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This study explores the utility of molecular classification for endometrial carcinoma in a Chinese patient cohort.

May 15, 2026Open Access

Evaluation of the TCGA-Surrogate (ProMisE) Molecular Classification and Clinical Features of Endometrial Carcinoma: A Study of 97 Cases from China

Key Points

This study explores the utility of molecular classification for endometrial carcinoma in a Chinese patient cohort.
Retrospective analysis of 97 patients with endometrial carcinoma
Molecular subtypes identified through POLE edm sequencing and immunohistochemistry for MMR and p53
Recurrence-free survival assessed using Kaplan-Meier curves and Log rank test.
Molecular subtype distribution: POLE edm (3.1%), MMR deficient (33%), abnormal p53 (50.5%), wild-type p53 (13.4%)
Recurrence-free survival rates: POLE edm (100%), MMRd (93.5%), p53abn (77.8%), p53wt (84.6%)
No significant prognostic differences noted for cervical stromal invasion; however, cervical mucosa invasion in POLE edm group was significantly different from others (p < 0.05).

Abstract

Li-Yu Chen,1 Jian-Hui Fu,2 Liu Liao,2 Dan Luo,2 Shu-Xia Xu,2 Hui-Bin Zhang,2 Jian-Song Lin2 1Department of Pathology, Affiliated Hospital of Putian University, Putian, Fujian, 351100, Peopleâs Republic of China; 2Department of Pathology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics 3.1%); MMR deficient (MMRd) (32 patients; 33%); abnormal p53 (p53abn) (49 patients; 50.5%) and wild-type p53 (p53wt) (13 patients; 13.4%). Actual RFS rates for the different molecular subtypes were as follows: POLE edm (100%); MMRd (93.5%); p53abn (77.8%) and p53wt (84.6%). Differences in morphology, myometrial invasion, cervical stromal invasion and lymphovascular space invasion among groups were not significant (p > 0.05), but the same was not the case for cervical epithelial invasion. Cervical mucosa invasion in the POLE edm group was significantly different from the other three groups (p < 0.05). The results of KaplanâMeier RFS curves showed that the p-value was 0.300 (Log rank test) in molecular subtypes and 0.386 (Log rank test) in the group with/without cervical involvement.Conclusion: Our results suggest that cervical stromal invasion in EC may have no prognostic significance, the EC ProMisE classifier has no relationship with morphology and routine use of molecular classification is premature. The study was limited by a relatively small sample size and short follow-up duration, and further multicenter studies are warranted to validate these findings.Keywords: endometrial carcinoma, molecular classification, polymerase-É, mismatch repair, cervical stromal invasion

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