Molecular approaches for classifying endometrial carcinoma

Gynecol Oncol. 2017 Apr;145(1):200-207. doi: 10.1016/j.ygyno.2016.12.015. Epub 2016 Dec 29.

Abstract

Endometrial carcinoma is the most common cancer of the female genital tract. This review article discusses the usefulness of molecular techniques to classify endometrial carcinoma. Any proposal for molecular classification of neoplasms should integrate morphological features of the tumors. For that reason, we start with the current histological classification of endometrial carcinoma, by discussing the correlation between genotype and phenotype, and the most significant recent improvements. Then, we comment on some of the possible flaws of this classification, by discussing also the value of molecular pathology in improving them, including interobserver variation in pathologic interpretation of high grade tumors. Third, we discuss the importance of applying TCGA molecular approach to clinical practice. We also comment on the impact of intratumor heterogeneity in classification, and finally, we will discuss briefly, the usefulness of TCGA classification in tailoring immunotherapy in endometrial cancer patients. We suggest combining pathologic classification and the surrogate TCGA molecular classification for high-grade endometrial carcinomas, as an option to improve assessment of prognosis.

Keywords: Apoptosis; Beta-catenin; Chromosomal instability; E-cadherin; Endometrial carcinoma; Genetics; K-RAS; Microsatellite instability; PIK3CA; PTEN; TP53.

Publication types

  • Review

MeSH terms

  • Cadherins / genetics
  • Carcinoma, Endometrioid / classification*
  • Carcinoma, Endometrioid / drug therapy
  • Carcinoma, Endometrioid / genetics
  • Carcinoma, Endometrioid / pathology
  • Class I Phosphatidylinositol 3-Kinases
  • DNA Polymerase II / genetics
  • DNA, Neoplasm / genetics*
  • Endometrial Neoplasms / classification*
  • Endometrial Neoplasms / drug therapy
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / pathology
  • Female
  • Humans
  • Microsatellite Instability*
  • Mutation
  • Neoplasm Grading
  • Neoplasms, Cystic, Mucinous, and Serous / classification*
  • Neoplasms, Cystic, Mucinous, and Serous / drug therapy
  • Neoplasms, Cystic, Mucinous, and Serous / genetics
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Neuroendocrine Tumors / classification*
  • Neuroendocrine Tumors / drug therapy
  • Neuroendocrine Tumors / genetics
  • Neuroendocrine Tumors / pathology
  • PTEN Phosphohydrolase / genetics
  • Phenotype
  • Phosphatidylinositol 3-Kinases / genetics
  • Poly-ADP-Ribose Binding Proteins
  • Prognosis
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Tumor Suppressor Protein p53 / genetics
  • beta Catenin / genetics

Substances

  • Cadherins
  • DNA, Neoplasm
  • KRAS protein, human
  • Poly-ADP-Ribose Binding Proteins
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • beta Catenin
  • Class I Phosphatidylinositol 3-Kinases
  • PIK3CA protein, human
  • DNA Polymerase II
  • POLE protein, human
  • PTEN Phosphohydrolase
  • PTEN protein, human
  • Proto-Oncogene Proteins p21(ras)