Dr. Rao on the Histogenesis of Endometrial Cancer

Jianyu Rao, MD, professor and chief of Cytopathology, University of California, Los Angeles, discusses the histogenesis of endometrial cancer.

There is some overlap in the histogenesis of endometrial cancer and ovarian cancer, says Rao. Cervical cancer, however, has a completely different histogenesis that is often related to an HPV infection, says Rao. Endometrial cancer is typically classified by 2 categories—tumors that are associated with high levels of estrogen, and tumors that are associated with low levels of estrogen.

Endometrial cancers can be classified as type 1 endometrial tumors or type 2 serous cancers. That distinction is often made by histology. Testing for mismatch repair deficiency and microsatellite instability is now recommended to help improve classification and treatment. Pembrolizumab (Keytruda) is the first agent to be FDA-approved based only on histology.

Ovarian cancer is identified by estrogen, but the other gynecologic cancers are more related to the genetic changes of the particular gene in question, states Rao.