Skip to main content

Molecular Diagnosis of Uterine Cancer

  • Chapter
  • First Online:
Book cover Molecular Diagnostics in Cancer Patients
  • 960 Accesses

Abstract

Uterine cancer is the most common malignancy of the female reproductive system in the developed world. Over the last few decades the incidence has been increasing, presumably due to an increase in risk factors such as obesity as well as a change in reproductive trends. As such, there is a great need for better prevention, earlier diagnosis and improved treatment options for endometrial cancer. Approximately 3–5% of endometrial cancers are due to genetic DNA mutations such as Lynch Syndrome; thus, an enhanced understanding of the genetic and molecular biology is required. Current diagnosis and treatment are based on surgical stage, tumor differentiation, depth of invasion, and presence of lymphovascular space invasion. Recent discoveries in molecular biology have great implications regarding diagnosis and treatment. New candidate biomarkers for endometrial cancer such as microRNAs may allow earlier detection as well as predict a patient’s ability to tolerate and/or respond to a particular therapy. In an age of personalized medicine, genetics and molecular biology hold the key to breakthroughs in prevention, diagnosis, and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA, editors. SEER Cancer Statistics Review, 1975-2014. Bethesda: National Cancer Institute; 2017. https://seer.cancer.gov/csr/1975_2014/, based on November 2016 SEER data submission, posted to the SEER web site, April 2017. 1975–2014.

    Google Scholar 

  2. Micco M, et al. Imaging after treatment in uterine malignancies: spectrum of normal findings and most common complications. J Med Imaging Radiat Oncol. 2017;61(6):777–90.

    Article  PubMed  Google Scholar 

  3. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10–7.

    Article  CAS  PubMed  Google Scholar 

  4. Liu FS. Molecular carcinogenesis of endometrial cancer. Taiwan J Obstet Gynecol. 2007;46(1):26–32.

    Article  CAS  PubMed  Google Scholar 

  5. Sherman ME, Bur ME, Kurman RJ. p53 in endometrial cancer and its putative precursors: evidence for diverse pathways of tumorigenesis. Hum Pathol. 1995;26(11):1268–74.

    Article  CAS  PubMed  Google Scholar 

  6. Sorosky JI. Endometrial cancer. Obstet Gynecol. 2008;111(2 Pt 1):436–47.

    Article  PubMed  Google Scholar 

  7. Felix AS, et al. Factors associated with Type I and Type II endometrial cancer. Cancer Causes Control. 2010;21(11):1851–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Fadare O, Zheng W. Endometrial Glandular Dysplasia (EmGD): morphologically and biologically distinctive putative precursor lesions of Type II endometrial cancers. Diagn Pathol. 2008;3:6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Matias-Guiu X, et al. Molecular pathology of endometrial hyperplasia and carcinoma. Hum Pathol. 2001;32(6):569–77.

    Article  CAS  PubMed  Google Scholar 

  10. Lax SF, et al. The frequency of p53, K-ras mutations, and microsatellite instability differs in uterine endometrioid and serous carcinoma: evidence of distinct molecular genetic pathways. Cancer. 2000;88(4):814–24.

    Article  CAS  PubMed  Google Scholar 

  11. Llobet D, et al. Molecular pathology of endometrial carcinoma: practical aspects from the diagnostic and therapeutic viewpoints. J Clin Pathol. 2009;62(9):777–85.

    Article  CAS  PubMed  Google Scholar 

  12. Abushahin N, Pang S, Li J, Fadare O, Zheng W. Endometrial intraepithelial neoplasia. In: Intraepithelial neoplasia. 2012. 10.5772/30988.

    Google Scholar 

  13. Matias-Guiu X, Prat J. Molecular pathology of endometrial carcinoma. Histopathology. 2013;62(1):111–23.

    Article  PubMed  Google Scholar 

  14. Doll A, et al. Novel molecular profiles of endometrial cancer-new light through old windows. J Steroid Biochem Mol Biol. 2008;108(3–5):221–9.

    Article  CAS  PubMed  Google Scholar 

  15. Hecht JL, Mutter GL. Molecular and pathologic aspects of endometrial carcinogenesis. J Clin Oncol. 2006;24(29):4783–91.

