Carvalho Filomena M, Carvalho Jesus P
Department of Pathology, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo 01246-903, Brazil.
Department of Obstetrics and Gynecology, Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo 01246-903, Brazil.
Cancers (Basel). 2024 Oct 11;16(20):3452. doi: 10.3390/cancers16203452.
Endometrial cancer (EC) poses a significant global health challenge, with increasing prevalence in 26 of 43 countries and over 13,000 deaths projected in the United States by 2024. This rise correlates with aging populations, the obesity epidemic, and changing reproductive patterns, including delayed childbearing. Despite the early diagnosis in 67% of cases, approximately 30% of cases present with regional or distant spread, leading to nearly 20% mortality rates. Unlike many cancers, EC mortality rates are escalating, outpacing therapeutic advancements until recently. One of the reasons for this was the lack of effective therapeutic options for advanced disease until recently. The introduction of immunotherapy has marked a turning point in EC treatment, particularly benefiting patients with defects in mismatch repair proteins (dMMRs). However, dMMR status alone does not ensure a favorable response, underscoring the need for precise patient selection. This review explores the pivotal role of mismatch repair proteins in EC, emphasizing their heterogeneity, the challenges in their assessment, and their potential as predictive biomarkers.
子宫内膜癌（EC）是一项重大的全球健康挑战，在43个国家中的26个国家，其患病率呈上升趋势，预计到2024年美国将有超过13000人死亡。这种上升与人口老龄化、肥胖流行以及生殖模式的改变（包括生育延迟）相关。尽管67%的病例能够早期诊断，但仍有大约30%的病例出现局部或远处转移，导致近20%的死亡率。与许多癌症不同，EC的死亡率正在上升，直到最近才超过治疗进展。造成这种情况的原因之一是直到最近晚期疾病都缺乏有效的治疗选择。免疫疗法的引入标志着EC治疗的一个转折点，尤其使错配修复蛋白（dMMR）有缺陷的患者受益。然而，仅dMMR状态并不能确保良好的反应，这突出了精确选择患者的必要性。本综述探讨了错配修复蛋白在EC中的关键作用，强调了它们的异质性、评估中的挑战以及它们作为预测生物标志物的潜力。
