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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We measured the levels of thrombin-antithrombin III complex (TAT) and fibrinogen and fibrin degradation products (FDP) in 115 patients with gynecological malignancies (ovarian cancer 34, cervical cancer 34, endometrial cancer 47). These concentrations were compared to those in control groups of 15 patients with benign ovarian tumor. The levels of TAT and FDP were significantly higher in patients with ovarian cancer compared to the control group (both: p less than 0.01), and these levels were higher than in other gynecological malignancies. In stages I and II the positive rate of TAT and FDP (TAT greater than 3.0 ng/ml, FDP greater than 1.40 microgram/ml) in patients with ovarian cancer was higher than that in other gynecological malignancies. TAT and FDP were increased following cancer dissemination, and the recovery of coagulative and fibrinolytic factors (TAT, FDP) with effective treatment was correlated to the prognosis for patients with ovarian cancer. These levels had no correlation with the levels of CA125 and histological classification in patients with ovarian cancer. Accordingly, these results suggest that these changes in TAT and FDP may be useful, together with other clinical signs, in detecting early stage ovarian cancer.
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PMID:[The clinical significance of thrombin-antithrombin III complex (TAT) and fibrinogen and fibrin degradation products (FDP) levels in ovarian cancer]. 154 65

Haematological and immunological studies were performed on 36 patients with carcinoma of the endometrium prior to treatment. Haematological and coagulation studies, excluding fibrinogen, showed only minimal abnormality. However, tests for acute phase reactant proteins were abnormal in the majority of patients. There was a reduction in T cells in 31% of patients and a reduction in stimulation with PHA and PWM in 84 and 42% of patients, respectively. Autoantibodies to normal tissue antigens were present in half the patients and immune complexes were increased in 45% of patients. Carcinoembryonic antigen and B(2)-microglobulin were increased in 27 and 47% of patients respectively. Although specific tests for endometrial cancer are not yet available, a profile of tests might be of value in the diagnosis and follow-up of patients with the condition.
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PMID:Cancer of the endometrium---a multiparametric study. 615 8

The study of blood coagulability in the coarse of combination (77 cases) and surgical (17 cases) treatment of endometrial carcinoma showed that surgery is followed by an increased plasma tolerance to heparin, a raised fibrinogen level and a lowered fibrinolytic activity. Therefore, surgery promotes blood coagulability, thus increasing the risk of thromboembolic complications in endometrial cancer patients in postoperative period. Preoperative hormonotherapy seems to contribute to this risk since it increases blood coagulability and delays its normalization in postoperative period.
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PMID:[Effect of surgical and combined treatments on the state of the blood coagulating system in cancer of the corpus uteri]. 732 99

I read with interest Dixit's review article concerning the liver and (OC) oral contraceptives (Can J Surg 23:222, 1980), and I think attention should be drawn to 1 or 2 possibly erroneous generalizations and inaccuracies. The author refers to both OCs and menopausal replacement medications and lists a group of general long-term effects which he describes as being common. In fact their rate of occurrence is quite low. Endometrial carcinoma has been reported to be associated with estrone sulfate therapy but not with combined estrogen-progesterone OCs; however, Silverberg and Makowski reported several cases of endometrial carcinoma associated with the use of the sequential OC Oracon, a product containing dimethisterone. Sequential agents are no longer used and indeed it is possible that combination agents may have a protective effect vis-a-vis endometrial carcinoma. Further, it is confusing to state that estrogen may be causally associated with carcinoma of the cervix; this was not the intent of the quoted article. All currently used OCs contain 19-nortestosterones but substituted progesterones have been used in the past. The progestins that have been used are numerous but should include norithisterone and d-norgestrel, the latter being 1 of the most widely used synthetic progestins. Estrogens are currently used in doses as low as 0.02 mg, and 0.035 mg doses are usual. The plasma coagulation proteins are indeed elevated (page 225) but in addition to those mentioned, factors 5 and 8 should have been included. In the section on changes in pregnancy (page 226), "increased serum fibrinogen" is mentioned. Surely the author means "plasma fibrinogen," as serum is totally devoid of that particular protein. This very comprehensive review emphasizes the effect of these potent agents on hepatic function in general. In view of the elevation of coagulation protein levels produced by OCs (and the consequent tendency to hypercoagulability), it might be interesting to ask general surgeons how frequently they discontinue OC medication before they perform elective surgery.
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PMID:Effects of oral contraceptives on the liver. 744 54

