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La relación entre los datos histopatológicos y las alteraciones moleculares con los resultados oncológicos en los

Elif Aksahin¹, Fuat Demirkiran², Tugan Bese²

¹Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. eliffaksahin@gmail.com.

Journal of gynecologic oncology

|August 29, 2025

Resumen

Este estudio identificó subgrupos moleculares en el cáncer endometrial endometrioide (CEE). Las mutaciones POLE indican un pronóstico favorable, mientras que las mutaciones p53 se asocian con una supervivencia más corta, lo que subraya la necesidad de una evaluación integrada del riesgo.

Área de la Ciencia:

Oncología ginecológica
Patología molecular
Genómica del cáncer

Sus antecedentes:

El cáncer endometrial endometrioide (CEE) es el tipo más común de cáncer uterino.
La estratificación precisa del riesgo es crucial para la gestión eficaz del paciente y la planificación del tratamiento.
La elaboración de perfiles moleculares ofrece la posibilidad de perfeccionar las evaluaciones de pronóstico en la CEE.

Objetivo del estudio:

Identificar los distintos subgrupos moleculares dentro del cáncer endometrial endometrioide.
Para correlacionar estos subgrupos moleculares con las características clínico-histopatológicas.
Desarrollar grupos integrados de bajo riesgo intermedio para la gestión de la CEE.

Principales métodos:

Análisis retrospectivo de 900 casos CEE con subgrupos moleculares.
El análisis incluyó la secuenciación de exones POLE, p53 y la expresión de la proteína de reparación de desajuste (MMR) a través de la inmunohistoquímica.
Se analizaron los casos coincidentes de tumores recurrentes y no recurrentes.

Principales resultados:

Subgrupos moleculares identificados: mutación POLE (5%), deficiencia de MMR (43%), mutación p53 (5%) y NSMP (42%).
Los tumores con POLE-mut mostraron un pronóstico favorable sin recurrencias; los tumores con MMR-d se asociaron con tasas de recurrencia más altas.
La supervivencia libre de enfermedad (DFS) y la supervivencia global (OS) variaron significativamente entre los subgrupos, con NSMP mostrando la supervivencia más larga y p53-mut la OS más corta.

Conclusiones:

Las mutaciones POLE representan un factor de pronóstico favorable en la CEE.
Las características moleculares por sí solas son insuficientes para la estratificación del riesgo; la histopatología sigue siendo crítica.
Los enfoques integrados que combinan datos moleculares e histopatológicos son esenciales para definir los grupos de riesgo en la CEE.

Palabras clave:

Cáncer de endometrio tipo endometrioide Se incluyen las siguientes categorías:Clasificación molecular Políticas de desarrollo y p53

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