| Objective Retrospective analysis of clinical and pathological characteristics and related factors of prognosis in patients diagnosed with endometrial cancer in our hospital in the past 5years,exploring the clinical and pathological characteristics and prognostic differences of different subtypes.Methods From August 2016 to August 2021,patients diagnosed with endometrial cancer at the General Hospital of Ningxia Medical University received surgical treatment and were discharged with a diagnosis of simple endometrial cancer.Subjects were identified based on inclusion and exclusion criteria.1.According to their postoperative pathological types,they were divided into group A1: type I endometrial carcinoma group(n = 716 cases);group A2:type II endometrial carcinoma group(n = 67 cases).2.For patients who had visited our hospital and had undergone MMR-D immunohistochemistry,pathological sections were obtained for POLE sequencing and redivided into four groups according to Pro-Mis E classification criteria,group B1: POLE mutant(n = 11 cases);group B2: MMR-d type(n =101 cases);group B3: P53 wild-type(n = 74 cases);and group B4: P53 mutant(n = 123 cases).The preoperative conditions(age,menopause,reproductive history,complications,BMI,CA125);intraoperative conditions(ascites cytology,tumor diameter,surgical approach);and postoperative conditions(surgical pathological stage,histological type,tumor grade,depth of myometrial invasion,vascular space involvement,lymph node metastasis,adjuvant therapy)were analyzed.Their survival,recurrence,and death were followed up;the 5-year OS overall survival rate was counted.The relationship between different types and clinical data,pathological features,and the prognosis was further compared,and other high-risk factors affecting prognosis were summarized.Results 1.This study included a total of 787 cases,with 638 satisfied patients,81 deaths,20 relapses,11 deaths after relapse,and 9 surviving patients,with an overall good prognosis.The 5-year overall survival rate was 84.70%.2.Univariate analysis showed that age,menopausal status,CA125,tumor diameter,histological grade,deep muscle infiltration,vascular infiltration,lymph node metastasis,surgical pathological staging,and postoperative adjuvant therapy were statistically significant and had an impact on the prognosis of endometrial cancer patients;primary infertility,obesity,hypertension,other malignant tumors,surgical approach,ascites cytology,and estrogen receptor expression had little effect on the prognosis of endometrial cancer patients.3.Multivariate analysis showed that deep muscle infiltration(P=0.027)was an independent risk factor affecting the prognosis of endometrial cancer patients.4.There were significant differences in age,menopausal status,surgical pathological staging,vascular infiltration,estrogen receptor expression,postoperative adjuvant therapy,whether combined with other tumors,diabetes,CA125,tumor grade,deep muscle infiltration,and lymph node metastasis between type I and type II endometrial cancer patients in the Bokhman classification,with statistical significance;there was no difference in hypertension,obesity,ascites cytology,surgical approach,tumor diameter,etc.The prognosis of type I endometrial cancer patients was better than that of type II.5.There were statistically significant differences in obesity,postoperative adjuvant therapy,and tumor grade among endometrial cancer patients with different molecular subtypes.The prognosis of POLE mutation-type patients was the best,while that of P53 mutation-type patients was the worst,and the prognosis of MMR-D and P53 wild-type patients was second.Conclusion 1.The overall prognosis of endometrial cancer patients is good,most cases can be detected early,and standardized diagnosis and treatment can significantly improve their survival rate.Age,menopausal status,tumor diameter,LVSI,lymph node metastasis,etc.are high-risk factors affecting the prognosis of endometrial cancer.2.There are significant differences in the clinical and pathological characteristics and survival prognosis between type I and type II endometrial cancer patients,with type I having a better prognosis than type II.3.Endometrial cancer patients with different molecular subtypes have different survival prognoses,with the P53 mutation type having the worst prognosis. |
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