Prognostic Significance of Mismatch Repair Protein Expression and Its Association with Clinical Outcomes in Endometrial Cancer

Ramazan Oğuz Yüceer; Mehmet Kıran; Serhan Can İscan

Makale detayları

Prognostic Significance of Mismatch Repair Protein Expression and Its Association with Clinical Outcomes in Endometrial Cancer

Yazarlar:

Ramazan Oğuz Yüceer | Mehmet Kıran | Serhan Can İscan

Yayıncı:

Süleyman Demirel University

Ana Başlıklar:

Patoloji

Dergi:

Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 2, pp.203-211

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001356551

pISSN:

2146-247X

Anahtar kelimeler:

Özet:

 Objective: This study aimed to evaluate the expression of mismatch repair MMR proteins in patients with endometrial cancer EC, compare the findings with clinicopathological data, and investigate their prognostic implications. Materials and Methods: A total of 116 patients diagnosed with EC via endometrial biopsy or resection at Isparta City Hospital between March 1, 2017, and January 1, 2023, were included. Immunohistochemical analysis was performed to assess the expression of MMR proteins MLH1, PMS2, MSH2, MSH6. Patients were classified as microsatellite stable MSS or microsatellite instable MSI based on MMR protein expression, and correlations with clinicopathological features and survival outcomes were analyzed. Results: Among the patients, 83.6 were classified as MSS and 16.4 as MSI. MSI was more frequently observed in patients under 60 years of age, with endometrioid type, low tumor grade, and hormone receptor positivity; however, these associations were not statistically significant. Estrogen receptor ER positivity, p53 mutation status, and microsatellite instability MSI were significant predictors of survival in endometrial cancer. The median overall survival OS was 31 months in the MSS group and 52 months in the MSI group, indicating a statistically significant difference p  0.002. Conclusion: MMR deficiency and MSI status are of prognostic significance in EC. MSI positivity is associated with longer survival and increased sensitivity to immunotherapy, highlighting its value as a clinically meaningful biomarker. Molecular classification can provide guidance for personalized treatment strategies.

 Objective: This study aimed to evaluate the expression of mismatch repair MMR proteins in patients with endometrial cancer EC, compare the findings with clinicopathological data, and investigate their prognostic implications. Materials and Methods: A total of 116 patients diagnosed with EC via endometrial biopsy or resection at Isparta City Hospital between March 1, 2017, and January 1, 2023, were included. Immunohistochemical analysis was performed to assess the expression of MMR proteins MLH1, PMS2, MSH2, MSH6. Patients were classified as microsatellite stable MSS or microsatellite instable MSI based on MMR protein expression, and correlations with clinicopathological features and survival outcomes were analyzed. Results: Among the patients, 83.6 were classified as MSS and 16.4 as MSI. MSI was more frequently observed in patients under 60 years of age, with endometrioid type, low tumor grade, and hormone receptor positivity; however, these associations were not statistically significant. Estrogen receptor ER positivity, p53 mutation status, and microsatellite instability MSI were significant predictors of survival in endometrial cancer. The median overall survival OS was 31 months in the MSS group and 52 months in the MSI group, indicating a statistically significant difference p  0.002. Conclusion: MMR deficiency and MSI status are of prognostic significance in EC. MSI positivity is associated with longer survival and increased sensitivity to immunotherapy, highlighting its value as a clinically meaningful biomarker. Molecular classification can provide guidance for personalized treatment strategies.

