与缺乏分子数据的分期系统相比，具有分子分类的2023年国际妇产科联合会分类显示出优越的区分能力。然而，子宫内膜活检数据在分子分类方面的准确性仍不确定。本研究旨在评估术前活检和子宫切除术之间分子分类的一致性，以预测手术分期前的预后。子宫内膜活检和相应的子宫切除标本于2012年至2023年间在国家癌症中心医院采集。p53和错配修复（MMR）的免疫组织化学对聚合酶 epsilon (POLE) 的所有外显子进行蛋白质和新一代测序。鉴于之前研究中 POLE mut 病例数量有限，我们准备了一个富含 POLE mut 的队列。 Cohen's kappa 估计用于确定分子和临床病理学亚组分配的一致性。在分为四个分子亚型组的 70 名患者中，33 名患者表现出 POLE 突变，15 名患者显示 MMR 蛋白表达缺失，13 名患者有 p53 异常，9 名患者没有特定的分子亚型。轮廓。活检和子宫切除标本之间的一致性为 100% (κ = 1.000)。相比之下，活检和手术标本之间的组织学类型和分级表现出中等和显着的一致性（分别为κ = 0.420和κ = 0.780）。分子亚型与手术标本的分子亚型完全一致，表明术前和术后分子分类之间具有高度一致性。这表明子宫内膜活检可以可靠地预测预后。未来的研究应该调查基于活检的分子分析如何影响治疗计划和患者结果。版权所有 © 2024 Elsevier Inc. 保留所有权利。

The 2023 International Federation of Gynecology and Obstetrics classification with molecular classification shows superior discriminatory ability compared to staging systems lacking molecular data. However, the accuracy of endometrial biopsy data in molecular classification remains uncertain. This study aimed to assess the concordance of molecular classifications between preoperative biopsy and hysterectomy to predict prognosis before surgical staging.Endometrial biopsies and corresponding hysterectomy specimens were collected at the National Cancer Center Hospital between 2012 and 2023. Immunohistochemistry for p53 and mismatch repair (MMR) proteins and next-generation sequencing of all exons of polymerase epsilon (POLE) were performed. Given the limited number of POLE mut cases in prior studies, we prepared a POLE mut-enriched cohort. Cohen's kappa estimates were used to determine concordance for molecular and clinicopathological subgroup assignments.Among 70 patients classified into four molecular subtype groups, 33 exhibited POLE mutations, 15 showed loss of MMR protein expression, 13 had p53-abnormality, and 9 had no specific molecular profile. Concordance between biopsy and hysterectomy specimens was 100% (κ = 1.000). In contrast, histological types and grades between biopsy and surgical specimens showed moderate and substantial agreement (κ = 0.420 and κ = 0.780, respectively).Molecular subtypes were completely consistent with those derived from surgical specimens, demonstrating high concordance between preoperative and postoperative molecular classifications. This suggests that endometrial biopsies could reliably predict prognosis. Future studies should investigate how biopsy-based molecular profiling influences treatment planning and patient outcomes.Copyright © 2024 Elsevier Inc. All rights reserved.