子宫内膜癌 TCGA 分子分型与治疗新进展.

In 2013, the Cancer Genome Atlas (TCGA) research center completed the molecular classification endometrial carcinoma (EC), categorizing patients into POLE (DNA polymerase epsilon) mutation type, microsatellite instability-high (MSI-H) type, copy number low (CN-L) type, and copy number high (CN-H) type. Subsequently Western scholars refined this into the ProMisE and Trans-PORTEC classification to better suit clinical applications. Patients with POLE mutation EC have excellent prognosis and lower recurrence rate, allowing for a reduction in surgical scope and a deescalation of treatment. Patients with MSI-H or CN-H are still POLE mutant. MSI-H type patients have a high burden of tumor mutations and significant benefits from immunotherapy. CN-L type patients are the most common, with a prognosis second only to POLE mutant patients. These patients have a higher response rate to hormone therapy to preserve fertility. CN-H type patients have the worst prognosis, with invasive features and a high risk of recurrence. For these patients, postoperative supplementary treatment is necessary to avoid inadequate treatment. However, there are some studies have shown that targeted therapy is more effective for CN-H type patients. The TCGA molecular typing of EC has overcome the limitations of traditional pathological and histological classification for evaluating prognosis, providing new insights into the pathological characteristics, prognosis, clinical diagnosis and treatment decisions of EC. [ABSTRACT FROM AUTHOR]