    Article  CAS  PubMed  Google Scholar 

  16. Chen LM, McGonigle KF, Berek JS. Endometrial cancer: recent developments in evaluation and treatment. Oncology (Williston Park). 1999;13(12):1665–70; discussion 1675–8, 1681–2

    CAS  Google Scholar 

  17. American College of Obstetricians and Gynecologists. ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer. Obstet Gynecol. 2005;106(2):413–25.

    Article  Google Scholar 

  18. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA, editors. SEER Cancer Statistics Review, 1975-2013. Bethesda: National Cancer Institute; 2016. https://seer.cancer.gov/csr/1975_2013/, based on November 2015 SEER data submission, posted to the SEER web site, April 2016. 1975–2013.

    Google Scholar 

  19. Braun MM, Overbeek-Wager EA, Grumbo RJ. Diagnosis and management of endometrial cancer. Am Fam Physician. 2016;93(6):468–74.

    PubMed  Google Scholar 

  20. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 440: the role of transvaginal ultrasonography in the evaluation of postmenopausal bleeding. Obstet Gynecol. 2009;114(2 Pt 1):409–11.

    Google Scholar 

  21. Dijkhuizen FP, et al. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer. 2000;89(8):1765–72.

    Article  CAS  PubMed  Google Scholar 

  22. Gbelcova H, et al. PTEN sequence analysis in endometrial hyperplasia and endometrial carcinoma in Slovak women. Anal Cell Pathol (Amst). 2015;2015:746856.

    CAS  Google Scholar 

  23. Ellis PE, Ghaem-Maghami S. Molecular characteristics and risk factors in endometrial cancer: what are the treatment and preventative strategies? Int J Gynecol Cancer. 2010;20(7):1207–16.

    Article  PubMed  Google Scholar 

  24. Ahmed Q, et al. Gynecologic cancers: molecular updates. Clin Lab Med. 2013;33(4):911–25.

    Article  PubMed  Google Scholar 

  25. Lax SF. Molecular genetic pathways in various types of endometrial carcinoma: from a phenotypical to a molecular-based classification. Virchows Arch. 2004;444(3):213–23.

    Article  CAS  PubMed  Google Scholar 

  26. Simpkins SB, et al. PTEN mutations in endometrial cancers with 10q LOH: additional evidence for the involvement of multiple tumor suppressors. Gynecol Oncol. 1998;71(3):391–5.

    Article  CAS  PubMed  Google Scholar 

  27. Bilbao C, et al. The relationship between microsatellite instability and PTEN gene mutations in endometrial cancer. Int J Cancer. 2006;119(3):563–70.

    Article  CAS  PubMed  Google Scholar 

  28. Sun H, et al. Mutational analysis of the PTEN gene in endometrial carcinoma and hyperplasia. Am J Clin Pathol. 2001;115(1):32–8.

    Article  CAS  PubMed  Google Scholar 

  29. Akiyama-Abe A, et al. Loss of PTEN expression is an independent predictor of favourable survival in endometrial carcinomas. Br J Cancer. 2013;109(6):1703–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Risinger JI, et al. PTEN mutation in endometrial cancers is associated with favorable clinical and pathologic characteristics. Clin Cancer Res. 1998;4(12):3005–10.

    CAS  PubMed  Google Scholar 

  31. Rajanbabu A. Molecular pathology and cytogenetics of endometrial carcinoma, carcinosarcoma, and uterine sarcomas. In: Rajaram S, Chitrathara K, Maheshwari A, editors. Uterine cancer: diagnosis and treatment. New Delhi: Springer; 2015. p. 13–23.

    Chapter  Google Scholar 

  32. Oza AM, Elit L, Provencher D, Biagi JJ, Panasci L, Sederias J, Dancey JE, Tsao MS, Eisenhauer EA. A phase II study of temsirolimus (CCI-779) in patients with metastatic and/or locally advanced recurrent endometrial cancer previously treated with chemotherapy: NCIC CTG IND 160b. J Clin Oncol. 2008;26(15_suppl):5516.

    Article  Google Scholar 

  33. Gao J, et al. Integrative analysis of complex cancer genomics and clinical profiles using the cBioPortal. Sci Signal. 2013;6(269):pl1.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. Oda K, et al. High frequency of coexistent mutations of PIK3CA and PTEN genes in endometrial carcinoma. Cancer Res. 2005;65(23):10669–73.

