子宫内膜癌的冷缺血时间和福尔马林固定时间:乳腺癌分析前变量指南是否应适用于子宫切除标本?

IF 4.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Gynecologic oncology Pub Date : 2024-10-22 DOI:10.1016/j.ygyno.2024.10.015
Paulina J. Haight , Sydney Lammers , Quinn Kistenfeger , Chelsea Leipold , Adrian A. Suarez , Gary H. Tozbikian , Ashwini Esnakula , Casey Cosgrove , Kristin L. Bixel
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Demographics, clinicopathologic and peri-operative factors, and IHC for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and mismatch repair (MMR) proteins were compared between patients with cIT &lt;60 min versus ≥60 min (prolonged), and compliant FFT (6–72 h) versus non-compliant FFT (&lt;6 or &gt; 72 h). Categorical variables were compared using χ<sup>2</sup> tests.</div></div><div><h3>Results</h3><div>941 patients were included in the analysis. Median cIT was 33 min. Prolonged cIT occurred in 95 (10 %) cases. African American/Black race (<em>p</em> &lt; 0.001), advanced stage (p &lt; 0.001), mini-laparotomy (p &lt; 0.001), performance of surgical procedures beyond standard EC staging (p &lt; 0.001), longer surgical length (p &lt; 0.001), and increased uterine weight (p &lt; 0.001) were independently associated with prolonged cIT. 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引用次数: 0

摘要

目的:美国临床肿瘤学会(ASCO)/美国病理学家学会(CAP)建议采用冷缺血时间(cIT)计算方法:cIT 的计算方法是:从标本放入福尔马林的时间减去术中组织去血管的时间。比较了 cIT 72 h)患者的人口统计学、临床病理学和围手术期因素,以及雌激素受体(ER)、孕酮受体(PR)、人表皮生长因子受体 2(HER2)和错配修复(MMR)蛋白的 IHC。分类变量的比较采用χ2检验:941名患者纳入分析。中位 cIT 为 33 分钟。有 95 例(10%)发生 cIT 延长。非裔美国人/黑人种族(P延长 cIT 与心肌梗死手术分期时通过 IHC 检测的生物标志物表达差异无关。尽管 cIT 存在变异,这主要是由于不可改变的因素造成的,但肿瘤分子特征仍然是一致的,可以可靠地用于预后和治疗决策。
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Cold ischemia time and formalin fixation time in endometrial cancer: Should breast cancer guidelines for preanalytical variables be applied to hysterectomy specimens?

Objectives

The American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) recommend cold ischemia time (cIT) be <60 min, and formalin fixation time (FFT) 6–72 h, to optimize immunohistochemistry (IHC) based on breast cancer data. We assessed whether cIT and FFT impact IHC in endometrial cancer (EC), and determined which factors affect cIT and FFT.

Methods

Surgical EC cases from 2019 to 2023 were reviewed. cIT was calculated by subtracting time of tissue devascularization intra-operatively from time the specimen was placed in formalin. Demographics, clinicopathologic and peri-operative factors, and IHC for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and mismatch repair (MMR) proteins were compared between patients with cIT <60 min versus ≥60 min (prolonged), and compliant FFT (6–72 h) versus non-compliant FFT (<6 or > 72 h). Categorical variables were compared using χ2 tests.

Results

941 patients were included in the analysis. Median cIT was 33 min. Prolonged cIT occurred in 95 (10 %) cases. African American/Black race (p < 0.001), advanced stage (p < 0.001), mini-laparotomy (p < 0.001), performance of surgical procedures beyond standard EC staging (p < 0.001), longer surgical length (p < 0.001), and increased uterine weight (p < 0.001) were independently associated with prolonged cIT. There were no significant differences in ER, PR, HER2, or MMR protein expression based on cIT or FFT.

Conclusion

Prolonged cIT was not associated with differences in biomarker expression via IHC at time of surgical staging for EC. Despite variability in cIT, which is largely due to non-modifiable factors, tumor molecular features remain consistent and can reliably be utilized for prognostic and therapeutic decision-making.
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
期刊介绍: Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy
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