Hecht Jonathan L, Mutter George L
Department of Pathology, Beth-Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.
J Clin Oncol. 2006 Oct 10;24(29):4783-91. doi: 10.1200/JCO.2006.06.7173.
Endometrial cancer is the most common gynecological malignancy, with 41,000 new cases projected in the United States for 2006. Two different clinicopathologic subtypes are recognized: the estrogen-related (type I, endometrioid) and the non-estrogen-related types (type II, nonendometrioid such as papillary serous and clear cell). The morphologic differences in these cancers are mirrored in their molecular genetic profile with type I showing defects in DNA-mismatch repair and mutations in PTEN, K-ras, and beta-catenin, and type II showing aneuploidy and p53 mutations. This article reviews the genetic aspects of endometrial carcinogenesis and progression. We will define the precursor lesion of type I endometrioid cancer and the role of genetics and estrogen in its progression.
子宫内膜癌是最常见的妇科恶性肿瘤，预计2006年美国将有41000例新发病例。目前已确认有两种不同的临床病理亚型：雌激素相关型（I型，子宫内膜样癌）和非雌激素相关型（II型，非子宫内膜样癌，如乳头状浆液性癌和透明细胞癌）。这些癌症的形态学差异反映在其分子遗传学特征上，I型表现为DNA错配修复缺陷以及PTEN、K-ras和β-连环蛋白突变，II型表现为非整倍体和p53突变。本文综述了子宫内膜癌发生和进展的遗传学方面。我们将定义I型子宫内膜样癌的前驱病变以及遗传学和雌激素在其进展中的作用。
