The frequency of POLE-mutation in endometrial carcinoma and prognostic implications: a systemic review and meta-analysis.

Autor:	Jumaah AS; Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq., Salim MM; Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq., Al-Haddad HS; Al-Furat Al-Awsat Hospital, Kufa, Iraq., McAllister KA; School of Biomedical Science, University of Ulster, Northern Ireland, UK., Yasseen AA; Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq.
Jazyk:	angličtina
Zdroj:	Journal of pathology and translational medicine [J Pathol Transl Med] 2020 Nov; Vol. 54 (6), pp. 471-479. Date of Electronic Publication: 2020 Sep 02.
DOI:	10.4132/jptm.2020.07.23
Abstrakt:	Background: Endometrial carcinoma (EC) is classified into four distinct molecular subgroups including ultramutated DNA polymerase epsilon (POLE). POLE-mutated tumors have the best prognosis and are a promising target for immunotherapy. This meta-analysis consolidated the reported variation of POLE-mutant frequency and assessed prognostic value in EC. Methods: Internet searches explored scientific data bases: EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials databases. Data was extracted from eligible studies including: sample size, number of positive POLE-mutant cases, sequencing information, clinicopathologic data, and survival data. Meta-analysis and a random-effects model produced pooled estimates of POLE frequency and prognostic parameters using 95% confidence intervals (CI), hazard ratios (HR), and odd ratios (OR). Results: Six thousand three hundred and forty-six EC patient cases were pooled from 25 studies. The pooled proportion of POLE gene mutation in EC was 8.59% (95% CI, 7.01 to 10.32), of which 8.22% (95% CI, 6.27 to 10.42) were type I and 0.93% (95% CI, 0.34 to 1.81) type 2. Clinicopathologic data showed that POLE-mutated tumors are mostly endometrioid. They present at higher levels in earlier stages (I-II) of EC (89.51%; 95% CI, 81.11 to 95.66) at the highest grade III (51.53%; 95% CI, 36.08 to 66.84) with reduced myometrial invasion (OR, 1.48, 95% CI, 0.99 to 2.20). Survival analysis indicated favorable overall survival (HR, 0.90), disease-specific survival (HR, 0.41), and progression-free survival (HR, 0.23) for POLE mutant EC. Conclusions: Almost one-tenth of EC patients have POLE-mutated tumors. Given their improved prognostic potential, identifying the POLE mutation status is key for the management of EC patients.
Databáze:	MEDLINE
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