目的:回顾子宫内膜癌FIGO2023分期系统新版本的变化。
结果:新的FIGO2023子宫内膜癌分期系统为子宫内膜癌的诊断和治疗提供了关键更新。诊断的一个重要步骤是分子分类,这可以更准确地对复发进行风险分层,并确定靶向治疗。新的暂存系统,根据国际社会ESGO的建议,ESTRO和ESP,不仅包括对疾病的病理和解剖范围的描述,还有肿瘤的组织病理学特征,包括组织学类型和淋巴管间隙侵犯的存在。此外,分期系统使用分子检测将子宫内膜癌分为四个预后组:POLEmut,MMRd,NSMP和p53abn。每个群体都有其特定的特点和预后。最显著的变化发生在第一和第二阶段,其中亚分期更好地反映了肿瘤的生物学行为。这一更新提高了预后的准确性,并改善了子宫内膜癌患者的个性化治疗选择。
结论:2023年子宫内膜癌的最新FIGO分期包括不同的组织学类型,肿瘤特征,和分子分类,以更好地反映当前对几种子宫内膜癌类型及其潜在生物学行为的复杂性的理解。新的子宫内膜癌分期系统的目的是更好地定义具有相似预后的分期。允许更精确地指示个体化辅助放射或全身治疗,包括使用免疫疗法。
To review the changes in the new version of the FIGO 2023 staging system for endometrial cancer.
The new FIGO 2023 endometrial cancer staging system provides key updates for the diagnosis and treatment of endometrial cancer. An important step in diagnosis is molecular classification, which allows more accurate risk stratification for recurrence and the identification of targeted therapies. The new staging system, based on the recommendations of the international societies ESGO, ESTRO and ESP, incorporates not only the description of the pathological and anatomical extent of the disease, but also the histopathological characteristics of the tumour, including the histological type and the presence of lymphovascular space invasion. In addition, the staging system uses molecular testing to classify endometrial cancers into four prognostic groups: POLEmut, MMRd, NSMP and p53abn. Each group has its own specific characteristics and prognosis. The most significant changes have occurred in stages I and II, in which the sub-staging better reflects the biological behaviour of the tumour. This
update increases the accuracy of prognosis and improves individualized treatment options for patients with endometrial cancer.
The updated FIGO staging of endometrial cancer for 2023 incorporates different histologic types, tumour features, and molecular classifications to better reflect the current improved understanding of the complex nature of several endometrial cancer types and their underlying bio logic behaviour. The aim of the new endometrial cancer staging system is to better define stages with similar prognosis, allowing for more precise indication of individualised adjuvant radiation or systemic treatment, including the use of immunotherapy.