Endometrial cancer (EC) rarely develops in young women. Most cases are associated with known risk factors: BMI > 30, history of Polycystic Ovary Syndrome (PCOs), and race differentiation. The molecular EC classification based on The Cancer Genome Atlas Research Network divides these heterogeneous cancers into four types: Polymerase Epsilon Mutation (POLE), Microsatellite Instability (MSI), Copy Number Low (CNL), and Copy Number High (CNH). This division was introduced to allow for early assessment of neoplastic changes and clinical management, including targeted therapies. The basic technique for imaging endometrium changes is transvaginal sonography. Hysteroscopy is the standard for obtaining endometrial material for histological evaluation. The MRI result permits assessment of the extent of EC cancer infiltration. In young women who want to preserve fertility, apart from surgery, conservative management is often implemented after strict selection based on clinical and pathological data. This pharmacological treatment involves the administration of progestogens MPA (medroxyprogesterone acetate) and MA (megestrol acetate). The use of metformin may increase the effectiveness of such treatment. An alternative option is to apply progestogens locally—via the levonorgestrel-releasing intrauterine device. In addition to pharmacological treatment, hysteroscopic resection may be used—part of the uterine muscle adjacent to the pathologically changed endometrium may also undergo resection. An alternative is the administration of estrogen receptor modulators (e.g., SERMs) or aromatase inhibitors, or GnRH agonists.

The presence of metastatic endometrial cancer (EC) is a key problem in treatment failure associated with reduced overall survival rates. The most common metastatic location is the pelvic lymph nodes, and the least common is the brain. The presence of metastasis depends on many factors, including the molecular profile of cancer (according to the TCGA—Genome Atlas), the activity of certain hormones (estrogen, prolactin), and pro-inflammatory adipocytokines. Additionally, an altered expression of microRNAs affecting the regulation of numerous genes is also related to the spread of cancer. This paper also discusses the value of imaging methods in detecting metastases; the primary role is attributed to the standard transvaginal USG with the tumor-free distance (uTFD) option. The influence of diagnostic and therapeutic methods on EC spread is also described. Hysteroscopy, according to the analysis discussed above, may increase the risk of metastases through a fluid medium, mainly performed in advanced stages of EC. According to another analysis, laparoscopic hysterectomy performed with particular attention to avoiding risky procedures (trocar flushing, tissue traumatization, preserving a margin of normal tissue) was not found to increase the risk of EC dissemination.

Endometrial cancer is one of the most common malignancies in women in Western Europe. Its incidence is constantly increasing. The prognosis is poor, especially in the case of recurrent and advanced stages of the disease. Therefore, new therapeutic options are constantly sought to improve the prognosis for women with this type of cancer. One of the targets of modern diagnostic and therapeutic methods for endometrial cancer may be cancer stem cells. These are cells with the properties of a bone marrow stem cell that has acquired an oncogenic mutation, gained the ability to self-renew, differentiate and generate the entire cancer cell population. Many studies are focused on searching for a marker (or markers) of cancer stem cells that would allow their precise identification and development of individualized targeted therapy. The CD133 glycoprotein, also known as prominin-1, appears to be a promising surface marker for identifying cancer stem cells, including endometrial cancer. The aim of the paper is to present studies on the concept of cancer stem cells in endometrial cancer, especially those related to CD133 cells, which display stem-like properties.

Evaluation of the effectiveness of histopathological verification of the endometrium by means of an outpatient aspiration biopsy

Systemic inflammatory response in gynecologic cancers