Clinical and Pathological Characteristics of Four Molecular Subtypes of Endometrial Cancer

MA Jinzhi; TAN Hui; ZHU Li

doi:10.3969/j.issn.1004-437X.2025.24.014

Abstract：Objective To explore the clinical and pathological characteristics of four molecular subtypes of endometrial cancer(EC).Methods The clinical data of 82 patients with EC treated in Yellow River Sanmenxia Hospital from March 2021 to April 2023 were analyzed retrospectively.All patients received immunohistochemical staining and Sanger sequencing.According to the typing results,the patients were divided into four groups:18 patients with DNA polymerase epsilon catalytic subunit(POLE)hypermutation,21 patients with phosphatase and tensin homolog deleted on chromosome ten(PTEN)mutation,20 patients with tumor protein p53(TP53)mutation,and 23 patients with Kirsten rat sarcoma viral oncogene homolog(KRAS)mutation.At the same time,34 patients negative for POLE hypermutation,PTEN gene,TP53 and KRAS testing were selected as the control group.The clinicopathological features of different molecular types and the differences in chemotherapy sensitivity were analyzed.Results Cancer staging in the POLE hypermutation group and the control group was significantly different(P＜0.05).The PTEN mutation group was significantly different from the control group in terms of the depth of invasion and involvement of isthmus of uterus(P＜0.05).Cancer staging in the TP53 mutation group and the control group was significantly different(P＜0.05).There were statistically significant differences in EC tissue differentiation degree and histological type between the KRAS mutation group and the control group(P＜0.05).POLE hypermutation was more likely to occur in patients with early carcinoma.PTEN mutation was more likely to occur in patients with infiltration depth≤1/2 muscle layer and without involvement of isthmus of uterus.TP53 mutation was more likely to occur in patients with early carcinoma,and KRAS mutation was more likely to occur in patients with high differentiation and type Ⅰ.There was a statistically significant difference in chemotherapy sensitivity between patients with PTEN gene mutation and the control group(P＜0.05).Conclusion POLE hypermutation and TP53 mutation are related to the stage of EC.PTEN mutation is related to the infiltration depth and involvement of isthmus of uterus.KRAS mutation is related to the differentiation degree and histological type of EC,suggests that gene mutations can serve as molecular markers for EC screening and diagnosis.