Mismatch repair deficiency and clinicopathological characteristics in endometrial carcinoma: a systematic review and meta-analysis.

Autor:	Jumaah AS; Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq., Al-Haddad HS; Al-Furat Al-Awsat Hospital, Kufa, Iraq., Salem MM; Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq., McAllister KA; School of Biomedical Sciences, Ulster University, 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] 2021 May; Vol. 55 (3), pp. 202-211. Date of Electronic Publication: 2021 Apr 14.
DOI:	10.4132/jptm.2021.02.19
Abstrakt:	Background: Loss of mismatch repair (MMR) occurs frequently in endometrial carcinoma (EC) and is an important prognostic marker. However, the frequency of MMR deficiency (D-MMR) in EC remains inconclusive. This systematic review and meta-analysis addressed this inconsistency and evaluated related clinicopathology. Methods: Electronic databases were searched for articles: PubMed, Science Direct, Web of Science, EMBASE, and the Wiley Online Library. Data were extracted from 25 EC studies of D-MMR to generate a clinical dataset of 7,459 patients. A random-effects model produced pooled estimates of D-MMR EC frequency with 95% confidence interval (CI) for meta-analysis. Results: The overall pooled proportion of D-MMR was 24.477% (95% CI, 21.022 to 28.106) in EC. The Lynch syndrome subgroup had 22.907% pooled D-MMR (95% CI, 14.852 to 32.116). D-MMR was highest in type I EC (25.810) (95% CI, 22.503 to 29.261) compared to type II (13.736) (95% CI, 8.392 to 20.144). Pooled D-MMR was highest at EC stage and grades I-II (79.430% and 65.718%, respectively) and lowest in stages III-IV and grade III (20.168% and 21.529%). The pooled odd ratios comparing D-MMR to proficient MMR favored low-stage EC disease (1.565; 0.894 to 2.740), lymphovascular invasion (1.765; 1.293 to 2.409), and myometrial invasion >50% (1.271; 0.871 to 1.853). Conclusions: Almost one-quarter of EC patients present with D-MMR tumors. The majority has less aggressive endometrioid histology. D-MMR presents at lower tumor stages compared to MMR-proficient cases in EC. However other metastatic parameters are comparatively higher in the D-MMR disease setting.
Databáze:	MEDLINE
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