PTEN gene and AKT/mTOR pathway in gynecological cancers and cancer immune escape

Gynecological cancers (GCs) include cervical, uterine, ovarian, vulvar and vaginal cancer. For women in China, 2 of the 10 most common cancers are GCs (8th: cervical cancer, incidence rate: 3.96%; 10th: ovarian cancer, incidence rate: 2.91%). These cancers can lead to enormous psychological and economic burdens. Phosphatase and tensin homolog (PTEN) gene and protein kinase B (AKT) and mammalian target of rapamycin (mTOR) pathway are widely involved in the development of GCs, and an imbalance in regulatory T cells (Treg) in the cancer micro-environment mediated by PTEN and AKT/mTOR pathway was shown to lead to cancer cell immune escape, growth and metastasis. Considering that the pathogenesis of PTEN and AKT/mTOR pathway in GCs and cancer immune escape remains unclear, this review article intends to provide an update in this field. We made a comprehensive search of several databases, including Web of Science, MEDLINE, Ovid and Cochrane Database of Systematic Reviews, was conducted from inception to March 2022. The search strategy included the combinations of the following medical terms: gynecological cancers, cervical cancer, uterine cancer, ovarian cancer, vulvar cancer, vaginal cancer, PTEN gene, AKT/mTOR pathway, and cancer immune escape. We found that currently the mechanism of the PTEN gene and AKT/mTOR pathway in GCs is not fully clear. However, the activation of the AKT/mTOR signaling pathway and imbalance of Treg cell in the micro-environment caused by the function loss of PTEN is involved in the occurrence and development of GCs, and related to the prognosis of patients. This review article presented the latest research progress on the PTEN gene and AKT/mTOR pathway in GCs and cancer cell immune escape.