Subtype-specific mechanisms of lipid metabolism in gynecological malignancies and novel targeted intervention strategies (Review).

Dysregulated lipid metabolism, a core metabolic hallmark of gynecological malignancies, plays a pivotal role in the initiation, progression, therapeutic resistance and prognosis of ovarian cancer, endometrial cancer and cervical cancer. Distinct pathological and molecular subtypes of ovarian, endometrial and cervical cancer exhibit highly heterogeneous and subtype-specific lipid metabolic reprogramming patterns, with core phenotypes ranging from enhanced fatty acid oxidation in high-grade serous ovarian cancer to sterol regulatory element-binding protein 1-driven lipogenesis in obesity-associated endometrial cancer and human papillomavirus-mediated cholesterol dysregulation in cervical cancer. These subtype-specific metabolic alterations drive tumor progression by mediating key malignant phenotypes, with mitochondrial lipid metabolism playing a central regulatory role in therapeutic resistance. The present review systematically summarizes the subtype-specific features of lipid metabolic dysregulation in gynecological malignancies, elaborates on the underlying molecular regulatory mechanisms, and summarizes the latest progress in lipid metabolism-targeted intervention strategies and their clinical translation. Finally, the current challenges and future directions in this field are discussed, aiming to provide new insights and theoretical support for the precision treatment of gynecological malignancies.