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What is endometrial cancer?
Endometrial cancer is a malignant tumor originating from the endometrial epithelium. It is a type of uterine corpus cancer and one of the three major malignancies of the female reproductive tract. Its development is a multistep process and it most commonly affects perimenopausal and postmenopausal women.
Main types of endometrial cancer
1.Major histopathological types
● Estrogen-dependent (Type I): The most common type, predominantly endometrioid adenocarcinoma, associated with prolonged estrogen stimulation, and generally associated with a favorable prognosis.
● Non–estrogen-dependent (Type II): Including serous carcinoma and clear cell carcinoma; characterized by aggressive behavior, less closely related to estrogen exposure, and a relatively poor prognosis.
2.Contemporary molecular subtypes
Based on molecular characteristics, endometrial cancer can be further classified into four subtypes, which are important for guiding precision therapy and prognostic stratification:
● POLE ultramutated: Characterized by a high mutational burden due to pathogenic POLE alterations and typically associated with an excellent prognosis.
● Microsatellite instability (MSI): Reflects mismatch repair deficiency and is more likely to respond to immunotherapy.
● Copy-number low: Relatively genomically stable with an intermediate prognosis.
● Copy-number high: Often associated with serous carcinoma and linked to poorer outcomes.
Etiology of endometrial cancer
The development of endometrial cancer is associated with multiple factors, including:
1.Reproductive endocrine disorders: such as anovulatory abnormal uterine bleeding and polycystic ovary syndrome (PCOS).
2.Obesity, hypertension, and diabetes: referred to as the “endometrial cancer triad.”
3.Early menarche and late menopause.
4.Exogenous estrogen exposure: use of unopposed estrogen therapy for more than 5 years markedly increases risk.
5.Genetic factors: approximately 20% of patients have a family history.
6.Disease-related factors such as ovarian tumors.
Prevention and health maintenance for endometrial cancer
1.Manage risk factors: control body weight, blood pressure, and blood glucose, and use exogenous estrogen rationally.
2.Regular screening: high-risk women (e.g., those with hereditary factors or reproductive endocrine disorders) should prioritize regular gynecologic examinations.
3.Healthy lifestyle: maintain a balanced diet, avoid high-fat diets, and increase physical activity.
Conclusion
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that the incidence of endometrial cancer is increasing, and early diagnosis and treatment are pivotal. The public should remain vigilant for abnormal bleeding, and high-risk populations should undergo regular screening. Individualized multimodal strategies—including surgery and targeted approaches—should be adopted based on subtype to improve outcomes and quality of survival.
What is endometrial cancer?
Endometrial cancer is a malignant tumor originating from the endometrial epithelium. It is a type of uterine corpus cancer and one of the three major malignancies of the female reproductive tract. Its development is a multistep process and it most commonly affects perimenopausal and postmenopausal women.
Main types of endometrial cancer
1.Major histopathological types
● Estrogen-dependent (Type I): The most common type, predominantly endometrioid adenocarcinoma, associated with prolonged estrogen stimulation, and generally associated with a favorable prognosis.
● Non–estrogen-dependent (Type II): Including serous carcinoma and clear cell carcinoma; characterized by aggressive behavior, less closely related to estrogen exposure, and a relatively poor prognosis.
2.Contemporary molecular subtypes
Based on molecular characteristics, endometrial cancer can be further classified into four subtypes, which are important for guiding precision therapy and prognostic stratification:
● POLE ultramutated: Characterized by a high mutational burden due to pathogenic POLE alterations and typically associated with an excellent prognosis.
● Microsatellite instability (MSI): Reflects mismatch repair deficiency and is more likely to respond to immunotherapy.
● Copy-number low: Relatively genomically stable with an intermediate prognosis.
● Copy-number high: Often associated with serous carcinoma and linked to poorer outcomes.
Etiology of endometrial cancer
The development of endometrial cancer is associated with multiple factors, including:
1.Reproductive endocrine disorders: such as anovulatory abnormal uterine bleeding and polycystic ovary syndrome (PCOS).
2.Obesity, hypertension, and diabetes: referred to as the “endometrial cancer triad.”
3.Early menarche and late menopause.
4.Exogenous estrogen exposure: use of unopposed estrogen therapy for more than 5 years markedly increases risk.
5.Genetic factors: approximately 20% of patients have a family history.
6.Disease-related factors such as ovarian tumors.
Prevention and health maintenance for endometrial cancer
1.Manage risk factors: control body weight, blood pressure, and blood glucose, and use exogenous estrogen rationally.
2.Regular screening: high-risk women (e.g., those with hereditary factors or reproductive endocrine disorders) should prioritize regular gynecologic examinations.
3.Healthy lifestyle: maintain a balanced diet, avoid high-fat diets, and increase physical activity.
Conclusion
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that the incidence of endometrial cancer is increasing, and early diagnosis and treatment are pivotal. The public should remain vigilant for abnormal bleeding, and high-risk populations should undergo regular screening. Individualized multimodal strategies—including surgery and targeted approaches—should be adopted based on subtype to improve outcomes and quality of survival.