尽管黑人和白人妇女发生子宫内膜癌的发病率相似，但在黑人患者中观察到的死亡率最高，因此存在明显的种族差异。在此研究中，使用经临床FDA认可的肿瘤-正常样本面板对1,882例患有子宫内膜癌（EC）的患者进行了前瞻性测序分析，发现自称为黑人的患者（n=259）中高风险组织学和分子学子宫内膜癌亚型的患病率明显高于白人患者（n=1,623）。与白人患者相比，来自黑人患者的子宫内膜癌中较少出现可影响免疫疗法效果的临床可操作变化，如高突变负荷/微卫星不稳定性。在黑人患者中，与有利结局相关的超突变POLE分子亚型子宫内膜癌很少见。结果经由遗传血统分析得到证实。与白人患者相比，黑人患者中发生癌肉瘤的子宫内膜癌中，与侵袭性临床行为有关的CCNE1基因扩增更为普遍。黑人和白人患者的子宫内膜癌在组织学类型、分子亚型、驱动基因变化和治疗靶点方面存在重要差异。

Although the incidence of endometrial carcinoma (EC) is similar in Black and White women, racial disparities are stark with the highest mortality rates observed among Black patients. Here, analysis of 1,882 prospectively sequenced ECs using a clinical FDA-authorized tumor-normal panel revealed a significantly higher prevalence of high-risk histologic and molecular EC subtypes in self-identified Black (n=259) compared to White (n=1,623) patients. Clinically actionable alterations, including high tumor mutational burden/ microsatellite-instability, which confer benefit from immunotherapy, were less frequent in ECs from Black than from White patients. Ultramutated POLE molecular subtype ECs associated with favorable outcomes were rare in Black patients. Results were confirmed by genetic ancestry analysis. CCNE1 gene amplification, which is associated with aggressive clinical behavior, was more prevalent in carcinosarcomas occurring in Black than in White patients. ECs from Black and White patients display important differences in their histologic types, molecular subtypes, driver genetic alterations and therapeutic targets.