    Article  CAS  PubMed  Google Scholar 

  35. Gymnopoulos M, Elsliger MA, Vogt PK. Rare cancer-specific mutations in PIK3CA show gain of function. Proc Natl Acad Sci U S A. 2007;104(13):5569–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Konopka B, et al. PIK3CA mutations and amplification in endometrioid endometrial carcinomas: relation to other genetic defects and clinicopathologic status of the tumors. Hum Pathol. 2011;42(11):1710–9.

    Article  CAS  PubMed  Google Scholar 

  37. Catasus L, et al. PIK3CA mutations in the kinase domain (exon 20) of uterine endometrial adenocarcinomas are associated with adverse prognostic parameters. Mod Pathol. 2008;21(2):131–9.

    Article  CAS  PubMed  Google Scholar 

  38. Lin DI. Improved survival associated with somatic PIK3CA mutations in copy-number low endometrioid endometrial adenocarcinoma. Oncol Lett. 2015;10(5):2743–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Enomoto T, et al. Alterations of the p53 tumor suppressor gene and its association with activation of the c-K-ras-2 protooncogene in premalignant and malignant lesions of the human uterine endometrium. Cancer Res. 1993;53(8):1883–8.

    CAS  PubMed  Google Scholar 

  40. Zyla MM, et al. The significance of markers in the diagnosis of endometrial cancer. Prz Menopauzalny. 2016;15(3):176–85.

    PubMed  PubMed Central  Google Scholar 

  41. Dobrzycka B, et al. Mutations of the KRAS oncogene in endometrial hyperplasia and carcinoma. Folia Histochem Cytobiol. 2009;47(1):65–8.

    Article  CAS  PubMed  Google Scholar 

  42. Sammoud S, et al. Relationship between expression of ras p21 oncoprotein and mutation status of the K-ras gene in sporadic colorectal cancer patients in Tunisia. Appl Immunohistochem Mol Morphol. 2012;20(2):146–52.

    Article  CAS  PubMed  Google Scholar 

  43. Lagarda H, et al. K-ras mutations in endometrial carcinomas with microsatellite instability. J Pathol. 2001;193(2):193–9.

    Article  CAS  PubMed  Google Scholar 

  44. Pallares J, et al. Promoter hypermethylation and reduced expression of RASSF1A are frequent molecular alterations of endometrial carcinoma. Mod Pathol. 2008;21(6):691–9.

    Article  CAS  PubMed  Google Scholar 

  45. Norimatsu Y, et al. Diagnostic utility of phosphatase and tensin homolog, beta-catenin, and p53 for endometrial carcinoma by thin-layer endometrial preparations. Cancer. 2008;114(3):155–64.

    Article  PubMed  Google Scholar 

  46. O’Hara AJ, Bell DW. The genomics and genetics of endometrial cancer. Adv Genomics Genet. 2012;2012(2):33–47.

    PubMed  PubMed Central  Google Scholar 

  47. Kurnit KC, et al. CTNNB1 (beta-catenin) mutation identifies low grade, early stage endometrial cancer patients at increased risk of recurrence. Mod Pathol. 2017;30(7):1032–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Moreno-Bueno G, et al. Abnormalities of the APC/beta-catenin pathway in endometrial cancer. Oncogene. 2002;21(52):7981–90.

    Article  CAS  PubMed  Google Scholar 

  49. Mahecha AM, Wang H. The influence of vascular endothelial growth factor-A and matrix metalloproteinase-2 and -9 in angiogenesis, metastasis, and prognosis of endometrial cancer. Onco Targets Ther. 2017;10:4617–24.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Topolovec Z, et al. Vascular endothelial growth factor and intratumoral microvessel density as prognostic factors in endometrial cancer. Coll Antropol. 2010;34(2):447–53.

    CAS  PubMed  Google Scholar 

  51. Saarelainen SK, et al. Endoglin, VEGF, and its receptors in predicting metastases in endometrial carcinoma. Tumour Biol. 2014;35(5):4651–7.

