Molecular classification characteristics in lower uterine segment cancer
ZHOU Yang
PANG Jun-yi
CAI Yu-meng
XIAO Yin-bo
CHEN Long-yun
LIANG Zhi-yong
SHI Xiao-hua
Abstract：Objective To analyze the molecular classification characteristics and related clinicopathological features of the lower uterine segment cancer(LUSC).Methods A total of 54 case samples diagnosed as LUSC were retrospectively analyzed on the correlation between molecular classification and clinicopathological features,including histological subtype,grade,and LVSI.Furthermore,the variations in different versions of International Federation of Gynecology and Obstetrics(FIGO)staging were described.Results The Results of molecular classification in 54 patients with LUSC revealed the following:POLE mut type in 6 cases,MMRd type in 14 cases,p53abn type in 9 cases,and NSMP type in 25 cases.Of the six cases of POLE mut,the majority were classified as endometrioid carcinomas(5/6),predominantly poorly differentiated(4/5).Of the nine p53abn cases,five were classified as endometrioid carcinomas,predominantly high to moderately differentiated(4/5).The difference in progression-free survival(PFS)and overall survival(OS)by molecular classification was not statistically significant.In the 2023 version,three patients of stage Ⅰ with p53abn were re-evaluated as stage Ⅱ.Two patients of stage Ⅱ with POLE mut were down staged to stage I.Conclusion This study systematically reveals the molecular classification features of LUSC and its clinicopathological significance for the first time,filling the gap in the field of this rare subtype.Despite the molecular classification distribution of LUSC being analogous to that of UCEC,the clinicopathological features associated with each molecular classification are differed from those of UCEC.Patients with NSMP in LUSC present with higher-risk clinicopathological factors.Compared to UCEC patients with p53abn,LUSC patients may lack of high-risk clinicopathological features.MMRd-type demonstrates a higher proportion of MSH2 and MSH6 loss.This suggests that the incidence of Lynch syndrome may be higher than that observed in patients with UCEC.These findings not only deepen the understanding of the biological behaviors of LUSC,but also provide an important basis for precise stratified management and individualized treatment in clinical practice.
Keywords：Lower uterine segment cancerMolecular classification2009 FIGO stage2023 FIGO stageLynch syndrome
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 621-628 )