 0.0079), mean depth of myometrial invasion (p = 0.0019), lymphovascular space invasion (p=0.0020), nodal metastases (p = 0.0157), and a lower incidence of Grade 1 (p = 0.0020) and stage 1A tumors (p = 0.0085). LOE had a significantly lower mean BMI (p = 0.0001). 35% of patients in the NE vs zero in the LOE group had a BMI greater than 40.Conclusion. Younger patients with LOE endometrial cancer appear to represent a clinically significant subgroup of patients without features characteristically found in classic type 1 endometrial cancer generally demonstrating lower BMI and tumors associated with poor prognostic characteristics. It is unclear if the distinctive ethnicity found in Hawaii has a significant impact on outcome. Further investigation is necessary to identify appropriate treatment strategies. (C) 2012 Published by Elsevier Inc.