基于分子亚型的子宫内膜癌三级淋巴结构的特征和意义

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY International Journal of Gynecological Pathology Pub Date : 2024-11-01 Epub Date: 2024-02-23 DOI:10.1097/PGP.0000000000001027
Hui-Qing Jia, Shu-Ping Zhang, Yang Chen, Ye-Hua Qiao, Yi-Fan Yao, Xiang-Yan Zhang, Si-Yu Wu, Yao-Lin Song, Xiao-Ming Xing
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引用次数: 0

摘要

本研究旨在根据分子亚型研究子宫内膜癌(EC)中三级淋巴结构(TLS)的特征和意义。研究共回顾性地纳入了220例子宫内膜癌患者,包括20例聚合酶ε超突变(POLE-mut)患者、63例错配修复缺陷患者、32例p53异常患者和105例无特定分子特征的患者。TLS的存在和成熟度通过免疫组化标记(CD3、CD20、CD21和Bcl6)来确定。无病生存作为终点事件。在220例患者中,有91例(41.1%)发现了TLS,其中68例位于瘤周组织,37例表现为形成良好的生殖中心结构。TLS的存在和不同成熟度与肿瘤浸润淋巴细胞和程序性细胞死亡配体-1的表达密切相关。此外,TLS在不同分子亚型中表现出异质性。值得注意的是,TLSs、肿瘤浸润淋巴细胞和程序性细胞死亡配体-1的表达在POLE-mut EC中明显富集。多变量逻辑回归分析显示,TLSs的存在(几率比:3.483,95% CI:1.044-11.623,P = 0.042)是POLE-突变EC的潜在预测因子。卡普兰-梅耶生存曲线显示,分子亚型对EC患者的预后有显著的分层作用(P = 0.002),而TLS则没有。多变量Cox回归分析表明,国际妇产科联盟分期和Ki-67表达是影响EC患者无病生存的独立预后因素,而TLS不包括在内。总之,根据分子亚型,TLSs在EC中表现出异质性,因此有必要进一步探讨以确定其临床应用价值。
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Characteristics and Significance of Tertiary Lymphoid Structures Based on Molecular Subtypes in Endometrial Cancer.

The purpose of this study is to investigate the characteristics and significance of tertiary lymphoid structures (TLSs) in endometrial cancer (EC) based on molecular subtypes. A total of 220 patients with EC were retrospectively enrolled, including 20 with polymerase epsilon ultramutated (POLE-mut), 63 with mismatch repair deficient, 32 with p53 abnormal, and 105 with no specific molecular profile. The presence and maturity of TLSs were determined by immunohistochemical markers (CD3, CD20, CD21, and Bcl6). Disease-free survival served as the endpoint event. TLSs were found in 91 out of 220 patients (41.1%), with 68 located in peritumoral tissues and 37 exhibiting well-formed germinal center structures. The presence and different maturity of TLSs were closely associated with tumor-infiltrating lymphocytes and the programmed cell death ligand-1 expression. Moreover, TLSs displayed heterogeneity across different molecular subtypes. Notably, the TLSs, tumor-infiltrating lymphocytes, and expression of the programmed cell death ligand-1 were significantly enriched in POLE-mut EC. Multivariate logistic regression analysis showed the presence of TLSs (odds ratio: 3.483, 95% CI: 1.044-11.623, P = 0.042) as a potential predictor of POLE-mut EC. Kaplan-Meier survival curves revealed that molecular subtypes significantly stratified prognosis in patients with EC (P = 0.002), whereas TLSs did not. Multivariate Cox regression analysis indicated that The International Federation of Gynecology and Obstetrics stage and Ki-67 expression were independent prognostic factors affecting disease-free survival in patients with EC, and TLSs were not included. In conclusion, TLSs in EC exhibit heterogeneity based on molecular subtypes, necessitating further exploration to determine their clinical application value.

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来源期刊
CiteScore
3.90
自引率
12.50%
发文量
154
审稿时长
6-12 weeks
期刊介绍: International Journal of Gynecological Pathology is the official journal of the International Society of Gynecological Pathologists (ISGyP), and provides complete and timely coverage of advances in the understanding and management of gynecological disease. Emphasis is placed on investigations in the field of anatomic pathology. Articles devoted to experimental or animal pathology clearly relevant to an understanding of human disease are published, as are pathological and clinicopathological studies and individual case reports that offer new insights.
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