叶酸受体α（FRα）在各种癌症中表达，是一种潜在的治疗靶点。然而，它在子宫（UCS）和卵巢肉瘤（OCS）中的表达和临床意义尚待阐明。本回顾性研究纳入了1997年至2019年期间在我们机构接受原发手术的妇科肉瘤患者。对手术FFPE标本进行FRα和HER2的免疫组化染色。使用H评分和4级评分系统（0到3+）评估FRα。随后，评估FRα表达度（≥5％的肿瘤细胞，≥1+的强度）和FRα高表达组（2+和3+的分数）。根据修改后的ASCO/CAP标准对HER2进行评分。在UCS中评估FRα高表达与临床病理特征、HER2表达和生存之间的关联。总共包括120例UCS患者和9例OCS患者。在UCS中，所有患者均观察到FRα表达，而FRα高表达状况出现在20％的患者中。在HER2阴性的UCS中，34％表现为FRα高表达。未观察到临床病理特征与FRα状况之间的显著关联。在随访期间（中位数为34.5个月），FRα高表达与进展、无进展生存和总生存之间没有明显关联。所有OCS肿瘤标本均显示FRα高表达。FRα表达在所有UCS和OCS标本中均有观察到，包括HER2阴性的UCS患者。这种广泛的FRα表达暗示FRα靶向治疗可能在妇科肉瘤治疗中具有前景。然而，在子宫肉瘤中，FRα表达与临床病理特征或预后之间没有明显关系。版权所有©2023，Elsevier Inc.发表。

Folate receptor alpha (FRα), which is expressed in various cancers, is a potential therapeutic target. However, its expression and clinical significance in uterine (UCS) and ovarian carcinosarcoma (OCS) remain to be elucidated.This retrospective study included patients with gynecologic carcinosarcoma who underwent primary surgery between 1997 and 2019 at our institution. Immunohistochemical staining of surgical FFPE specimens was performed for FRα and HER2. FRα was evaluated using the H-score and the 4-tired scoring system (0 to 3+). Subsequently, FRα expression (≥5% of tumor cells with ≥1+ intensity) and FRα-high (score 2+ and 3+) were evaluated. HER2 was scored according to the modified ASCO/CAP criteria. The association between FRα-high and clinicopathological features, HER2 expression, and survival was assessed in UCS.A total of 120 patients with UCS and nine patients with OCS were included. In UCS, FRα expression was observed in all patients, whereas FRα-high status was present in 20% of patients. Among HER2-negative UCS, 34% exhibited FRα-high. No significant association was observed between clinicopathological characteristics and FRα status. During the follow-up period (median 34.5 mo), FRα-high was not strongly associated with progression, free survival, and overall survival. All the OCS tumor specimens showed FRα-high expression.FRα expression was observed in all the UCS and OCS specimens, including HER2-negative UCS patients. This widespread FRα expression suggests that FRα-targeted therapies may hold promise for the treatment for gynecologic carcinosarcoma. However, in uterine carcinosarcoma, no significant relationship was observed between FRα expression and clinicopathological features or prognosis.Copyright © 2023. Published by Elsevier Inc.