DNA Mismatch Repair (MMR) Genes and Endometrial Cancer

Abstract

The incidence of endometrial cancer among malignant gynecological tumors has increased with lifestyle and environmental changes. In the US, 40,000 patients are diagnosed with endometrial cancer annually, and 7,500 patients die of this disease (Jemal et al., 2009). The number and prevalence of cases of endometrial cancer have increased worldwide and control of this cancer is urgently required. However, many aspects of the mechanism of carcinogenesis and pattern of advancement are unclear. Environmental factors such as obesity and a high estrogen level are thought to play important carcinogenic roles, but a close association with hereditary disposition has also been suggested, since double cancer and an increased incidence of cancer in relatives are common in patients with endometrial cancer. Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), is a hereditary disease in which there is frequent development of colorectal, endometrial, and ovarian cancers. The cause is thought to be mutation of the DNA mismatch repair (MMR) gene in germ cells. However, the conventional explanation of the mechanism involving genetic changes mutations of cancer-related genes is inadequate and epigenetic changes in endometrial cancer are now being examined. In particular, aberrant DNA methylation is thought to play a key role in endometrial carcinogenesis. Breakdown of the DNA mismatch repair mechanism due to DNA hypermethylation plays a particularly important role in the development of endometrial cancer.