Epidemiology, Molecular Typing, Microbiome-Immune Interactions and Treatment Strategies of Endometrial Cancer: A Review

Bingyan Liang^1,2Jia Tan³Jia Li⁴Xiaolan Wang⁵Li Genlin⁵Huanhuan Li⁶Ting Li⁶Hong Gao^1,2,7*

• ¹School of Nursing, University of South China, Hengyang, Hunan Province, China
• ²Scientific Research Department, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China, Hengyang, Hunan Province, China
• ³Department Of Neonatology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China, Hengyang, China
• ⁴Operating Room, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China, Hengyang, China
• ⁵Center for a combination of Obstetrics and Gynecology & Reproductive medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China, Hengyang, China
• ⁶Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China, Hengyang, China
• ⁷Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada

This review focuses on the field of endometrial cancer. Since 2020, there have been 417,367 new cases of endometrial cancer diagnosed globally and 97,370 deaths reported. Endometrial cancer ranks second in terms of incidence among female genital malignancies and third in terms of mortality among gynecological cancers.The stage, grade, and histological subtype of endometrial cancer were closely correlated with the risk of recurrence and prognosis for survival. Meanwhile, endometrial cancer exhibits significant biological heterogeneity. The complex interactions among the reproductive tract, host cells, and the microbial environment may harbor novel disease mechanisms. In this review, we provide an overview of the epidemiological characteristics, major risk factors, histological and molecular subtypes of endometrial cancer, as well as explore the associations between the female reproductive tract microbiome, immunity, and cancer progression. We also identify the specific roles of different cytokines in the pathophysiology of endometrial cancer. By integrating findings from diverse research fields, this comprehensive review offers an in-depth understanding of the multidimensional nature of endometrial cancer and highlights the significant potential and promising avenues that microbiological factors present for advancing future cancer research and guiding the development of innovative therapeutic strategies.