Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine.
Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.
Curr Opin Obstet Gynecol. 2019 Feb;31(1):24-30. doi: 10.1097/GCO.0000000000000508.
The present article reviews genomic subtyping of endometrial carcinoma and new molecular markers with therapeutic and prognostic implications.
Endometrial cancer has historically been classified through histology into endometrioid (type 1) and nonendometrioid (type II, mainly serous) subtypes. Molecular classification through genomic analysis now allows for a major advance in characterization; four distinct subgroups have been identified: polymerase ε (POLE) ultramutated, microsatellite unstable, copy number low/microsatellite stable, and copy number high/'serous-like'. These subtypes have prognostic implications and may aid in the identification of early-stage patients who are at high risk for recurrence. Through analysis of surrogate markers (POLE, MSI, and p53) and other validated molecular alterations (L1CAM), it may be possible to obtain an integrated molecular risk profile. Ongoing studies are utilizing this risk profile in order to identify patients who may benefit from additional treatment for early-stage disease.
Molecular characterization of endometrial cancer into subgroups has prognostic and therapeutic implications. Further development of an integrated molecular risk profile may identify patients who could benefit from additional treatment because of a higher risk of recurrence.
本文综述了子宫内膜癌的基因组亚型和具有治疗及预后意义的新分子标志物。
子宫内膜癌的组织学分类传统上分为子宫内膜样型（1 型）和非子宫内膜样型（2 型，主要为浆液型）。通过基因组分析的分子分类现在可以实现重大进展；现已确定了四个不同的亚组：聚合酶ε（POLE）超突变、微卫星不稳定、拷贝数低/微卫星稳定和拷贝数高/“浆液样”。这些亚型具有预后意义，并可能有助于识别复发风险高的早期患者。通过分析替代标志物（POLE、MSI 和 p53）和其他经过验证的分子改变（L1CAM），可能获得综合分子风险谱。正在进行的研究正在利用该风险谱来识别可能因早期疾病而受益于额外治疗的患者。
将子宫内膜癌的分子特征分为亚组具有预后和治疗意义。综合分子风险谱的进一步发展可能会识别出因复发风险较高而可能受益于额外治疗的患者。
