The role of the microbiome in uterine cancer: insights into tumorigenesis, therapeutic implications, and clinical prospects

Malignant tumors of the uterine cavity are a leading cause of cancer-related mortality in women worldwide. In recent years, the tumor microenvironment, as a novel biological concept, has garnered increasing attention. The microenvironment plays a crucial role in the initiation, progression, and response to treatment of tumors. Although research on the microenvironment of malignant uterine tumors is in its early stages, preliminary findings suggest that alterations in the microbial communities of cervical and endometrial cancers are closely associated with tumorigenesis, immune evasion, metastasis, and treatment resistance. Notably, specific microbial community changes have potential diagnostic and prognostic implications, offering novel insights into the management of these cancers.This review aims to summarize and analyze the current state of research on the microenvironment of malignant uterine tumors, particularly its role in cervical and endometrial cancers. We first overview the epidemiological landscape and microenvironmental features of these tumors, emphasizing how microbial communities influence tumor initiation and progression. This influence occurs through immune modulation, metabolic changes, and alterations within the tumor microenvironment. Second, the potential role of the microenvironment in tumor therapy is explored, particularly its application prospects in chemotherapy, radiotherapy, and immunotherapy. In addition, the application potential of microbial communities in early tumor diagnosis, efficacy monitoring, and prognosis assessment is discussed.