根据雌激素受体 (ER) 和 L1 细胞粘附分子 (L1CAM) 表达评估临床病理学和分子分类子宫内膜癌的风险分层。这是一项针对在单一三级中心接受初级治疗的患者的回顾性研究。根据欧洲指南，癌症被分为 5 个临床病理学风险组。采用免疫组织化学和聚合酶-ϵ测序进行分子分类并测定 ER 和 L1CAM 表达。分析了 1044 名患者的数据。中位随访时间为 67.5 个月。在单变量分析中，ER 表达与“无特定分子谱”(NSMP) (P < 0.001) 和错配修复缺陷 (MMRd) (P = 0.002) 亚组中疾病特异性生存 (DSS) 的改善相关。仅 NSMP 亚组中 L1CAM 负表达与 DSS 增强相关（P < 0.001）。当控制诊断时可用的参数（肿瘤组织类型、分级、年龄）时，ER（风险比 [HR] 0.18）而非 L1CAM 在 NSMP 中表现出预后意义。当控制手术后可用的参数（临床病理学风险组、年龄、辅助治疗）时，ER 和 L1CAM 与 NSMP 中的 DSS 不独立相关。然而，在高风险晚期转移病例中，ER (HR 0.26) 和 L1CAM (HR 3.9) 均与 DSS 独立相关。同样，在 MMRd 中，ER 与高风险晚期转移癌的 DSS 改善相关（HR 0.42）。ER 和 L1CAM 的预后意义因子宫内膜癌的临床病理学风险组和分子亚组而异。值得注意的是，高风险晚期转移性 NSMP 和 MMRd 亚型癌的风险评估可以通过 ER 状态进行细化。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

To assess the risk stratification of clinicopathologically and molecularly classified endometrial cancer based on estrogen receptor (ER) and L1 cell adhesion molecule (L1CAM) expression.This was a retrospective study of patients who underwent primary treatment at a single tertiary center. Carcinomas were classified into 5 clinicopathological risk groups, as per European guidelines. Immunohistochemistry and polymerase-ϵ sequencing were conducted for molecular classification and determination of ER and L1CAM expression.Data from 1044 patients were analyzed. The median follow-up was 67.5 months. In univariable analyses, ER expression correlated with improved disease-specific survival (DSS) in the "no specific molecular profile" (NSMP) (P < 0.001) and mismatch repair deficient (MMRd) (P = 0.002) subgroups. Negative L1CAM expression was associated with enhanced DSS in the NSMP subgroup alone (P < 0.001). ER (hazard ratio [HR] 0.18), but not L1CAM, exhibited prognostic significance within NSMP when controlling for parameters available at the time of diagnosis (tumor histotype, grade, age). ER and L1CAM were not independently associated with DSS within NSMP when controlling for parameters available after surgery (clinicopathological risk groups, age, adjuvant therapy). However, in high-risk-advanced-metastatic cases, both ER (HR 0.26) and L1CAM (HR 3.9) independently correlated with DSS. Similarly, within MMRd, ER was associated with improved DSS in high-risk-advanced-metastatic carcinomas (HR 0.42).The prognostic significance of ER and L1CAM varies across clinicopathological risk groups and molecular subgroups of endometrial cancer. Notably, risk assessment for high-risk-advanced-metastatic NSMP and MMRd subtype carcinomas can be refined by ER status.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.