重视子宫内膜癌的防治

Prevention and treatment of endometrial cancer

子宫内膜癌(EC)发病率持续升高并呈现年轻化趋势。针对发病危险因素进行一级预防和高危人群筛查,有望降低EC发病率,实现早诊早治。EC病理学和分子生物学的研究进展加深了人们对EC高度异质性的认识,国际妇产科联盟(FIGO)新分期在手术病理基础上融入组织学特征和分子分型,有助于更加精准地判断预后、指导治疗。EC初始治疗规范化十分重要,辅助治疗的选择尚存争议。复发性EC免疫检查点抑制剂疗效显著,已从后线前移一线联合治疗,多种靶向药物成为新的研发方向。EC生存者管理尚需加强。

Endometrial cancer is rising in incidence,especially in young women.This rise in incidence has implications for both primary prevention and screening in high-risk population.In the past several years,our understanding of the integration of clinically related genomic and pathologic data optimized the management of endometrial cancer.The updated 2023 FIGO staging includes the histological and molecular classification to better reflect the improved understanding of the heterogenous nature of endometrial carcinoma.Standard primary treatment is quite essential,however,selection of patients for adjuvant radiation or chemotherapy remains in controversy.Molecular characterization of endometrial cancer is becoming critical in directing treatment for advanced and recurrent disease,and the addition of immunotherapy to frontline chemotherapy is becoming the standard of care.More attention should be given to increase awareness of survivorship issues and improve patient quality-of-life.