| 摘要: |
| [摘 要]目的 探讨2023年子宫内膜癌（EC）国际妇产科联盟（FIGO）分期中高级别子宫内膜样癌（EEC）的免疫组织化学（IHC）表达状态与侵袭性组织类型的相关性。 方法 回顾性收集2020年1月至2025年3月于绍兴市妇幼保健院收治的153例EC患者的临床资料。根据盆腔淋巴结转移（LNM）状态结合IHC表达状态分流高级别ECC的危险度，并采用Logistic回归分析验证其与侵袭性组织学类型相关性。 结果 153例EC患者，其中EEC占81.7%（125/153）、高级别EEC占17.6%（27/153）、盆腔LNM占9.8%（15/153）。Logistic 回归分析示:广泛性淋巴血管间隙侵犯（LVSI）、MELF浸润模式和雌激素受体（ER）低/阴性表达是盆腔LNM的独立危险因素；p53异常型和FIGO 2023 Ⅱ/Ⅲ期是侵袭性组织学类型的独立危险因素（均P＜0.05）。高级别EEC中ER低/阴性表达较中/高表达者更易发生深肌层浸润、LNM及广泛性LVSI；EEC中ER低/阴性表达与广泛性LVSI、PR低/阴性表达、高级别EEC组织类型显著相关（均P＜0.05）。 结论 2023版EC的FIGO分期系统进一步推进了评估预后和制定治疗策略的精准化。基于IHC染色强度和阳性占比的ER评分标准有助于弥补形态学诊断不足，进一步分流高级别EEC的侵袭性组织学类型，有助于探索细化分期和个性化治疗方案。 |
| 关键词: 子宫内膜样癌 FIGO分期 侵袭性组织类型 激素受体 |
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| Analyze the correlation between hormone receptor expression and aggressive histological types in high grade endometrioid carcinoma according to 2023 FIGO staging of endometrial carcinoma |
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gewenshun
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Shaoxing Maternity and Child Health Care Hospital
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| Abstract: |
| [Abstract] Objective To investigate the correlation between immunohistochemical (IHC) expression status and aggressive histologic subtypes in high-grade endometrioid carcinoma (EEC) under the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial carcinoma (EC).Methods Clinical data from 153 EC patients treated at Shaoxing Maternal and Child Health Care Hospital from January 2020 to March 2025 were retrospectively analyzed. Risk stratification of high-grade EEC was performed based on pelvic lymph node metastasis (LNM) status and IHC expression. Logistic regression assessed correlations with aggressive histologic subtypes.Results Among 153 cases of EC, 81.7% (125/153) were EEC, 17.6% (27/153) were high-grade EEC, and 9.8% (15/153) had pelvic LNM.Logistic regression analysis showed that extensive lymphovascular space invasion (LVSI), MELF infiltration pattern, and low/negative expression of estrogen receptor (ER) were independent risk factors for pelvic LNM; p53abn and FIGO stage II/III were independent risk factors for aggressive histological type (all P < 0.05). In high-grade EEC, low/negative expression of ER was more likely to have deep myometrial invasion, LNM, and extensive LVSI than medium/high expression; in EEC, low/negative expression of ER was significantly associated with extensive LVSI, low/negative expression of PR, and high-grade EEC histological type (all P < 0.05).Conclusions The 2023 FIGO staging system enhances precision in prognostic evaluation and treatment planning for EC. The ER scoring system (integrating staining intensity and positive cell proportion) compensates for limitations of morphologic diagnosis, further stratifies aggressive subtypes in high-grade EEC, and facilitates refined staging and personalized therapeutic strategies. |
| Key words: Endometrioid carcinoma International Federation of Gynecology and Obstetrics staging Aggressive histological types Hormone receptor |