两种测序技术在子宫内膜癌分子分型中的应用比较
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南京医科大学附属妇产医院(南京市妇幼保健院)病理科,江苏 南京 210004

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国家自然科学基金(82403223)


Comparison of two sequencing technologies for molecular classification of endometrial carcinoma
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Department of Pathology, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing 210004 , China

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    摘要:

    目的:探讨免疫组织化学(immunohistochemistry,IHC)染色联合Sanger测序与二代测序(next-generation sequencing,NGS)在子宫内膜癌(endometrial carcinoma,EC)分子分型中的应用价值。方法:回顾性分析2019年10月—2023年6月123例EC患者资料,其中48例采用IHC联合Sanger测序,75例采用NGS技术进行分子分型,比较两组分子分型结果。另选取10例涵盖POLE超突变型(POLE ultramutated,POLEmut)、错配修复缺陷型(mismatch repair deficiency,dMMR)、无特定分子特征型(no specific molecular profile,NSMP)和p53异常型(p53 abnormal,p53abn)4种分子亚型且兼具不同临床分期与组织学分级的代表性样本,同步进行IHC联合Sanger测序与NGS检测结果的比较分析。结果:123例EC患者中,POLEmut型12例(9.7%)、dMMR型31例(25.2%)、NSMP型67例(54.5%)及p53abn型13例(10.6%)。其中48例经IHC联合Sanger测序检出POLEmut型1例(2.1%)、dMMR型12例(25.0%)、NSMP型29例(60.4%)及p53abn型6例(12.5%);75例经NGS检出POLEmut型11例(14.7%)、dMMR型19例(25.3%)、NSMP型38例(50.7%)及p53abn型7例(9.3%)。10例验证实验发现,IHC联合Sanger测序与NGS在检测POLE突变和微卫星状态方面结果完全一致,但IHC对p53异常表达的漏检率为10%(1/10)。结论:IHC联合Sanger测序与NGS在EC分子分型中具有较好的一致性,但NGS对POLE突变及复杂亚型的检测更具优势,有助于提高分型准确性,降低临床误判风险。

    Abstract:

    Objective: To explore the application value of immunohistochemistry (IHC) combined with Sanger sequencing versus next-generation sequencing (NGS) in the molecular classification of endometrial carcinoma (EC). Methods: Clinical data of 123 patients with EC between October 2019 and June 2023 were retrospectively analyzed. Among them, 48 cases were classified using IHC combined with Sanger sequencing, and 75 cases were classified using NGS technology. The molecular classification results of the two groups were compared. Additionally, 10 representative samples covering the four molecular subtypes, POLE ultramutated(POLEmut), mismatch repair deficiency(dMMR), no specific molecular profile(NSMP), and p53 abnormal(p53abn), with varying clinical stages and histological grades were selected for a comparative analysis of the results obtained from IHC combined with Sanger sequencing and NGS. Results: Among the 123 EC patients, 12(9.7%) were POLEmut, 31(25.2% ) were dMMR, 67(54.5% ) were NSMP, and 13 (10.6%) were p53abn. Of the 48 cases assessed by IHC combined with Sanger sequencing, 1(2.1% ) was POLEmut, 12(25.0%) were dMMR, 29(60.4%) were NSMP, and 6(12.5%) were p53abn. Among the 75 cases assessed by NGS, 11(14.7%) were POLEmut, 19 (25.3%) were dMMR, 38(50.7%) were NSMP, and 7(9.3%) were p53abn. The validation experiment on 10 samples showed that IHC combined with Sanger sequencing and NGS yielded completely consistent results in detecting POLE mutations and microsatellite status. However, IHC had a 10% (1/10) missed detection rate for aberrant p53 expression. Conclusion: IHC combined with Sanger sequencing and NGS show good consistency in the molecular classification of EC. Nevertheless, NGS offers advantages in detecting POLE mutations and complex subtypes, contributing to improved classification accuracy and reduced risk of clinical misjudgment.

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张志聪,戚晓瑜,马志芳,徐敏,顾芸.两种测序技术在子宫内膜癌分子分型中的应用比较[J].南京医科大学学报(自然科学版),2026,(5):644-651

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  • 收稿日期:2025-07-13
  • 最后修改日期:2026-03-03
  • 录用日期:2026-03-10
  • 在线发布日期: 2026-05-18
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