Analysis of the Clinicopathological Characteristics of Different Molecular Subtypes in Endometrial Cancer: A Retrospective Single Center Study.

Background: There is significant heterogeneity in the proportion of molecular subtypes of endometrial cancer and its relationship with clinicopathological characteristics among different races and regions. It aims to analyze the differences in the clinicopathological characteristics of different molecular subtypes of endometrial cancer in Eastern Guangdong Province, China. Methods: Five hundred and sixty-three endometrial cancer patients in Meizhou People's Hospital from January 2018 to August 2024 were collected. The relationship of molecular subtypes (DNA polymerase epsilon (POLE) mutant, mismatch repair deficiency (dMMR), p53 abnormal, and non-specific molecular profile (NSMP)) and clinicopathological characteristics (age, reproductive history, menopausal status, and pathological data covered histological type, tumor differentiation, muscular infiltration, lymphovascular invasion, perineural invasion) were analyzed. Results: The molecular subtypes dMMR, p53 abnormal, POLE mutant, and NSMP were detected in 197 (35.0%), 155 (27.5%), 52 (9.2%), and 159 (28.2%) patients, respectively. There were statistically significant differences in distributions of histological types (p = 0.012, χ2= 14.073), tumor differentiation (p < 0.001, χ2= 16.457), and disease stage (p = 0.019, χ2= 9.796) in NSMP and non-NSMP cases. The proportion of POLE mutant in endometrioid carcinoma was higher than those of other histological types, while the proportion of p53 abnormal was relatively high in high-grade and highly invasive histological types. The proportion of p53 abnormal subtype was relatively high among patients with mixed carcinoma. In addition, the proportions of poor tumor differentiation in the dMMR and p53 abnormal groups were higher than that in the NSMP group. Conclusion: The distribution of molecular subtypes among patients with different histopathological types shows significant differences. The proportion of POLE mutant type in endometrioid carcinoma is higher than that of other histological types, while the proportion of p53 abnormal type is relatively high in high-grade and highly invasive histological types such as serous carcinoma and clear cell carcinoma. It provides valuable reference for guiding the diagnosis and treatment of endometrial cancer by integrating molecular subtypes with clinicopathological characteristics.