A analysis of the impact of incorporating molecular subtyping into the FIGO(2023)staging of endometrial cancer on cancer staging
10.13315/j.cnki.cjcep.2025.11.008
- VernacularTitle:FIGO(2023)子宫内膜癌分期纳入分子分型后对癌症分期的影响分析
- Author:
Wenqi LI
1
;
Haixia WU
1
;
Hanbo LI
1
;
Jingwen SI
1
;
Qing ZHANG
1
;
Yan SHEN
1
Author Information
1. 天津市中心妇产科医院病理科,天津 300100
- Publication Type:Journal Article
- Keywords:
endometrial cancer;
2023 FIGO stage;
molecular classification
- From:
Chinese Journal of Clinical and Experimental Pathology
2025;41(11):1454-1461
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To analyze and compare the impact of incorporating molecular classification into the new FI-GO(2023)staging system for endometrial cancer(EC).Methods A retrospective analysis was conducted on 332 ca-ses of EC diagnosed and molecular subtyped by Department of Pathology Tianjin Central Hospital of Gynecology Obstet-rics in 2023.All cases were staged according to the FIGO(2023)staging criteria for EC.Results The median age of the 332 EC patients was 56 years(range:27-76 years).Molecular subtypes included 30 POLE mutation(POLE-mut),80 mismatch repair deficiency(MMRd),194 no specific molecular profile(NSMP),and 28 p53 abnormal(p53abn).Significant differences were observed among the four molecular subtypes regarding age,FIGO stage,patho-logical type,and lymph node metastasis rate(P＜0.05).However,no significant differences were found in the depth of myometrial invasion or lymphovascular space invasion.In the POLEmut group,19 cases(63.33％)were of non-ag-gressive histological types and 11(36.67％)were aggressive.After incorporating molecular subtyping,all 11 stage Ⅱ patients were downgraded to stage Ⅰ AmPOLEmut,increasing the proportion of stage Ⅰ patients from 62.07％to 100％.In the p53abn group,9 cases(32.14％)were non-aggressive and 19(67.86％)were aggressive.Molecular integra-tion led to the upstaging of 4 stage Ⅰ patients with myometrial invasion to stage Ⅱ Cmp53abn,increasing the proportion of stage Ⅱ patients from 34.61％to 50％.Conclusion Molecular subtypes p53abn and POLEmut are associated with distinct alterations in EC staging,specifically leading to tumor upstaging or downstaging.Our findings underscore the critical importance of comprehensive molecular subtyping in EC staging,as it refines prognostic risk stratification and provides valuable guidance for adjuvant treatment decisions.
