Molecular studies of endometrial cancer have evolved with the tools available to researchers: the methods for measuring nucleic acids, protein expression, and combinations thereof. Today "molecular genetic analysis" implies a broad range of indirect and direct tests that yield molecular phenotypes or genotypes, immunotypes, or signatures that were not conceived of when the histologic and biologic heterogeneity was first fully acknowledged.We will provide a historical perspective on molecular genetic studies of endometrial cancers focusing on candidate genes and how early foundational research shaped both our understanding of the disease and current research directions. Examples of direct tests (mutation, DNA methylation, and/or protein expression) will be provided along with examples of indirect tests that have been and continue to be central to endometrial cancer molecular biology, such as DNA content or microsatellite instability analysis. We will highlight clinically relevant examples of molecular phenotyping and direct evaluation of candidate genes that integrate direct and indirect testing as part of routine patient care. This is not intended to be an exhaustive review but rather an overview of the progress that has been made and how early work is shaping current molecular, clinical, and biologic studies of endometrial cancer.
Keywords: Biologic relevance; Candidate genes; Clinical significance; Direct tests; Indirect tests; Mutation testing.