    Article  CAS  PubMed  Google Scholar 

  52. Soufla G, Sifakis S, Spandidos DA. FGF2 transcript levels are positively correlated with EGF and IGF-1 in the malignant endometrium. Cancer Lett. 2008;259(2):146–55.

    Article  CAS  PubMed  Google Scholar 

  53. Winterhoff B, Konecny GE. Targeting fibroblast growth factor pathways in endometrial cancer. Curr Probl Cancer. 2017;41(1):37–47.

    Article  PubMed  Google Scholar 

  54. Byron SA, Pollock PM. FGFR2 as a molecular target in endometrial cancer. Future Oncol. 2009;5(1):27–32.

    Article  CAS  PubMed  Google Scholar 

  55. Rai R, et al. p53: its alteration and gallbladder cancer. Eur J Cancer Prev. 2011;20(2):77–85.

    Article  CAS  PubMed  Google Scholar 

  56. Schultheis AM, et al. TP53 mutational spectrum in endometrioid and serous endometrial cancers. Int J Gynecol Pathol. 2016;35(4):289–300.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Hayes MP, Ellenson LH. Molecular alterations in uterine serous carcinoma. Gynecol Oncol. 2010;116(2):286–9.

    Article  CAS  PubMed  Google Scholar 

  58. Kohler MF, et al. p53 overexpression in advanced-stage endometrial adenocarcinoma. Am J Obstet Gynecol. 1996;175(5):1246–52.

    Article  CAS  PubMed  Google Scholar 

  59. Abu Backer FM, Nik Mustapha NR, Othman NH. Clinicopathological comparison of adenocarcinoma of cervix and endometrium using cell cycle markers: P16ink4a, P21waf1, and p27Kip1 on 132 cancers. Infect Dis Obstet Gynecol. 2011;2011:857851.

    PubMed  Google Scholar 

  60. Salvesen HB, Das S, Akslen LA. Loss of nuclear p16 protein expression is not associated with promoter methylation but defines a subgroup of aggressive endometrial carcinomas with poor prognosis. Clin Cancer Res. 2000;6(1):153–9.

    CAS  PubMed  Google Scholar 

  61. Banno K, et al. Biomarkers in endometrial cancer: possible clinical applications (Review). Oncol Lett. 2012;3(6):1175–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Villella JA, et al. HER-2/neu overexpression in uterine papillary serous cancers and its possible therapeutic implications. Int J Gynecol Cancer. 2006;16(5):1897–902.

    Article  CAS  PubMed  Google Scholar 

  63. Roses RE, et al. HER-2/neu overexpression as a predictor for the transition from in situ to invasive breast cancer. Cancer Epidemiol Biomarkers Prev. 2009;18(5):1386–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Williams JA Jr, et al. Fluorescence in situ hybridization analysis of HER-2/neu, c-myc, and p53 in endometrial cancer. Exp Mol Pathol. 1999;67(3):135–43.

    Article  CAS  PubMed  Google Scholar 

  65. Morrison C, et al. HER-2 is an independent prognostic factor in endometrial cancer: association with outcome in a large cohort of surgically staged patients. J Clin Oncol. 2006;24(15):2376–85.

    Article  CAS  PubMed  Google Scholar 

  66. Diaz-Montes TP, et al. Clinical significance of Her-2/neu overexpression in uterine serous carcinoma. Gynecol Oncol. 2006;100(1):139–44.

    Article  CAS  PubMed  Google Scholar 

  67. Sakuragi N, et al. Decreased E-cadherin expression in endometrial carcinoma is associated with tumor dedifferentiation and deep myometrial invasion. Gynecol Oncol. 1994;53(2):183–9.

    Article  CAS  PubMed  Google Scholar 

  68. Moinfar F, Azodi M, Tavassoli FA. Uterine sarcomas. Pathology. 2007;39(1):55–71.

    Article  PubMed  Google Scholar 

  69. Bansal N, Yendluri V, Wenham RM. The molecular biology of endometrial cancers and the implications for pathogenesis, classification, and targeted therapies. Cancer Control. 2009;16(1):8–13.

    Article  PubMed  Google Scholar 

  70. Holcomb K, et al. E-cadherin expression in endometrioid, papillary serous, and clear cell carcinoma of the endometrium. Obstet Gynecol. 2002;100(6):1290–5.

