Advances in management algorithm in clear cell carcinoma of cervix  

作　　者：Xuanwei Peng Dongdong Xu Huaiwu Lu Zhongqiu Lin 

机构地区：[1]Department of Gynecological Oncology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou,Guangdong,China

出　　处：《Holistic Integrative Oncology》2024年第1期94-102,共9页整合肿瘤学(英文)

基　　金：funded by Guangdong Basic and Applied Basic Research Foundation(2024A1515013255);Guangdong Basic and Applied Basic Research Foundation(2022A1515012432);Beijing Xisike Clinical Oncology Research Foundation(Y-Young2022-0145);Sun Yat-sen Clinical Research Cultivating Program(SYS-C-202001);Beijing Kanghua Foundation for the Development of Traditional Chinese and Western Medicine(KH-2021-LLZX-049).

摘　　要：This comprehensive review critically assesses tailored management strategies for clear cell carcinoma of the cervix(cCCC),an uncommon subtype of cervical adenocarcinomas.A globally prevalent condition,cCCC affects individuals across diverse racial and ethnic groups.Notably,a significant risk factor associated with cCCC is intrauterine exposure to diethylstilbestrol(DES),a synthetic estrogen historically prescribed to address pregnancy-related complications.Intriguingly,almost two-thirds of cCCC cases are linked to DES exposure.Studies reveal a notable surge in cCCC incidence among offspring born to women administered DES during pregnancy,with DES-exposed daughters facing a staggering 40-fold higher risk compared to their non-DES-exposed counterparts.Turning to the molecular intricacies of cCCC,gene expressions within this subtype exhibit intriguing parallels with clear cell carcinomas found in the ovary,endometrium,and kidney.Additionally,there is a noteworthy explo-ration of cervical endometriosis as a potential precursor to cCCC.Molecular pathways,specifically the PI3K/AKT and Hippo pathways,have garnered attention in understanding the pathogenesis of cCCC.From a prognostic standpoint,disparities emerge,with non-DES-related cCCC cases generally exhibiting a grimmer prognosis than their DES-related counterparts.This discrepancy becomes starkly evident in advanced disease stages.Early detection proves crucial,as patients diagnosed in initial stages experience commendable outcomes,markedly superior to those facing advanced or recurrent manifestations.Fertility-preserving treatments are highly endorsed for early-stage patients.Simultaneously,the therapeutic landscape is evolving,with PD-L1 inhibitors gaining prominence as a burgeoning treatment modality,particularly beneficial for those navigating advanced stages of cCCC.Furthermore,the combina-tion of PARP inhibitors(PARPi)and immune checkpoint inhibitors(ICI)emerges as a promising and innovative treat-ment alternative for cCCC.In summary,this review encompasses a

关 键 词：Cervical cancer Clear cell carcinoma HPV-independent adenocarcinoma Treatment regimens 

分 类 号：R73[医药卫生—肿瘤]