清细胞癌是子宫内膜癌的高风险亚型。一些患者同时患有清细胞癌与其他组织学类型（内膜样或浆液样）的混合型，或者无法明确归类为这些类型之一。GOG-210中的GOG-8032方案旨在确定这些肿瘤在诊断时期、初期扩散模式或患者生存率方面是否与纯清细胞癌有所不同。对于有多个可识别组分的肿瘤，应用术语"混合型"，对于具有中介于不同组织学类型之间的特征的肿瘤，应用术语"不确定型"。在GOG-210的较大一组接受子宫切除术治疗子宫内膜癌的患者中，确定了311名纯、混合或不确定的清细胞癌女性患者。组织学玻片由专家病理学家进行集中复审。基线和随访数据进行了分析。136名患者患有纯清细胞癌，175名患者患有混合或不确定的清细胞类型。除了患者首次发病年龄有小差异外，基线临床病理特征相似。单变量生存分析证实了典型子宫内膜癌预后因素的重要性。混合型患者的无病生存和总体生存与纯清细胞癌类似，但不确定型清细胞/内膜样组具有更长的生存期。在清细胞子宫内膜癌中，有明确混合的内膜样或浆液样成分不与预后显著差异相关。肿瘤具有不确定的清细胞特征的患者有更好的预后。其中一些肿瘤可能是模拟清细胞癌的内膜样肿瘤。版权所有 © 2023 Elsevier Inc. 保留所有权利。

Clear cell carcinoma is a high-risk subtype of endometrial cancer. Some patients have a mixture of clear cell carcinoma with other histologic types (endometrioid or serous) or cannot be neatly assigned to one of these types. Protocol GOG-8032 within GOG-210 was designed to determine whether these tumors differ from pure clear cell carcinoma in stage at diagnosis, initial pattern of spread, or patient survival.The term "mixed" was applied to tumors with multiple identifiable components, and "indeterminate" was applied to tumors with features intermediate between different histologic types. Three hundred eleven women with pure, mixed, or indeterminate clear cell carcinoma were identified in a larger cohort of patients undergoing hysterectomy for endometrial cancer in GOG-210. Histologic slides were centrally reviewed by expert pathologists. Baseline and follow-up data were analyzed.One hundred thirty-six patients had pure clear cell carcinoma and 175 had a mixed or indeterminate clear cell pattern. Baseline clinicopathologic characteristics were similar except for a small difference in age at presentation. Univariate survival analysis confirmed the significance of typical endometrial cancer prognostic factors. Patients in the mixed categories had disease-free and overall survival similar to pure clear cell carcinoma, but the indeterminate clear cell/endometrioid group had longer survival.In clear cell endometrial cancer, the presence of a definite admixed endometrioid or serous component did not correlate with a significant difference in prognosis. Patients whose tumors had indeterminate clear cell features had better prognosis. Some of these tumors may be endometrioid tumors mimicking clear cell carcinoma.Copyright © 2023 Elsevier Inc. All rights reserved.