    CAS  PubMed  Google Scholar 

  71. Leslie KK, et al. A phase II evaluation of gefitinib in the treatment of persistent or recurrent endometrial cancer: a Gynecologic Oncology Group study. Gynecol Oncol. 2013;129(3):486–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Tsikouras P, et al. Endometrial cancer: molecular and therapeutic aspects. Eur J Obstet Gynecol Reprod Biol. 2013;169(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  73. Decruze SB, Green JA. Hormone therapy in advanced and recurrent endometrial cancer: a systematic review. Int J Gynecol Cancer. 2007;17(5):964–78.

    Article  CAS  PubMed  Google Scholar 

  74. Tangen IL, et al. Loss of progesterone receptor links to high proliferation and increases from primary to metastatic endometrial cancer lesions. Eur J Cancer. 2014;50(17):3003–10.

    Article  CAS  PubMed  Google Scholar 

  75. Huvila J, et al. Progesterone receptor negativity is an independent risk factor for relapse in patients with early stage endometrioid endometrial adenocarcinoma. Gynecol Oncol. 2013;130(3):463–9.

    Article  CAS  PubMed  Google Scholar 

  76. Li M, et al. Clinical implications and prognostic value of single and combined biomarkers in endometrial carcinoma. Chin Med J (Engl). 2014;127(8):1459–63.

    CAS  Google Scholar 

  77. Ferrandina G, et al. Expression of cyclooxygenase-2 (COX-2), receptors for estrogen (ER), and progesterone (PR), p53, ki67, and neu protein in endometrial cancer. Gynecol Oncol. 2005;98(3):383–9.

    Article  CAS  PubMed  Google Scholar 

  78. Kitson S, et al. Ki-67 in endometrial cancer: scoring optimization and prognostic relevance for window studies. Mod Pathol. 2017;30(3):459–68.

    Article  CAS  PubMed  Google Scholar 

  79. Horree N, et al. The invasive front in endometrial carcinoma: higher proliferation and associated derailment of cell cycle regulators. Hum Pathol. 2007;38(8):1232–8.

    Article  CAS  PubMed  Google Scholar 

  80. Kosmas K, et al. Expression of Ki-67 as proliferation biomarker in imprint smears of endometrial carcinoma. Diagn Cytopathol. 2013;41(3):212–7.

    Article  PubMed  Google Scholar 

  81. Lax SF, et al. Clear cell carcinoma of the endometrium is characterized by a distinctive profile of p53, Ki-67, estrogen, and progesterone receptor expression. Hum Pathol. 1998;29(6):551–8.

    Article  CAS  PubMed  Google Scholar 

  82. Shih HC, et al. Immunohistochemical expression of cyclins, cyclin-dependent kinases, tumor-suppressor gene products, Ki-67, and sex steroid receptors in endometrial carcinoma: positive staining for cyclin A as a poor prognostic indicator. Hum Pathol. 2003;34(5):471–8.

    Article  CAS  PubMed  Google Scholar 

  83. Saraiva AL, et al. Immunohistochemical expression of cyclooxygenase-2 (COX-2) in feline endometrial adenocarcinoma and in normal and hyperplastic endometria. Reprod Domest Anim. 2015;50(2):333–40.

    Article  CAS  PubMed  Google Scholar 

  84. Ma X, et al. Clinical significance of COX-2, GLUT-1 and VEGF expressions in endometrial cancer tissues. Pak J Med Sci. 2015;31(2):280–4.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Ferrandina G, et al. Cyclooxygenase-2 expression in endometrial carcinoma: correlation with clinicopathologic parameters and clinical outcome. Cancer. 2002;95(4):801–7.

    Article  CAS  PubMed  Google Scholar 

  86. Werner HM, Salvesen HB. Current status of molecular biomarkers in endometrial cancer. Curr Oncol Rep. 2014;16(9):403.

    Article  CAS  PubMed  Google Scholar 

  87. Proctor L, et al. Assessment of DNA Ploidy in the ProMisE molecular subgroups of endometrial cancer. Gynecol Oncol. 2017;146(3):596–602.

