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分子分类的预后和治疗影响,包括L1CAM表达在高风险子宫内膜癌的预后和治疗影响

Andreas Kleppe¹, Kristina Lindemann², Wanja Kildal³

¹Institute for Cancer Genetics and Informatics, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Department of Informatics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Centre for Research-based Innovation Visual Intelligence, UiT The Arctic University of Norway, Tromsø, Norway.

Gynecologic oncology

|November 16, 2024

概括

分子造型和L1CAM表达对于预测高风险子宫内膜癌复发和存活率至关重要. L1CAM是一个重要的预后因素,特别是在p53异常和NSMP组.

科学领域:

妇科瘤学妇科瘤学
分子病理学分子病理学
癌症基因组学癌症基因组学

背景情况:

分子分类和L1细胞粘附分子 (L1CAM) 在高风险子宫内膜癌的预后作用仍然不清楚.
了解这些因素对于完善治疗策略和改善患者治疗结果至关重要.

研究的目的:

调查分子分析 (ProMisE分类) 和L1CAM表达与高风险子宫内膜癌的复发模式和癌症特异性生存率 (CSS) 之间的关联.
确定L1CAM与已确定的分子亚型相关的独立预后值.

主要方法:

对489名患有高风险子宫内膜癌的患者进行了回顾性队列研究.
使用ProMisE (POLE,MMRd,p53,NSMP) 和L1CAM表达分析进行分子分类.
时间到复发 (TTR) 和CSS是主要终点,使用多变量模型进行分析.

主要成果:

在486名被分类的患者中,分子亚型是POLE突变 (8%),MMRd (30%),p53异常 (39%) 和NSMP (23%). 在53%的瘤中发现了高L1CAM表达.
在多变量分析中,L1CAM表达是TTR和CSS的显著独立预测指标.
虽然ProMisE对TTR显示出意义,但L1CAM在与ProMisE一起纳入模型时保留了意义,表明其独特的预后价值. POLE突变瘤的预后很好;p53异常或高L1CAM瘤的预后很差.

结论:

L1CAM作为子宫内膜癌的独立不良预后因素,特别是在p53异常和NSMP分子组内.
患有p53异常或NSMP瘤和高L1CAM表达的患者需要专门注意并可能加强辅助治疗策略.

关键词:

辅助疗法是一种辅助疗法.这是子宫内膜癌的癌症.这是高风险的高风险.这是一个L1CAM表达式.分子分类的分子分类.预测预后预测预测复发的位置是重复的位置.

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