Department of Medical Oncology, Catalan Institute of Cancer (ICO), IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.
Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.
Gynecol Oncol. 2017 Apr;145(1):200-207. doi: 10.1016/j.ygyno.2016.12.015. Epub 2016 Dec 29.
Endometrial carcinoma is the most common cancer of the female genital tract. This review article discusses the usefulness of molecular techniques to classify endometrial carcinoma. Any proposal for molecular classification of neoplasms should integrate morphological features of the tumors. For that reason, we start with the current histological classification of endometrial carcinoma, by discussing the correlation between genotype and phenotype, and the most significant recent improvements. Then, we comment on some of the possible flaws of this classification, by discussing also the value of molecular pathology in improving them, including interobserver variation in pathologic interpretation of high grade tumors. Third, we discuss the importance of applying TCGA molecular approach to clinical practice. We also comment on the impact of intratumor heterogeneity in classification, and finally, we will discuss briefly, the usefulness of TCGA classification in tailoring immunotherapy in endometrial cancer patients. We suggest combining pathologic classification and the surrogate TCGA molecular classification for high-grade endometrial carcinomas, as an option to improve assessment of prognosis.
子宫内膜癌是女性生殖道最常见的癌症。本文综述了分子技术在子宫内膜癌分类中的应用价值。任何肿瘤的分子分类建议都应整合肿瘤的形态学特征。因此，我们从当前的子宫内膜癌组织学分类开始，讨论基因型与表型的相关性，以及最近的重要进展。然后，我们通过讨论高级别肿瘤病理解释中的观察者间变异性，评论该分类的一些可能缺陷，并评价分子病理学在改善这些缺陷中的作用。第三，我们讨论了将 TCGA 分子方法应用于临床实践的重要性。我们还评论了分类中肿瘤内异质性的影响，最后，我们将简要讨论 TCGA 分类在子宫内膜癌患者免疫治疗中的作用。我们建议将病理分类和 TCGA 分子分类相结合，作为改善高级别子宫内膜癌预后评估的一种选择。
