Background: According to epidemiological studies, endometrial carcinoma is one of the most frequently diagnosed malignancies of the female reproductive system, with an increasing incidence. Currently, the risk stratification of this neoplasm takes into account the stage, degree of tumor differentiation, histological type and depth of myometrial invasion. Since the publication of the last International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer in 2009, numerous reports have appeared on the molecular characteristics of different types of endometrial carcinoma. Taking this into account, the FIGO Committee determined in 2023 that changes and updates to the staging system are justified to reflect new information about this tumor. Due to the high prevalence of the disease and mortality from endometrial cancer, an in-depth study of the molecular genetic characteristics of tumor cells is relevant; the results of such studies can be used to improve the efficiency of diagnosis, assess the risk of metastasis and prognosis of the disease. Lymph node assessment is crucial for the choice of treatment strategy for endometrial cancer, since metastatic lymph node involvement is one of the main factors affecting prognosis. At the same time, the criteria for the appropriateness of lymphadenectomy in low-differentiated malignant tumors are not clearly defined. Various molecular methods have been proposed to assess the status of lymph nodes; candidate genes are being studied as potential diagnostic biomarkers, as well as microRNA. The aim of the study was to analyze the literature data on numerous studies of molecular risk factors for progression in endometrioid carcinoma, as well as to preserve the most important marker changes in relation to the prognostic development of this disease. Methods: A literature review was conducted using data from the electronic databases PubMed, Google Scholar, and Wiley Cochrane Library for the period from 2018 to 2023 using the specific keywords. Results: The current scientific genetic studies on metastasis and prognostic factors in uterine cancer were analyzed, and a systematization of the reviewed data from the modern literature was done. Conclusions: To select the most effective treatment - intraoperative, adjuvant or combination therapy, minimize postoperative risks of lymphadenectomy and clearly predict the results - further study of the molecular genetic features of endometrial cancer is necessary.
背景：根据流行病学研究，子宫内膜癌是女性生殖系统最常诊断的恶性肿瘤之一，其发病率呈上升趋势。目前，该肿瘤的风险分层主要依据分期、肿瘤分化程度、组织学类型及肌层浸润深度。自2009年国际妇产科联盟（FIGO）发布上一版子宫内膜癌分期系统以来，关于不同类型子宫内膜癌分子特征的研究报告大量涌现。鉴于此，FIGO委员会于2023年认定，为反映该肿瘤的新信息，对分期系统进行修订和更新是必要的。由于子宫内膜癌的高患病率及死亡率，深入研究肿瘤细胞的分子遗传特征具有重要意义；此类研究成果可用于提高诊断效率、评估转移风险及疾病预后。淋巴结评估对子宫内膜癌治疗策略的选择至关重要，因为淋巴结转移是影响预后的主要因素之一。同时，低分化恶性肿瘤淋巴结清扫术的适用标准尚未明确。目前已有多种分子方法被提出用于评估淋巴结状态；候选基因及microRNA正作为潜在诊断生物标志物被研究。本研究旨在通过文献分析，梳理子宫内膜样腺癌进展的分子风险因素相关研究，并筛选与该疾病预后发展相关的重要标志物变化。方法：通过检索PubMed、Google Scholar和Wiley Cochrane Library电子数据库（2018-2023年），采用特定关键词进行文献综述。结果：系统分析了当前关于子宫癌转移及预后因素的遗传学研究，并对现代文献数据进行了系统化梳理。结论：为选择最有效的治疗方案（术中、辅助或联合治疗）、最小化淋巴结清扫术后风险并精准预测疗效，有必要进一步深入研究子宫内膜癌的分子遗传学特征。
Molecular Genetic Factors of Risk Stratification of Lymph Node Metastasis in Endometrial Carcinoma
肿瘤(癌症)患者之家