{
  "abstract": "Background: Mismatch repair deficiency defines an immunologically distinct subgroup of endometrioid endometrial carcinoma, but its relationship with CD163-positive macrophage infiltration in early-stage disease remains incompletely characterized. We evaluated the association between MMR status and quantitative CD163-positive TAM infiltration, together with secondary clinicopathologic and exploratory DFS analyses.\n\nMethods: This single-center retrospective cohort included patients with surgically treated FIGO 2009 stage I–II endometrioid endometrial carcinoma and available formalin-fixed paraffin-embedded tumor tissue. Immunohistochemistry for MLH1, PMS2, MSH2, MSH6, and CD163 defined MMR status and quantified macrophage density. CD163-positive TAM density was analyzed quantitatively as the principal measure, with a cohort-median low/high categorization retained for secondary phenotypic analyses. Median regression evaluated the association between MMR status and continuous CD163-positive TAM density, whereas logistic regression was used for the secondary binary TAM analysis and the composite adverse pathologic endpoint. Exploratory DFS analyses included single-marker and combined Cox models, formal MMR-by-TAM interaction testing, and comparison of models with and without continuous CD163-positive TAM density.\n\nResults: Among 254 patients assessed, 236 were included. MMR protein expression was retained in 172 tumors (72.9%), whereas 64 (27.1%) were classified as dMMR. CD163-positive TAM density was higher in dMMR than pMMR tumors (median, 76 vs 47 cells/HPF; P<0.001), and high TAM infiltration was more frequent in dMMR tumors (44/64, 68.8% vs 71/172, 41.3%; P<0.001). After adjustment for age, FIGO stage, tumor grade, tumor size, and deep myometrial invasion, dMMR remained associated with high macrophage infiltration (adjusted OR, 2.27; 95% CI, 1.19–4.18; P = 0.008). High macrophage infiltration was associated with grade 3 histology, deep myometrial invasion, LVSI, and the composite adverse pathologic feature; the association with the composite endpoint persisted after adjustment (adjusted OR, 1.78; 95% CI, 1.01–3.14; P = 0.047). During follow-up, 26 DFS events occurred. In exploratory Cox analyses, dMMR was associated with DFS (adjusted HR, 2.76; 95% CI, 1.25–6.10; P = 0.012), whereas continuous CD163-positive TAM density was not (adjusted HR per 10 cells/HPF, 1.04; 95% CI, 0.97–1.12; P = 0.281), and addition of CD163-positive TAM density did not significantly improve model fit beyond MMR status (likelihood-ratio P = 0.279). The dMMR/high-TAM phenotype retained an exploratory association with DFS in the conventional model (adjusted HR, 2.21; 95% CI, 1.02–4.81; P = 0.044), but the association was attenuated after additional adjustment for adjuvant therapy (HR, 2.04; 95% CI, 0.93–4.52; P = 0.075).\n\nConclusions: IHC-defined dMMR was associated with increased CD163-positive macrophage infiltration, and higher TAM infiltration was associated with adverse pathologic features. DFS findings were exploratory and did not establish incremental prognostic value of CD163-positive TAM infiltration beyond MMR status; larger externally validated cohorts are required to assess prognostic relevance.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pathology, Ganzhou Maternal and Child Health Hospital , ,",
    "Department of Obstetrics and Gynecology, Ganzhou Maternal and Child Health Hospital , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Donglian Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaojuan Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Linhong Liao"
    },
    {
      "affs": [
        0
      ],
      "name": "Qianqian Ye"
    },
    {
      "affs": [
        0
      ],
      "name": "Yu Guo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0rde7v716bxfn.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1954599",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671934/?tool=EBI",
  "id": "0rde7v716bxfn",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13671934",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2729|Endometrial and Cervical Cancer Treatments"
    ]
  ],
  "openalex": "W7215116408",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671934/pdf/?tool=EBI",
  "pmcid": "PMC13671934",
  "pmid": null,
  "published": "2026-10-02",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/0rde7v716bxfn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:18Z",
      "native_id": "PMC:PMC13671934",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13671934"
    },
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1954599",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1954599/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Endometrial and Cervical Cancer Treatments",
      "subfield": "reproductive-child"
    }
  ],
  "title": "CD163-positive macrophage enrichment is associated with mismatch repair deficiency and adverse pathologic features in early-stage endometrioid endometrial carcinoma: a retrospective cohort study",
  "title_text": "CD163-positive macrophage enrichment is associated with mismatch repair deficiency and adverse pathologic features in early-stage endometrioid endometrial carcinoma: a retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:13Z",
  "url": "https://research.draconitic.com/paper/0rde7v716bxfn",
  "venue": "Frontiers in oncology",
  "versions": []
}