 Objective: This study aimed to evaluate the expression of mismatch repair MMR proteins in patients with endometrial cancer EC, compare the findings with clinicopathological data, and investigate their prognostic implications. Materials and Methods: A total of 116 patients diagnosed with EC via endometrial biopsy or resection at Isparta City Hospital between March 1, 2017, and January 1, 2023, were included. Immunohistochemical analysis was performed to assess the expression of MMR proteins MLH1, PMS2, MSH2, MSH6. Patients were classified as microsatellite stable MSS or microsatellite instable MSI based on MMR protein expression, and correlations with clinicopathological features and survival outcomes were analyzed. Results: Among the patients, 83.6 were classified as MSS and 16.4 as MSI. MSI was more frequently observed in patients under 60 years of age, with endometrioid type, low tumor grade, and hormone receptor positivity; however, these associations were not statistically significant. Estrogen receptor ER positivity, p53 mutation status, and microsatellite instability MSI were significant predictors of survival in endometrial cancer. The median overall survival OS was 31 months in the MSS group and 52 months in the MSI group, indicating a statistically significant difference p  0.002. Conclusion: MMR deficiency and MSI status are of prognostic significance in EC. MSI positivity is associated with longer survival and increased sensitivity to immunotherapy, highlighting its value as a clinically meaningful biomarker. Molecular classification can provide guidance for personalized treatment strategies.

 Amaç: Bu çalışmada, endometrial kanser EK hastalarında MMR Mismatch Repair protein ekspresyonunu değerlendirmek, bu bulguları klinikopatolojik verilerle karşılaştırmak ve prognostik etkilerini incelemek amaçlanmıştır. Gereç ve Yöntem: Çalışmaya, 1 Mart 2017 - 1 Ocak 2023 tarihleri arasında Isparta Şehir Hastanesinde endometrial biyopsi veya rezeksiyon ile EK tanısı alan 116 hasta dahil edilmiştir. MMR protein ekspresyonu MLH1, PMS2, MSH2, MSH6 immünohistokimyasal yöntemle değerlendirilmiştir. MSS mikrosatellit stabil ve MSI mikrosatellit instabil olarak sınıflandırılan hastalar klinikopatolojik özellikler ve sağkalım açısından analiz edilmiştir. Bulgular: Hastaların 83.6sı MSS, 16.4ü MSI olarak saptanmıştır. MSI olguları daha çok 60 yaş, endometrioid tip, düşük tümör derecesi ve hormon reseptör pozitifliği ile ilişkilidir; ancak bu ilişkiler istatistiksel anlamlılık göstermemiştir. Endometrial kanserde östrojen reseptörü ER pozitifliği, p53 mutasyon durumu ve mikrosatellit instabilitesi MSI, sağkalımın anlamlı belirleyicileri olarak saptanmıştır. Medyan genel sağkalım OS, MSS grubunda 31 ay iken, MSI grubunda 52 ay olarak bulunmuş ve bu fark istatistiksel olarak anlamlıdır p0.002. Sonuç: MMR yetersizliği ve MSI durumu, EKde prognostik öneme sahiptir. MSI pozitifliği, daha uzun sağkalım ve immünoterapiye duyarlılık açısından klinik olarak anlamlı bir biyobelirteçtir. Moleküler sınıflandırma, kişiselleştirilmiş tedavi stratejileri açısından yol gösterici olabilir.

Makale detayları

Prognostic Significance of Mismatch Repair Protein Expression and Its Association with Clinical Outcomes in Endometrial Cancer

Yazarlar:

Ramazan Oğuz Yüceer | Mehmet Kıran | Serhan Can İscan

Yayıncı:

Süleyman Demirel University

Ana Başlıklar:

Patoloji

Dergi:

Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 2, pp.203-211

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001356551

pISSN:

2146-247X

Endometrial cancer

Mismatch Repair Protein

Instability

SurvivalEndometrium kanseri

Mismatch Tamir Proteini

Kararsızlık

Sağkalım

Sayı

Makale detayları

Yazarlar: Ramazan Oğuz Yüceer | Mehmet Kıran | Serhan Can İscan

Yayıncı: Süleyman Demirel University

Ana Başlıklar: Patoloji

Dergi: Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 2, pp.203-211

Belge Tipi: Makale

Yayın Tarihi: 8/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001356551

pISSN: 2146-247X

Sayı

Yazarlar:

Ramazan Oğuz Yüceer | Mehmet Kıran | Serhan Can İscan

Yayıncı:

Süleyman Demirel University

Ana Başlıklar:

Patoloji

Dergi:

Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi Vol.16 Issue 2, pp.203-211

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001356551

pISSN:

2146-247X