在确定子宫内膜癌辅助治疗时，决策通常依赖于癌症分期、组织学分级、亚型以及几个组织病理标记物等因素。癌症基因组图谱揭示了子宫内膜癌的分子亚型，可以提供更准确的预后信息并指导个体化治疗计划。为了总结子宫内膜癌主要生物标志物的表达和分子基础，从2000年1月到2023年3月在PubMed上进行了搜索。研究评估子宫内膜癌分子亚型及对辅助治疗策略的影响。三位作者独立进行了广泛的文献搜索，收集和提取数据，并评估了纳入研究的方法学质量。我们总结了子宫内膜癌的分子亚型，包括错配修复缺陷、高度微卫星不稳定性、聚合酶ε（POLE）外切酶结构域突变、TP53基因突变和非特异性分子谱。我们还总结了计划中和正在进行的临床试验以及子宫内膜癌常用的治疗方法。无论辅助治疗如何，POLE突变子宫内膜癌均表现出有利的患者预后。TP53异常子宫内膜癌和高级别浆液性卵巢癌之间的基因组相似性表明可能存在重叠的治疗策略。免疫检查点分子，如程序性细胞死亡1和程序性细胞死亡1配体1，的高水平可以平衡错配修复缺陷子宫内膜癌的免疫表型。激素治疗对于高风险非特异性分子谱子宫内膜癌是一种有吸引力的选择，这些癌症通常是子宫内膜样和激素受体阳性。将临床和病理特征结合起来指导患者的治疗决策，包括并行放化疗、化疗、抑制剂治疗、内分泌治疗和免疫治疗，可能改善子宫内膜癌的管理，并为患者提供更有效的治疗选择。我们对子宫内膜癌的分子亚型进行了特征化，并讨论了它们在个体化治疗中的价值，以避免重大的过度或不足治疗。© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

When determining adjuvant treatment for endometrial cancer, the decision typically relies on factors such as cancer stage, histologic grade, subtype, and a few histopathologic markers. The Cancer Genome Atlas revealed molecular subtyping of endometrial cancer, which can provide more accurate prognostic information and guide personalized treatment plans.To summarize the expression and molecular basis of the main biomarkers of endometrial cancer.PubMed was searched from January 2000 to March 2023.Studies evaluating molecular subtypes of endometrial cancer and implications for adjuvant treatment strategies.Three authors independently performed a comprehensive literature search, collected and extracted data, and assessed the methodological quality of the included studies.We summarized the molecular subtyping of endometrial cancer, including mismatch repair deficient, high microsatellite instability, polymerase epsilon (POLE) exonuclease domain mutated, TP53 gene mutation, and non-specific molecular spectrum. We also summarized planned and ongoing clinical trials and common therapy methods in endometrial cancer. POLE mutated endometrial cancer consistently exhibits favorable patient outcomes, regardless of adjuvant therapy. Genomic similarities between p53 abnormality endometrial cancer and high-grade serous ovarian cancer suggested possible overlapping treatment strategies. High levels of immune checkpoint molecules, such as programmed cell death 1 and programmed cell death 1 ligand 1 can counterbalance mismatch repair deficient endometrial cancer immune phenotype. Hormonal treatment is an appealing option for high-risk non-specific molecular spectrum endometrial cancers, which are typically endometrioid and hormone receptor positive. Combining clinical and pathologic characteristics to guide treatment decisions for patients, including concurrent radiochemotherapy, chemotherapy, inhibitor therapy, endocrine therapy, and immunotherapy, might improve the management of endometrial cancer and provide more effective treatment options for patients.We have characterized the molecular subtypes of endometrial cancer and discuss their value in terms of a patient-tailored therapy in order to prevent significant under- or overtreatment.© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.