    Article  CAS  PubMed  Google Scholar 

  88. Susini T, et al. Ten-year results of a prospective study on the prognostic role of ploidy in endometrial carcinoma: dNA aneuploidy identifies high-risk cases among the so-called ‘low-risk’ patients with well and moderately differentiated tumors. Cancer. 2007;109(5):882–90.

    Article  CAS  PubMed  Google Scholar 

  89. Dotters DJ. Preoperative CA 125 in endometrial cancer: is it useful? Am J Obstet Gynecol. 2000;182(6):1328–34.

    Article  CAS  PubMed  Google Scholar 

  90. Jiang T, Huang L, Zhang S. Preoperative serum CA125: a useful marker for surgical management of endometrial cancer. BMC Cancer. 2015;15:396.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  91. Moore RG, et al. Utility of a novel serum tumor biomarker HE4 in patients with endometrioid adenocarcinoma of the uterus. Gynecol Oncol. 2008;110(2):196–201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  92. Bie Y, Zhang Z. Diagnostic value of serum HE4 in endometrial cancer: a meta-analysis. World J Surg Oncol. 2014;12:169.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Li X, et al. Expression of HE4 in endometrial cancer and its clinical significance. Biomed Res Int. 2015;2015:437468.

    PubMed  PubMed Central  Google Scholar 

  94. Dong C, Liu P, Li C. Value of HE4 combined with cancer antigen 125 in the diagnosis of endometrial cancer. Pak J Med Sci. 2017;33(4):1013–7.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Kunitomi H, et al. New use of microsatellite instability analysis in endometrial cancer. Oncol Lett. 2017;14(3):3297–301.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  96. Popat S, Hubner R, Houlston RS. Systematic review of microsatellite instability and colorectal cancer prognosis. J Clin Oncol. 2005;23(3):609–18.

    Article  CAS  PubMed  Google Scholar 

  97. An HJ, et al. Microsatellite instability in endometrioid type endometrial adenocarcinoma is associated with poor prognostic indicators. Am J Surg Pathol. 2007;31(6):846–53.

    Article  PubMed  Google Scholar 

  98. Kanopiene D, et al. Endometrial cancer and microsatellite instability status. Open Med (Wars). 2015;10(1):70–6.

    CAS  Google Scholar 

  99. Lee TS, et al. Aberrant microRNA expression in endometrial carcinoma using formalin-fixed paraffin-embedded (FFPE) tissues. PLoS One. 2013;8(12):e81421.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  100. Jurcevic S, Olsson B, Klinga-Levan K. MicroRNA expression in human endometrial adenocarcinoma. Cancer Cell Int. 2014;14(1):88.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Widodo, Djati MS, Rifa’i M. Role of MicroRNAs in carcinogenesis that potential for biomarker of endometrial cancer. Ann Med Surg (Lond). 2016;7:9–13.

    Article  CAS  PubMed Central  Google Scholar 

  102. Banno K, et al. Candidate biomarkers for genetic and clinicopathological diagnosis of endometrial cancer. Int J Mol Sci. 2013;14(6):12123–37.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  103. Panici PB, et al. Multiple serum markers in patients with endometrial cancer. Gynecol Obstet Invest. 1989;27(4):208–12.

    Article  CAS  PubMed  Google Scholar 

  104. Leslie KK, et al. Lapatinib and potential prognostic value of EGFR mutations in a Gynecologic Oncology Group phase II trial of persistent or recurrent endometrial cancer. Gynecol Oncol. 2012;127(2):345–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Fleming GF, et al. Phase II trial of trastuzumab in women with advanced or recurrent, HER2-positive endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2010;116(1):15–20.

    Article  CAS  PubMed  Google Scholar 

  106. Luque-Cabal M, et al. Mechanisms behind the resistance to trastuzumab in HER2-amplified breast cancer and strategies to overcome it. Clin Med Insights Oncol. 2016;10(Suppl 1):21–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  107. Diver EJ, et al. The therapeutic challenge of targeting HER2 in endometrial cancer. Oncologist. 2015;20(9):1058–68.

