在子宫内膜癌中,分子分类驱动的阶段迁移和预后风险分层:FIGO 2023与FIGO 2009对比
Neha Bakshi1, Rahul Modi2, Vandana Arya3
1Department of Pathology, Histopathology Division, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India.
Virchows Archiv : an international journal of pathology
|December 4, 2025
概括
将分子分类纳入FIGO 2023对子宫内膜癌 (ECs) 的分期,显著改变了阶段和风险分层. 这种形态分子方法完善了预后,并指导了EC患者个性化辅助治疗决策.
科学领域:
- 妇科瘤学 妇科瘤学
- 癌症基因组学 癌症基因组学
- 病理学 病理学 病理学
背景情况:
- 对于子宫内膜癌 (ECs) 的FIGO 2023分期系统强调将分子分类与组织病理学整合起来.
- 由于分子分析的可用性有限,这对新阶段化系统的广泛采用构成了挑战.
- 准确的分期对于预后和指导EC中辅助治疗决策至关重要.
研究的目的:
- 评估分子分类对阶段迁移和风险组分层的影响,使用FIGO 2023和FIGO 2009分级.
- 评估综合形态分子分期如何影响辅助治疗方案.
- 为了比较分期结局与没有分子分析的结果.
主要方法:
- 根据FIGO 2023和FIGO 2009标准分阶段处理了234起欧盟案件.
- 仅利用组织形态学和完整的形态分子分类 (POLE突变,p53,不匹配修复蛋白).
- 分析了阶段转移,风险组变化和潜在的治疗影响.
主要成果:
- FIGO 2023分阶段导致了显著的阶段转移,主要是早期阶段EC的上升.
- 与单独的形态学相比,分子分类增加了9.3%的阶段转移.
- 在分子分析的12.5%情况下,风险组分层发生了变化,影响了治疗建议.
结论:
- 综合形态分子FIGO 2023分期显著改善了子宫内膜癌的阶段和风险分层.
- 这种方法为个性化辅助治疗提供了潜在的好处,特别是在高档早期EC中.
- 需要进一步的研究,以充分阐明分子分类在FIGO 2023系统中的含义.
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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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