| Research purpose:This study retrospectively analyzed the impact of MMR protein expression status on the clinical and pathological characteristics of endometrial cancer(EC),explored the prognosis of EC patients with MMR protein deficiency in stage Ⅱ-Ⅳ,and analyzed the population characteristics of Lynch syndrome(LS)related EC patients.Research methods:Collect case data of EC patients admitted to Qilu Hospital of Shandong University from January 2017 to December 2020.The impact of MMR protein expression status on the clinical pathological characteristics of EC was analyzed using univariate analysis,and factors related to the prognosis of stage Ⅱ-Ⅳ EC patients were analyzed using Kaplan Meier(KM)and COX risk models.Single factor analysis of population characteristics of LS-EC.Research results:1.The impact of MMR expression status on the clinical pathological characteristics of EC patients:A total of 698 EC patients were included,and 165 patients showed missing MMR protein expression.Univariate analysis showed that age(P=0.028),family cancer history(P<0.001),histological grade(P=0.003),lymphatic space infiltration(LVSI)(P=0.003),and postoperative adjuvant therapy selection(P=0.028)were all closely related to MMR protein deficiency.There was no statistically significant difference in other parameters.2.Survival analysis was conducted on patients with stage Ⅱ-Ⅳ EC.The median overall survival(OS)of patients with MMR protein deficiency was 25 months,and the median progression free survival(PFS)was 23 months.The expression status of MMR protein did not affect the patient’s OS and PFS(P>0.05).COX proportional hazards regression model analysis showed that TNM stage,pathological type,complications and family history were independent factors affecting OS and PFS in EC patients with MMR protein expression loss in stage Ⅱ-Ⅳ(P<0.05).3.Among the 30 EC patients who underwent embryo line gene testing,7(23.3%)were diagnosed with LS.Family cancer history and Bethesda criteria are of significant importance in the diagnosis of LS(P=0.014,0.031),but there is no correlation with the type of MMR protein deficiency(P>0.05).There were no significant differences in age,FIGO stage,histological grade,pathological type,and personal cancer history between LS patients and Lynch like syndrome(LLS)patients(P>0.05).Research conclusion:1.Age,family cancer history,histological grade,and LVSI are closely related to MMR protein deficiency,which affects the selection of postoperative adjuvant therapy.2.In patients with stage Ⅱ-Ⅳ EC,the expression status of MMR protein does not affect the prognosis of the patient.TNM stage,pathological type,complications and family history are independent factors affecting OS and PFS in EC patients with MMR protein deficiency in stage Ⅱ-Ⅳ.3.Family cancer history and Bethesda criteria are of great significance for the diagnosis of LS.4.There were no significant differences in age,FIGO staging,histological grade,pathological type,and personal cancer history between LS patients and LLS patients. |
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