Int J Gynecol Pathol. 2020 Jan;39(1):26-35. doi: 10.1097/PGP.0000000000000585.
Recent advances in molecular studies, especially genome-wide analyses, have revealed the landscape of genomic alterations present in endometrial carcinomas, and have provided valuable insight into the pathogenesis of this disease. The current challenges are in developing a molecular-morphologic classification system to enhance traditional pathologic diagnosis and in determining the optimal approach to using this new information to guide clinical management. Molecular assays may be particularly beneficial in allowing the earlier detection of endometrial cancer or precursor lesions and in guiding personalized treatment approaches. In this review, we describe the current molecular landscape of endometrial cancers, efforts underway to incorporate molecular alterations into the current classification systems, and the development of diagnostic tools for the early detection of endometrial cancer. Finally, we present opportunities for using these data to tailor therapeutic strategies. A comprehensive understanding of the molecular alterations responsible for the origination, relapse, and resistance patterns of this disease will ultimately improve outcomes for patients with endometrial cancer.
最近在分子研究方面的进展,特别是全基因组分析,揭示了子宫内膜癌中存在的基因组改变的全貌,并为该疾病的发病机制提供了有价值的见解。当前的挑战在于开发一种分子-形态学分类系统,以增强传统的病理诊断,并确定使用这种新信息来指导临床管理的最佳方法。分子检测可能特别有助于更早地发现子宫内膜癌或癌前病变,并指导个性化的治疗方法。在这篇综述中,我们描述了子宫内膜癌的当前分子全景,以及将分子改变纳入当前分类系统的努力,以及用于早期检测子宫内膜癌的诊断工具的开发。最后,我们提出了利用这些数据制定治疗策略的机会。全面了解导致这种疾病起源、复发和耐药模式的分子改变最终将改善子宫内膜癌患者的预后。