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Types Of Endometrial Cancer

Endometrial cancer is a type of cancer that begins in the uterus. Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. It is found that due to changes in our lifestyle the cases of endometrial cancer are increasing day by day. That is why we should be aware of endometrial cancer more than ever.

The types of endometrial cancers are as follows:

  • Endometrioid Adenocarcinoma 

The most common type 1 is endometrial carcinoma, which is also called endometrioid carcinoma because the tumors grow in a way that looks like a normal endometrial gland. It usually involves several genetic mutations in endometrial cells, including PTEN, a tumor suppressor gene, PIK3CA, an oncogene, and ARID1A, a gene regulating chromatin structure.

All of these mutations increase signaling in the P13k/AKT pathway, which promotes the growth, and replication of endometrial cells. More signaling in the p13K/AKT pathway also enhances the expression of genes that are linked to estrogen receptors. So having high levels of estrogen will cause the endometrium to undergo hyperplasia, leading to an increased risk of developing type 1 endometrial carcinoma.

Now excessive estrogen can come from obesity because fat cells convert adrenal precursors into sex hormones, taking tamoxifen a breast cancer medication that blocks estrogen receptors in the breasts, but stimulates them in the uterus, and postmenopausal estrogen therapy given without a progestin to” balance it out”. 

  • Clear Cell Carcinoma 

A form of kidney cancer is known as clear cell renal cell carcinoma, or ccRCC. The kidneys are situated on either side of the spine, toward the lower back. The kidneys function by eliminating waste from circulation. Renal cell carcinoma with clear cells is sometimes referred to as typical renal cell cancer.

Genetic changes underlying clear cell renal cell carcinoma (ccRCC) include alterations in genes controlling cellular oxygen sensing and the maintenance of chromatin states. For 466 ccRCC cases, TCGA evaluated clinical and pathological features of genomic alterations, DNA methylation profiles and RNA, and proteomic signatures. 

In all, 466 tumors were profiled on most of the platforms while 372 tumors were profiled for all of the RNA and DNA data types. And so, some of the integrative analyses focused on this core set of 372 but then other analyses made use of all data available. We surveyed these tumors by whole exome sequencing and found 39 significantly mutated genes, the most frequently mutated subset. 

And the somatic mutations were initially called by three sequencing centers. So, each center analyzed the BAM files using their respective mutation calling algorithms, and the number of variant calls for each center for the top 50 or most significant genes.

It can see the intersection between any two centers as well as calls that were made by one center but not by the other two centers. And the analysis for integrative and pathway analysis, we focused on the calls that were made by the other two or more centers as being of higher confidence. 

  • Serous carcinoma

The genetic mutations found most often in serous carcinoma involving the TP53 gene, another tumor suppressor, and aneuploidy or an abnormal number of chromosomes after cell division. Type 2 carcinomas don’t appear to be linked with estrogen levels. These cancers typically affect women who have endometrial atrophy and who have lower body weight. They also tend to develop later in life than type 1 and are more common in women of African descent. 

Even though there are two distinct types of endometrial carcinomas, we use the same stages to describe their development. 

In stage 1 the carcinoma is only in the uterus.

Stage 2 it has spread to the cervix.

In stage 3, it has spread outside the uterus but is still within the lesser, or “true” pelvis. This means it could affect the structures like the vagina and pelvic lymph nodes.

Stage 4, it has spread beyond the pelvis.

Most type 1 endometrial carcinomas are diagnosed in stage 1 and aren’t very aggressive and because of that, they have a good prognosis. But type 2 carcinomas are thicker and much more aggressive and often spread to other parts of the body via the lymphatic system and fallopian tubes.

The main symptoms of endometrial carcinoma are abnormal vaginal bleeding, usually without pain. If it’s more advanced, there might be enlargement of the uterus if the tumor or tumors are large enough and this can cause abdominal pain and cramping.

The treatment for each of these types differs. Doctors advise the treatment method according to the patient’s needs.


    About Author

    Dr. Nilesh is a renowned Cancer surgeon/consultant practicing at SSO Hospital, Infinity Media Surge Hospital, and Navkaar Cancer Clinic Mumbai and he is also a visiting consultant at various hospitals in Mumbai, Thane, Dombivali, Kalyan, Navi Mumbai, etc. With over 10+ years of experience, he is highly trained and specialized in performing GI & Gynae cancer surgery procedures from the simplest to the most complicated surgeries.