The concentrations of kininogens, prokallikrein, fibrinogen, plasma protein, proteinase inhibitor antigens, and the kininase, fibrinolytic and antipapain activities in plasma of 29 patients with various tumours (lung cancers, lymphomas, and others) during chemotherapy were measured. The same studies were performed on blood plasma of female patients operated on because of cervical or endometrial carcinoma (37 subjects) and submitted to subsequent local radiotherapy (before and after radiotherapy). A weak activation of kallikrein-kinin system and significant decrease in kininase and fibrinolytic activities were found in those patients. It may suggest a role of bradykinin in prevention of therapy-induced hypercoagulability in patients with neoplastic diseases.
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PMID:Kallikrein-kinin system in patients with neoplastic diseases. 902 May 55

Estrogen replacement therapy (ERT) after menopause prevents the development of osteoporosis and reduces the risk of fracture. Other potential benefits are cardioprotection--probably related to the effects of estrogen on lipid profile and fibrinogen levels--and a delay in the onset of Alzheimer's disease and perhaps amelioration of the disease. ERT, however, increases the risk of endometriosis and endometrial cancer unless given with a progestin for at least 10 days per menstrual cycle. It also results in a small but real increase in breast cancer. Alendronate, a bisphosphonate, is the first serious competitor of conjugated equine estrogen for the treatment of osteoporosis. Nearing FDA approval are so-called designer estrogens (e.g., raloxifene), which may selectively prevent osteoporosis with little or no effects on endometrial and breast tissue.
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PMID:Prevention and treatment of osteoporosis: does the future belong to hormone replacement therapy? 950 3

We report on a 64-year-old patient with a recurrent endometrial carcinoma which was associated with disseminated intravascular coagulation (DIC) and excessive hyperfibrinolysis. The patient presented with severe bleeding due to hypofibrinogenemia. Fibrin degradation products were excessively elevated and there were also increased levels of activation markers of coagulation. Free plasmin was demonstrated in the circulation and alpha 2-antiplasmin was almost completely depleted. No increase in t-PA or u-PA level was demonstrated. Antifibrinolytic treatment led to a decrease of fibrin degradation products, but to an increase of activation markers of coagulation and was not associated with an increase of fibrinogen. Combination chemotherapy led to a rapid decrease of activation markers of coagulation and a sustained increase of fibrinogen. The beneficial effects on DIC/hyperfibrinolysis occurred despite the absence of any measurable effect of chemotherapy on the tumour. The patient finally died due to progression of the tumour, but without recurrence of the DIC/hyperfibrinolysis.
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PMID:[Disseminated intravascular coagulation (DIG) with massive hyperfibrinolysis in metastatic uterine cancer. Observations on the effects on the coagulopathy of various treatments (a case report)]. 953 80

Coronary heart disease is the leading cause of death in women in the United States and increases dramatically in postmenopausal women. The following review summarizes the known benefits and risks of hormone replacement therapy and gives recommendations for use of hormone replacement in women. Estrogen may play a role in preventing the development of atherosclerosis in women by raising levels of HDL cholesterol, lowering levels of LDL cholesterol and lipoprotein (a), lowering levels of fibrinogen and plasminogen activator inhibitor-1, dilating coronary arteries, preventing the oxidation of LDL cholesterol, decreasing the proliferation and migration of smooth muscle cells, and decreasing the production of inflammatory cell activators. These antiatherogenic effects of estrogen may translate into clinical benefits. A meta-analysis of 31 studies yielded a 44% reduction in the risk of coronary heart disease in women taking estrogen alone. Unopposed estrogen is associated with an increased risk of endometrial cancer; therefore, progestin is added to estrogen in women with an intact uterus. Less is known about the effect of the combination of estrogen and a progestin on the risk of coronary heart disease. Estrogen is also beneficial in the prevention of osteoporosis; however, long-term use of estrogen alone and estrogen in combination with progestin may increase the risk for breast cancer. Mathematical modeling predicted that women with no risk for cardiovascular disease, cancer, or osteoporosis may gain 0.9 years of life with the use of estrogen alone; women with risk factors for cardiovascular disease can expect to gain 1.5 years of life; and women with coronary heart disease at the age of 50 can expect to gain 2.1 years of life. The current American College of Physicians recommendations for hormone replacement are as follows: (1) All women should be considered; (2) women with a hysterectomy should receive estrogen alone; (3) women at risk for, or with, coronary heart disease are most likely to benefit from estrogen; with an intact uterus, progestin must be added; (4) risks of estrogen may outweigh benefits in women at increased risk for breast cancer. Definitive guidelines for the treatment of women must await the results of randomized clinical trials in the ongoing Women's Health Initiative. These will not be available for several years, and until then any recommendations for women will have to be judged from estimates of risk rather than of benefit from reduction of risk. The decision whether to initiate estrogen replacement in postmenopausal women is one that still needs to be made on an individual patient basis.
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PMID:Who Should Receive Hormone Replacement Therapy? 1060 35

