Fig. 6: Summary of microbiome findings in endometrial cancer compared to benign gynecologic conditions.

Diagram of major findings between endometrial cancer and benign gynecologic conditions observed by vaginal and rectal microbiome. A The rectal microbiome of patients with benign gynecologic conditions such as endometriosis, adenomyosis, and fibroids was revealed to have increased microbial diversity, increased abundance of Peptoniphilus and Prevotella species, increased bacterial networks, and increased valine degradation pathways when compared to patients with endometrial cancer. B The rectal microbiome of patients with the diagnosis of endometrial cancer, either low-grade endometrioid carcinoma or other endometrial cancer subtypes, revealed to have an increase in the abundance of Buttiauxella agretis, less bacterial community networks and a increased potential translocation of microbes from the rectum to vagina. C The vaginal microbiome of patients with benign gynecologic conditions was revealed to have increased Lactobacillus abundance and, specifically, an increased abundance of a particular Limosilactobacillus species; most bacterial networks were negatively correlated. In addition, multiple putative metabolic pathways relating to amino acid metabolism, steroid metabolism, and antibiotic metabolism were enriched when compared to profiles from patients with endometrial cancer. D The vaginal microbiome of patients with EC was revealed to have increased microbial diversity as well as increased Prevotella, Anaerococcus, Peptoniphilus, and Porphyromonas abundance. Most bacterial networks were positively correlated with Prevotella, indicating the highest correlations. In addition, Lactobacillus gasseri, Veillonella sp., and Fannyhessea vaginae were increased in low-grade endometrioid carcinoma compared to other endometrial cancer subtypes.