Javadian Pouya, Washington Christina, Mukasa Shylet, Benbrook Doris Mangiaracina
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
Arkansas College of Osteopathic Medicine, Fort Smith, AR 72916, USA.
Cancers (Basel). 2021 Apr 15;13(8):1900. doi: 10.3390/cancers13081900.
In contrast to the decline in incidence and mortality of most other cancers, these rates are rising for endometrial cancer. Black women with endometrial cancer have earlier diagnosis, more aggressive histology, advanced stage and worse outcomes compared with their White counterparts. Socioeconomic status, a higher incidence of aggressive histology, and comorbid conditions are known factors leading to racial disparity in patients with endometrial cancer; nevertheless, they do not account for the entire racial disparity; which emphasizes the roles of molecular, histopathological and genetic factors. We performed a comprehensive review of all published scientific literature up to January 2021 reporting histopathologic, genetic and molecular factors associated with racial disparities in patients with endometrial cancer. The interactions and pathways of molecules reported to have significant differential expression in endometrial cancers from Black and White patients were identified with Ingenuity Pathway Analysis. The majority of studies compared Black and White patients; however, limited data are available for other racial and ethnic groups. Reported differences that could account for the worse survival of Black endometrial cancer patients include more aggressive histopathologies and molecular alterations, including upregulation of molecules driving cell cycle progression, and p53 and HER2/NEU signaling. Several of these molecules are targeted by existing pharmaceuticals. These findings encourage further study and the development of race-specific treatment strategies.
与大多数其他癌症的发病率和死亡率下降形成对比的是，子宫内膜癌的这些比率正在上升。与白人女性相比，患有子宫内膜癌的黑人女性诊断更早，组织学更具侵袭性，分期更晚且预后更差。社会经济地位、侵袭性组织学的较高发病率以及合并症是导致子宫内膜癌患者种族差异的已知因素；然而，它们并不能解释全部的种族差异；这凸显了分子、组织病理学和遗传因素的作用。我们对截至2021年1月发表的所有科学文献进行了全面综述，这些文献报告了与子宫内膜癌患者种族差异相关的组织病理学、遗传和分子因素。通过 Ingenuity 通路分析确定了在黑人和白人患者的子宫内膜癌中报告有显著差异表达的分子的相互作用和通路。大多数研究比较了黑人和白人患者；然而，其他种族和族裔群体的数据有限。据报道，导致黑人子宫内膜癌患者生存率较低的差异包括更具侵袭性的组织病理学和分子改变，包括驱动细胞周期进程的分子上调以及p53和HER2/NEU信号传导。这些分子中有几种是现有药物的靶点。这些发现鼓励进一步研究并制定针对种族的治疗策略。