In cancer patients impaired blood rheology in the presence of coagulation activation may reduce blood flow in the vascular microcirculation that favors thrombosis but may also support tumor progression and metastasis. In 451 patients with gynecological cancer and 177 patients with corresponding benign tumor disease preoperatively, during adjuvant treatment, when venous thrombosis (VT) or cancer progression was diagnosed hematocrit (micro centrifuge), hemoglobin, leukocytes, platelets (Coulter Counter); red blood cell (RBC) aggregation (aggr.) during stasis and low shear conditions (MA 1, Myrenne), plasma viscosity (viscosimeter KSPV 1 Fresenius), and fibrinogen (Multifibren Behring Dade) were investigated. One hundred and twelve healthy women served as controls. Preoperatively, mean plasma viscosity (pv) was significantly higher in cancer patients as compared to patients with the corresponding benign tumor disease (breast cancer: n = 261; pv = 1.32 vs. 1.27 mPa s; p = 0.023; ovarian cancer: n = 68; pv = 1.39 vs. 1.31 mPa s; p < 0.001; endometrial cancer: n = 70; pv = 1.37 vs. 1.25 mPa s; p < 0.001; cervical cancer: n = 52; pv = 1.33 vs. 1.26 mPa s; p = 0.004). RBC aggr. was significantly lower in controls compared to the preoperative values in cancer patients but mean (median) values (RBC aggr. stasis < 21) were within the normal range in all. Preoperatively, plasma viscosity was a significant risk factor for the overall survival in ovarian cancer patients (p = 0.02) and for subsequent thrombosis in ovarian (p = 0.02) and cervical cancer patients (p = 0.007). In the multivariate analysis plasma viscosity was an independent prognostic marker for the overall survival of breast cancer patients (r = 99.45; 95% CI: 7.32-980.2; p < 0.0001). An optimized preoperative cut-off value above 1.40 mPa s (Log-Rank-test) was significantly associated with poor outcome in the Kaplan-Mayer survival estimates, even in node-negative breast cancer. In gynecologic cancer patients the combination of an increase in RBC aggregation and plasma viscosity impairs blood-flow-properties and may induce hypoxia in the microcirculation that favors thrombosis, settlement of tumor-cells and thus metastasis. Improvement of blood fluidity and thus oxygen transfer in the tumor-vascular-microcirculation may increase susceptibility of systemic anti-cancer therapy.
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PMID:Association between blood rheology, thrombosis and cancer survival in patients with gynecologic malignancy. 1083 Oct 62

Raloxifene is a selective estrogen receptor modulator, a compound that has estrogen agonist activity at some sites and antagonist activity at others. In investigations in animals and in rigorously conducted trials in humans, raloxifene treatment is associated with a 30%-40% reduction in risk of one or more spine fractures using the 60 mg dose. This reduction in risk is found in women with or without baseline fractures, in women with bone mineral density (BMD) in the lower, middle, or upper third of the low range (all had BMD reduced by more than 2.5 SD) and in women aged less than 65 years, between 65-70 years, and greater than 70 years. A reduction in ankle fractures, but not hip or wrist fractures, was found. Raloxifene treatment also is associated with a 60%-70% reduction in risk for breast cancer and is associated with reduced total and LDL cholesterol, lower fibrinogen, and no rise in triglyceride. Reduced aortic wall cholesterol content is reported in animal studies. These are surrogate endpoints of cardioprotection. There is no evidence that raloxifene reduces the incidence of myocardial or cerebrovascular events. Raloxifene does not induce breast tenderness, endometrial hyperplasia, menstrual bleeding, or endometrial cancer, but may be associated with an increased risk of thromboembolic disease (1/1000 cases per year), leg cramps in 2%-4% of cases and hot flushes in 4%-6% of cases, usually in first 6 months.
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PMID:Raloxifene. 1128 Nov 62


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