Pathogenèse du cancer de l'endomètre de type I : de l'hyperplasie au cancer

Endometrial carcinomas are currently classified into two clinical, five histological, and four molecular types. Type I endometrial carcinoma, the most frequent clinical type, includes low grade (grade 1 or 2) endometrioid carcinomas. Atypical hyperplasia is the precursor lesion. These cancers are often revealed at an early stage by abnormal vaginal bleeding in post-menopausal women. The outcome is overall favorable. The risk factors observed in a majority of cases (high body mass index, type II diabetes, substitutive hormonal treatment, tamoxifen) act through unopposed hyperestrogenism. Less than 5 % of endometrial carcinoma cases occur in the context of a Lynch syndrome (germinal mutation of a mismatch repair gene) in younger women with low body mass index. Type II endometrial carcinomas, which comprise serous, clear cell, and undifferentiated carcinomas, are aggressive tumors typically diagnosed in older patients, at an advanced stage, with a poor prognosis.