Aimagambetova Gulzhanat, Terzic Sanja, Laganà Antonio Simone, Bapayeva Gauri, la Fleur Philip, Terzic Milan
Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Nur-Sultan 010000, Kazakhstan.
Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan 010000, Kazakhstan.
J Clin Med. 2021 Dec 30;11(1):196. doi: 10.3390/jcm11010196.
Incidence of endometrial cancer (EC) has been increasing in recent years, especially in high-income countries. The disease commonly affects peri- and postmenopausal women; however, about 5% of women are diagnosed with EC in their reproductive age. Due to both the increasing incidence of EC among reproductive age women and trends to delayed childbearing, fertility-sparing treatment for young patients with EC has become extremely important for researchers and practitioners. Because the classic treatment with total hysterectomy and bilateral saplingo-oophorectomy is not an appropriate approach for young women demanding fertility preservation, several fertility-sparing options have been developed and summarized in this review. Utilization of different medications and their combination (progestagens, gonadotropin releasing hormones analogues, and metformin in different formulations) are tested and found as efficient for fertility-sparing treatment. New minimally invasive surgical techniques, combined with progestagens, are also confirmed as valuable. There are many novel conservative and surgical treatment approaches under investigation. Assuming that molecular biomarkers can be both diagnostic and prognostic to assist in prediction of response to a certain therapy, prognostic risk groups' stratification along with specific biomarkers' identification will ensure low recurrence and decrease mortality rates in young women with EC.
近年来，子宫内膜癌（EC）的发病率一直在上升，尤其是在高收入国家。这种疾病通常影响围绝经期和绝经后女性；然而，约5%的女性在育龄期被诊断出患有子宫内膜癌。由于育龄期女性子宫内膜癌发病率的上升以及生育推迟的趋势，对于患有子宫内膜癌的年轻患者而言，保留生育功能的治疗对研究人员和从业者来说变得极其重要。因为经典的全子宫切除术和双侧附件切除术对要求保留生育功能的年轻女性而言并非合适的治疗方法，所以本综述总结了几种保留生育功能的选择。不同药物及其联合使用（不同剂型的孕激素、促性腺激素释放激素类似物和二甲双胍）经过测试，发现对保留生育功能的治疗有效。新的微创手术技术与孕激素联合使用也被证实具有价值。目前有许多新型保守和手术治疗方法正在研究中。假设分子生物标志物既具有诊断性又具有预后性，有助于预测对某种治疗的反应，那么预后风险组的分层以及特定生物标志物的识别将确保患有子宫内膜癌的年轻女性低复发率并降低死亡率。
