Zhongguo quanke yixue (Jan 2022)
Microsatellite Instability and Its Clinical Significance in Endometrial Carcinoma
Abstract
BackgroundThe role of microsatellite instability in the progression of endometrial cancer, a common cancer in women, has obtained increasing attentions in recent years. However, there are few studies regarding the association of microsatellite instability with clinicopathologic features and prognosis in patients with endometrial cancer.ObjectiveTo investigate the microsatellite instability and its clinical significance in patients with endometrial carcinoma.MethodsA total of 248 endometrial cancer patients who underwent surgery in Shiyan People's Hospital Affiliated to Hubei University of Medicine from January 2015 to December 2020 were selected. Their cancer tissue specimens were collected to detect the expression of MLH1, MSH2, MSH6 and PMS2 by immunohistochemistry. Relations of microsatellite instability with clinicopathologic features and prognosis were analyzed.ResultsThe rates of lost expression of MLH1, MSH2, MSH6 and PMS2 were 32.6% (78/239) , 22.2% (53/239) , 2.9% (7/239) and 65.7% (157/239) , respectively, in patients with endometrioid adenocarcinoma. For those with endometrial squamous cell carcinoma, the rates of lost expression of MLH1, MSH2, MSH6 and PMS2 were 5/5, 3/5, 5/5 and 4/5, respectively. And rates of lost expression of MLH1, MSH2, MSH6 and PMS2 were 4/4, 2/4, 3/4, and 2/4, respectively, in those with endometrial clear cell carcinoma. The rates of lost expression of MLH1, MSH2, MSH6 and PMS2 varied significantly by the pathological pattern of endometrial carcinoma (P<0.05) . The prevalence of high-level microsatellite instability (MSI-H) , low-level microsatellite instability (MSI-L) and microsatellite stability (MSS) was 19.7% (47/239) , 34.7% (83/239) and 45.6% (109/239) , respectively, in patients with endometrioid adenocarcinoma. The prevalence of MSI-H, MSI-L and MSS was 4/5, 1/5 and 0, respectively, in patients with endometrial squamous cell carcinoma. And that of MSI-H, MSI-L and MSS was 3/4, 1/4 and 0, respectively, in patients with endometrial clear cell carcinoma. The prevalence of MSI-H, MSI-L and MSS differed significantly by the pathological pattern of endometrial carcinoma (P<0.05) . The prevalence of MSI-H, MSI-L and MSS was associated with the depth of myometrial invasion (P<0.05) , but was not associated with age and degree of histologic differentiation of endometrial cancer (P>0.05) . There were no significant differences of Kaplan-Meier curves for overall survival and disease-free survival in endometrial cancer patients with MSI-H, MSI-L and MSS (P>0.05) . Cox proportional hazards regression analysis results showed that the expression of mismatch repair protein was not the independent influencing factor for disease-free survival (P>0.05) , but for overall survival (P<0.05) in patients with endometrial cancer.ConclusionMicrosatellite instability is correlated with the progression and prognosis of endometrial cancer, so detecting it may have some referential value for clinical prevention and treatment of endometrial cancer.
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