时间标签：数据日期 2026-10-31 · 生成时间 2026-11-01 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/10/28–2026/10/31 ｜ 情报发生日期 2026-10-31
研究问题
However, both chemotherapy and radiotherapy are frequently limited by primary or acquired resistance, underscoring the urgent need for novel strategies to enhance therapeutic efficacy.；Crucially, the long-standing premise that the endometrium constitutes a sterile environment was definitively challenged by 16S rRNA gene sequencing studies conducted in the mid-2010s, which identified bacterial DNA signatures in intrauterine specimens obtained from women undergoing hysterectomy., Despite legitimate concerns about contamination — inherent to any sequencing study of low-biomass tissues, — the compositional distinctiveness of endometrial microbial communities from those of surrounding anatomical niches has been confirmed across multiple independent cohorts.；However, existing reviews have largely focused on individual anatomical sites, and a cross-compartment synthesis that integrates the gut,
方法
During screening, we gave priority to prospective cohort research, clinical trials and functional mechanistic experiments that adopted 16S rRNA gene sequencing, shotgun metagenomics or metabolomic detection to characterize microbial profiles and metabolites.；Studies satisfying all the following items were incorporated: (i) human clinical cohorts, cellular or animal experimental researches related to vaginal, endometrial or gut microbiota in EC patients; (ii) original studies adopting sequencing or metabolomic platforms to analyze microbial composition and function; (iii) complete full-text resources written in English.；At these abundances, even a small contribution from reagent-associated kitome organisms, vaginal microbiota introduced during transcervical instrument passage, or skin commensals from specimen handling can dominate a sequencing library and generate findings that are artefa
核心结论
The GLOBOCAN 2022 estimates place the global burden at approximately 420,000 incident cases and 97,000 deaths annually, with the United States alone accounting for some 67,880 new diagnoses in 2024., While the majority of patients present with localized disease and achieve long-term remission following surgical resection, those with advanced-stage, recurrent, or high-grade disease face a substantially poorer outlook, with five-year survival falling below 20% for stage IV disease.；The classical risk framework for endometrial cancer (EC) revolves around sustained, unopposed estrogen exposure—deriving endogenously from obesity, polyendocrine metabolic ovarian syndrome (PMOS), and anovulation, or exogenously from tamoxifen and postmenopausal estrogen therapy—which operates concomitantly with metabolic disturbances including insulin resistance, hyperinsulinemia, and dyslipidemia. ‖ 结论：None of these observations is trivial, and collectively they represent a reconceptualization of EC as a disease in which the microbial environment of the patient is as relevant to risk and treatment as the hormonal and molecular environment of the tumor.
局限
At the same time, intellectual honesty demands acknowledging the current evidence base’s limitations.；Most studies are small, cross-sectional, and methodologically heterogeneous.；Confounding by obesity, menopausal status, antibiotic exposure, and metabolic comorbidities is inadequately controlled in most analyses.
对本项目的价值
★☆☆☆☆ 方法学进展决定我们能否在有限样本下检出真实效应，属基础设施级收益。设计 multi-omics、prospective cohort。
全文来源
PMC JATS 全文（正文 76,476 字符，已过标题/DOI 逐字归属校验）
原文题录
- 英文标题：Multi-Niche Microbiome Alterations in Endometrial Cancer: Drivers, Biomarkers and Translational Targets.
- 期刊与标识：Int J Womens Health · PMID 42960262 · DOI 10.2147/ijwh.s643435
A 级证据分级：A 级（同行评议人体研究）
本文属人体研究证据，但需注意：观察性或小样本干预的结论不等于已证实临床获益；效应量与长期安全性仍需更大规模、更长随访的试验验证。
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