Table 1 Major tumor types in gynaecological cancer; genetic mutations and clinical treatments
From: Normal and cancer stem cells of the human female reproductive system
Organ | Common tumor type | Mutations | Treatment |
|---|---|---|---|
Ovary[12] | Ovarian epithelial carcinoma | Loss of heterozygosity of PTEN, P53, K-ras, HNPCC mutations. BRCA1 and 2 inactivating mutation. ABCG2 overexpression, β-Catenin expression | Early stage: Ovarian surgery. Rarely detected at an early stage, because there is no definitive marker, but a combined immunoassay with six markers [leptin, prolactin, osteopontin, insulin-like growth factor II, macrophage inhibitory factor and CA 125]. In addition, the use of kallikrein or protease M and osteopontin are helpful |
Endometrioid, Serous, Clear cells, Transitional, Mucinous and Undifferentiated carcinoma | |||
Endometriosis related tumor | Advanced stage: Platinum based chemotherapy and adjuvant radiotherapy | ||
Adenofibroma, Tubal intraepithelial carcinoma | Novel Agents: Antiangiogenic agents, Tyrosine kinase, SRC and PARP-1 inhibitors. | ||
Germ cell tumor | |||
Uterus[28] | Endometrial carcinoma type I [estrogen] and II [no estrogen related], Adenocarcinoma Sarcoma | PTEN inactivation, K-ras, P53 and P16 mutations, Microsatellite instability, HER-2/neu overexpression | Early stage: Hysterectomy, bilateral salpingoophorectomy and pelvic and periaortic lymph node dissection. Hormonal therapy with Progesterone in the form of an intrauterine device [IUD], cyclic progesterone or Megace |
Myometrium cancer | Advanced and/or recurrent stage: Chemotherapy with doxorubicin, paclitaxel and the platinum agents | ||
Leiomyoma [Commonly benign smooth muscle tumor] | Adjuvant radiation. Hormonal Therapy with medroxyprogesterone | ||
Endometrial cancer in advanced stage with myometrial invasion | Novel Agents: Ephotilones, Mammalian target of Rapamycin [mTOR] Inhibitors, Angiogenesis inhibitors. Myomectomy, and/or advanced stage treatments | ||
Cervix[29] | Cervical carcinoma | K-ras mutations Carbonic anhydrase | Early stage: Laparotomic lymphadenectomy Radical trachelectomy, Hysterectomy. Adjuvant and neoadjuvant platinum-based chemotherapy. Local radiotherapy |
Squamous-cell, adenocarcinoma, adenosquamous and small-cell carcinoma | IX [CAIX], CAXII, hypoxia-inducible factor 1α, and VEGF upregulation | Advanced and/or recurrent stage: Adjuvant Chemotherapy | |
Deregulated expression of E6 and E7 viral oncogenes | Novel Agents:Genome wide expression arrays, MiRNAs, Hyperbaric oxygenation for tumour sensitisation to radiotherapy. |