Mismatch Repair Deficiency as a Predictor of Lymph Node Metastasis in Endometrioid Endometrial Carcinoma

Authors : Esra Keles, Mustafa Maraşlı, Meziha Taşyürek Coşkun, Elif Ünlügedik Sayın, Öncel İpekçi, Mervernur Şahin, Fatih Şanlıkan, Uğur Kemal Öztürk, İsmail Bağlar, Sahra Sultan Kara, Melis Hazırlar
Pages : 269-274
Doi:10.47572/muskutd.1777110
View : 76 | Download : 85
Publication Date : 2025-12-29
Article Type : Research Paper
Abstract :To investigate the clinicopathologic characteristics and prognostic outcomes of mismatch repair (MMR) protein expression in patients with endometrioid endometrial carcinoma (EEC). This retrospective study included 197 patients with histologically confirmed EEC who underwent primary surgical staging between 2014 and 2020. MMR status was determined by immunohistochemistry for MLH1, PMS2, MSH2, and MSH6, classifying tumors as MMR-deficient (MMRd) or MMR-proficient (MMRp). Clinicopathologic variables and survival outcomes were compared between groups. Multivariate logistic regression identified independent predictors of LN metastasis. Overall (OS) and progression-free survival (PFS) were assessed. Of the 197 patients included, 67 (34.0%) had MMRd tumors, and 130 (66.0%) had MMRp tumors. No significant differences were observed between MMRd and MMRp groups in age (p=0.083), grade (p=0.149), FIGO stage (p=0.172), depth of myometrial invasion (p=0.295), and LVSI (p=0.474). LN metastasis was significantly more frequent in MMRd tumors (13.4%) compared to MMRp tumors (5.4%) (p=0.05). In multivariate analysis, grade 3 (RR=0.177, 95% CI: 0.084–0.374, p 50%) (RR=0.427, 95% CI: 0.270–0.673, p=0.003), and MMR deficiency (RR=0.570, 95% CI: 0.352–0.922, p=0.050) were independently associated with LN metastasis. MMR status was not a significant predictor of LVSI or survival outcomes. Our findings indicate that MMR deficiency is an independent predictor of LN metastasis in EEC. However, MMR status did not significantly impact overall or progression-free survival.
Keywords : Endometriyal Neoplaziler, İmmünohistokimya, Lenf Nodu Metastazı, Mismatch Repair Eksikliği, Prognoz

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