关键词: 子宫内膜肿瘤, 抗肿瘤联合化疗方案, 放射疗法, 基因, 肿瘤抑制

Abstract: Endometrial carcinoma is a common malignant tumor in female genital tract. The incidence of endometrial carcinoma is second only to cervical cancer in China. The treatment methods include surgical treatment and adjuvant therapy (radiotherapy, chemotherapy, endocrine therapy), which are usually used in patients with stageⅠb ~ Ⅳ. However, overtreatment and ineffective treatment may lead to recurrence in some patients with stage Ⅰ to Ⅱ, and lead to significant differences in clinical outcomes of endometrial endometroid carcinoma (EECs) with high grade (grade 3, G3). The evaluation of molecular characteristics can be used to guide the accurate treatment of endometrial carcinoma with pathological difficulties and rare types. The resistance to platinum chemotherapy in endometrial carcinoma with polymerase ε gene (POLE) mutation is high. Anti-cytotoxic T lymphocyte antigen 4/programmed death protein 1 (CTLA4/PD1) antibody and phosphatidylinositol kinase 3/mitogen activator inhibitor (PI3K/MEK) were effective for POLE. Mismatch repair gene expression deficient endometrial carcinoma is highly resistant to conventional radiotherapy and chemotherapy. Anti-cell programmed death protein ligand 1/fusion protein (PD-L1/B7-H4) antibody is effective in the treatment of microsatellite instability. The combination of PI3K and cyclin dependent kinase (CDK) inhibitors could be used to reduce the level of regional  gene expression in copy number high group. Double microbody protein 4 (MDM4) inhibitors may be effective in the treatment of copy number low group. By hierarchical cluster analysis, some prognostic genes were found to be significantly correlated with the prognosis, and the expression level of these genes could be combined with molecular typing to predict the prognosis of endometrial carcinoma. We will summarize the clinical significance of TCGA molecular typing and the prognostic genes found by our team in precise adjuvant therapy of endometrial carcinoma.

Key words: Endometrial neoplasms, Antineoplastic combined chemotherapy protocols, Radiotherapy, Genes, tumor suppressor