    Article  CAS  PubMed  Google Scholar 

  108. Aghajanian C, et al. Phase II trial of bevacizumab in recurrent or persistent endometrial cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2011;29(16):2259–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Carol Aghajanian VLF, Dizon DS, Carlson J, Powell MA, Secord AA, Tewari KS, Bender D, O’Malley DM, Stuckey A, Rotmensch J, Levine DA, Lankes HA, Moore KN. A randomized phase II study of paclitaxel/carboplatin/bevacizumab, paclitaxel/carboplatin/temsirolimus and ixabepilone/carboplatin/bevacizumab as initial therapy for measurable stage III or IVA, stage IVB or recurrent endometrial cancer, GOG-86P. J Clin Oncol. 2015;33(15 Suppl):5500.

    Article  Google Scholar 

  110. Lorusso D, Ferrandina G, Colombo N, Pignata S, Salutari V, Maltese G, Pisano C, Lapresa M, Savarese A, Tagliaferri P, Sorio R, Cinieri S, Breda E, Sabbatini R, Lepori S, Conte C, Cecere SC, Raspagliesi F, Scambia G. Randomized phase II trial of carboplatin-paclitaxel (CP) compared to carboplatin-paclitaxel-bevacizumab (CP-B) in advanced (stage III-IV) or recurrent endometrial cancer: the MITO END-2 trial. J Clin Oncol. 2015;33(15 Suppl):5502.

    Article  Google Scholar 

  111. Dutt A, et al. Drug-sensitive FGFR2 mutations in endometrial carcinoma. Proc Natl Acad Sci U S A. 2008;105(25):8713–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  112. Konecny GE, et al. Activity of the fibroblast growth factor receptor inhibitors dovitinib (TKI258) and NVP-BGJ398 in human endometrial cancer cells. Mol Cancer Ther. 2013;12(5):632–42.

    Article  CAS  PubMed  Google Scholar 

  113. Powell MA, et al. A phase II trial of brivanib in recurrent or persistent endometrial cancer: an NRG Oncology/Gynecologic Oncology Group Study. Gynecol Oncol. 2014;135(1):38–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  114. Ignace Vergote MT, Powell MA, Miller DS, Garcia AA, Mikheeva ON, Pinter T, Bidzinski M, Cebotaru CL, Fan J, Ren M, Meneses N, Funahashi Y, Kadowaki T, O’Brien JP, Penson RT. A phase II trial of lenvatinib in patients with advanced or recurrent endometrial cancer: angiopoietin-2 as a predictive marker for clinical outcomes. J Clin Oncol. 2013;31(15 Suppl):5520.

    Google Scholar 

  115. Konecny GE, et al. Second-line dovitinib (TKI258) in patients with FGFR2-mutated or FGFR2-non-mutated advanced or metastatic endometrial cancer: a non-randomised, open-label, two-group, two-stage, phase 2 study. Lancet Oncol. 2015;16(6):686–94.

    Article  CAS  PubMed  Google Scholar 

  116. Meireles CG, et al. Effects of metformin on endometrial cancer: systematic review and meta-analysis. Gynecol Oncol. 2017;147(1):167–80.

    Article  CAS  PubMed  Google Scholar 

  117. Foretz M, et al. Metformin: from mechanisms of action to therapies. Cell Metab. 2014;20(6):953–66.

    Article  CAS  PubMed  Google Scholar 

  118. Wheaton WW, et al. Metformin inhibits mitochondrial complex I of cancer cells to reduce tumorigenesis. Elife. 2014;3:e02242.

    Article  PubMed  PubMed Central  Google Scholar 

  119. Zhao Y, et al. Metformin is associated with reduced cell proliferation in human endometrial cancer by inbibiting PI3K/AKT/mTOR signaling. Gynecol Endocrinol. 2018;34(5):428–32.

    Article  CAS  PubMed  Google Scholar 

  120. Evans JM, et al. Metformin and reduced risk of cancer in diabetic patients. BMJ. 2005;330(7503):1304–5.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vishal Chandra .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rai, R., Fatima, I., Essel, K., Chandra, V. (2019). Molecular Diagnosis of Uterine Cancer. In: Shukla, K., Sharma, P., Misra, S. (eds) Molecular Diagnostics in Cancer Patients. Springer, Singapore. https://doi.org/10.1007/978-981-13-5877-7_18

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-5877-7_18

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-5876-0

  • Online ISBN: 978-981-13-5877-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics