基于分子分型的子宫内膜癌风险分层与辅助治疗决策优化OA
Optimization of risk stratification and adjuvant treatment decisions in endometrial cancer based on molecular classification
子宫内膜癌是一组高度异质性肿瘤,发病率呈逐年上升趋势,手术切除仍是有指征患者的主要初始治疗手段.基于对癌症基因组图谱(TCGA)分类的子宫内膜癌分子亚型更精确的理解,辅助治疗决策已发展为以分子学特征为导向的新模式.鼓励所有子宫内膜癌患者进行分子分型检测,遵循"POLE突变→错配修复(MMR)状态→p53状态"的阶梯式检测流程,精准分为POLE突变(POLEmut)型、错配修复缺陷(dMMR)型、p53异常(p53abn)型及无特定分子改变(NSMP)型4种分子亚型,并基于分子分型进行预后风险分层和制定辅助治疗方案,实现治疗的精准化,提高患者的治疗效果和生活质量.
Endometrial cancer comprises a high heterogeneous group of neoplasms with incidence rates rising year by year.Surgical removal of the tumor remains the mainstay of initial therapy for patients with indications,but based on more precise understanding of the molecular subtypes of endometrial cancer by the Cancer Genome Atlas(TCGA)classification,adjuvant treatment decisions have developed into a new mode of being directed by molecular characteristics.Molecular classification should be done for all types of endometrial cancer and follow the stepwise detection process of"POLE mutation-MMR status-p53 status",which is precisely categorized into four distinct molecular subtypes:POLE-mutated(POLEmut),mismatch repair deficient(MMRd),p53-abnormal(p53abn)and no specific molecular profile(NSMP).Based on the molecular classification,the risk stratification of prognosis is made and adjuvant treatment strategies are developed to achieve treatment precision and improve the treatment effects and patients' quality of life.
冯莉苹;张师前
山东大学齐鲁医院妇产科,山东济南 250012山东大学齐鲁医院妇产科,山东济南 250012
医药卫生
子宫内膜癌分子分型风险分层辅助治疗
endometrial cancermolecular classificationrisk stratificationadjuvant treatment
《中国实用妇科与产科杂志》 2026 (5)
498-505,8
中国医药教育协会2022重大科学攻关问题和医药技术难题课题项目(2022KTM024) The research projects of 2022 major scien-tific problems and medical technology problems of China Medical Education Association(2022KTM024)
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