目的:癌症基因组图谱研究显示,2013年子宫内膜癌的高拷贝数(p53异常)基因突变与不良预后之间存在关联。这项回顾性研究调查了p53异常表达和I期患者的预后。低级别子宫内膜子宫内膜样癌(EEC)。
方法:我们招募了I期女性,在2019年1月至2022年12月期间在麦凯纪念医院接受全面分期和辅助治疗的1级或2级EEC,台北,台湾。病理学家解释癌组织的免疫组织化学染色以检测p53突变。我们比较了复发,生存,无进展生存期,p53异常组和p53正常组之间的总生存率。
结果:在115名患者中,26例病理证实p53表达异常。在这26名患者中,5人(19.2%)出现复发,两个人因疾病进展而死亡。相比之下,正常p53组没有患者出现疾病复发或因疾病进展而死亡.在复发性疾病状态方面发现了显著的组间差异(19.4%vs.0%,p<0.001),死亡率(7.7%vs.0%,p<0.001),无进展生存期(p<0.001)。总生存率(p=0.055)也显示出强烈的恶化趋势。
结论:对于I期患者,低等级EEC,p53异常表达可作为预后不良的指标。因此,我们建议考虑对这些患者进行积极的辅助治疗.
OBJECTIVE: The Cancer Genome Atlas study revealed an association between copy-number high (p53 abnormal) genetic mutation and poor prognosis in endometrial cancer in 2013. This retrospective study investigated outcomes in patients with abnormal p53 expression and stage I, low-grade endometrial endometrioid carcinoma (EEC).
METHODS: We enrolled women with stage I, grade 1 or 2 EEC who received comprehensive staging and adjuvant therapy between January 2019 and December 2022 at MacKay Memorial Hospital, Taipei, Taiwan. Pathologists interpreted immunohistochemistry stains of cancerous tissues to detect p53 mutation. We compared recurrence, survival, progression-free survival, and overall survival between p53 abnormal and p53 normal groups.
RESULTS: Of the 115 patients included, 26 had pathologically confirmed abnormal p53 expression. Of these 26 patients, five (19.2%) experienced recurrence, and two died due to disease progression. By contrast, no patients in the normal p53 group experienced disease recurrence or died due to disease progression. Significant intergroup differences were discovered in recurrent disease status (19.4% vs. 0%, p<0.001), mortality (7.7% vs. 0%, p<0.001), and progression-free survival (p<0.001). The overall survival (p=0.055) also showed powerful worse trend.
CONCLUSIONS: For patients with stage I, low-grade EEC, abnormal p53 expression may be used as an indicator of poor prognosis. Therefore, we suggest considering aggressive adjuvant therapies for these patients.