Abstract
Endometrial cancer is one of the most common gynaecological malignancies worldwide. Histologically, two types of endometrial cancer with morphological and molecular differences and also therapeutic implications have been identified. Type I endometrial cancer has an endometrioid morphology and is estrogen-dependent, while Type II appears with non-endometrioid differentiation and follows an estrogen-unrelated pathway. Understanding the molecular biology and genetics of endometrial cancer is crucial for its prognosis and the development of novel therapies for its treatment. However, until now, scant attention has been paid to environmental components like the microbiome. Recently, due to emerging evidence that the uterus is not a sterile cavity, some studies have begun to investigate the composition of the endometrial microbiome and its role in endometrial cancer. In this review, we summarize the current state of this line of investigation, focusing on the relationship between gut and endometrial microbiome and inflammation, estrogen metabolism, and different endometrial cancer therapies.
Highlights
The endometrium is a very dynamic tissue that undergoes proliferation and differentiation processes during the menstrual cycle in response to variations in the levels of steroid sex hormones produced in the ovaries, and the release of local factors [1].Endometrial cancer is the sixth most common malignancy in women, and the fifteenth most common cancer [2]
The results of this study demonstrated that 24 h was sufficient to induce production of pro-inflammatory cytokines in endometrial cells cultured with Atopobium vaginae and Porphyromonas somerae
Due to the importance of the microbiome in many human physiological processes and recent advances in highly sensitive molecular techniques which facilitate the identification of microorganisms, several emergent studies have shown interest in investigating the relationship between gut and endometrial microbiome in endometrial cancer, one of the most common cancers in women worldwide, which occurs more frequently after menopause
Summary
The endometrium is a very dynamic tissue that undergoes proliferation and differentiation processes during the menstrual cycle in response to variations in the levels of steroid sex hormones (estrogen and progesterone) produced in the ovaries, and the release of local factors [1]. Women with Lynch syndrome have an increased endometrial cancer risk as well as an increased risk for other types of cancer such us colorectal cancer [8] This syndrome is caused by a loss-of-function germline mutation in one of four genes (human mutL homolog 1 (MLH1), MSH2, MSH6, and PMS1 Homolog 2 (PMS2)) involved in mismatch-pair recognition and initiation of repair [9]. In addition to phosphatase and tensin homolog (PTEN) and phosphatidylinositol 3-kinase (PIK3CA) mutations, which are the most common in Type I endometrial cancer, other mutations have been identified in KRAS and cadherin associated protein (β-catenin) genes [16]. In addition to phosphatase and tensin homolog (PTEN) and phosphatidylinositol 3-kinase (PIK3CA) mutations, which are the most common in Type I endometrial cancer, other mutations have been identified in KRAS.
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