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

Sixteen cases of small-cell carcinoma of the endometrium were encountered in patients who ranged in age from 30 to 78 (mean, 57.4) years. Of the 12 patients whose presenting features are known, eight had abnormal vaginal bleeding, three had pain related to metastatic tumor, and one patient had both symptoms. On pelvic examination, adnexal masses were palpable in three patients, and vaginal involvement was evident in two; one patient had a large palpable periumbilical mass. Thirteen patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Extrauterine spread was documented intraoperatively in eight cases, including widespread intraabdominal and ovarian metastases in four cases, vaginal involvement in the two cases noted previously, paraaortic lymph node involvement in one case, and tubal involvement in one case. Three tumors were International Federation of Gynecology and Obstetrics (FIGO) stage I, four were stage II, two were stage III, and six were stage IV; in one case, there was insufficient information to allow staging. On gross examination, the tumors were usually described as bulky, ill-defined, and invasive of the myometrium; four were polypoid. Microscopic examination revealed sheets, cords, and nests of small or intermediate-sized cells with scanty cytoplasm, hyperchromatic nuclei, and a high mitotic rate. Single-cell and zonal necrosis and vascular invasion were typically present. Synchronous grade 1 or grade 2 endometrial endometrioid adenocarcinoma was present in eight cases, and complex atypical endometrial hyperplasia, in two others. In three cases, the adenocarcinoma merged almost imperceptibly with the small-cell component. None of the tumors contained argyrophil or argentaffin cells, although nine of 11 tumors were immunoreactive for neuron-specific enolase (one of these was also Leu-7 positive), and another was chromogranin positive. Of the 11 cases with follow-up information, seven patients died of disease (at least four with distant metastases) with a median survival of 12 months, and another patient was alive with distant metastases at 18 months. The remaining patients were clinically free of disease at postoperative intervals of < or = 1 year (two cases) and 4.5 years (one case). This study confirms that small-cell carcinomas of the endometrium are a histologically distinctive subtype of endometrial carcinoma, which, like their counterparts in the uterine cervix, are aggressive tumors with a propensity for systemic spread and a poor prognosis.
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PMID:Small-cell carcinoma of the endometrium. A clinicopathological study of sixteen cases. 751 54

In this country, hormone replacement therapy (HRT) has been used more extensively in the last few years. The benefits of HRT in cardiovascular diseases, osteoporosis and quality of life has been well established. Breast cancer and endometrial carcinoma have been considered as contraindications for HRT. A reappraisal of this practice is necessary since we have no evidence that HRT may adversely influence the outcome of these tumours. Nevertheless, theoretically this is possible because the effect of estrogens on occult metastases in unknown. The relationship between replacement therapy and the uterine sarcomas is of particular concern. HRT is safe in patients successfully treated for carcinoma of the vulva, vagina, uterine cervix and in those with ovarian cancer. Experience suggests that the estrogen can also be used safely in women treated previously for endometrial cancer. As far as breast cancer is concerned it appears logical to discuss the risk-benefit considerations with our patients before embarking on using HRT. Consultation with a gynaecological oncologist prior to HRT in patients with endometrial and/or breast cancer is strongly recommended.
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PMID:[Should estrogen replacement therapy be applied in women with genital and breast cancer?]. 787 21

The PAPNET system is an automated interactive instrument for analysis of conventional (Papanicolaou) cervical smears. The instrument, described in this paper, introduces several important innovations to cytology automation. The cell selection system is composed of two stages: an algorithmic classifier, followed by a trained neural network allowing for great flexibility and precision in recognition of abnormal cell images. Contrary to other attempts at cytology automation, this machine does not attempt to diagnose cell abnormalities. Instead, it is interactive, leaving the assessment of the cells displayed on a high-resolution video screen to trained human observers. The slides judged to contain abnormal cells or to be inadequate are referred for a second microscopic review. Two versions of the instrument (Alpha and Beta) were evaluated in several modes. Initial testing was performed on archival smears with known, histologically confirmed neoplastic lesions of the uterine cervix. These lesions comprised the entire spectrum of abnormalities, from low-grade lesions to invasive cancers of several types. The Alpha machine displayed recognizable abnormal cells in 97% of the 201 cases, and the Beta machine displayed such cells in 97.2% of 176 cases. The Beta instrument was subsequently tested on 500 sequential archival cervical smears that had been previously subjected to a rigorous quality control. One hundred forty smears (28%), which either displayed atypical cells or were considered "inadequate," were referred for further rescreening. Fifteen of 16 previously diagnosed neoplastic smears were appropriately identified with the help of the machine. The one missed case contained a single cluster of vacuolated cancer cells from an endometrial carcinoma. As a result of PAPNET-triggered review, three new cases of low-grade squamous intraepithelial lesions view, three new cases of low-grade squamous intraepithelial lesions (SIL) came to light in previously negative smears; three additional cases, previously classified as atypical, were also reclassified as SIL, for a net gain of six neoplastic abnormalities. In two additional atypical cases, colposcopic follow-up was recommended, even though the diagnosis was not modified. Two cases of cervical intraepithelial neoplasia, represented by tiny single clusters of abnormal cells missed on original screening, quality control, and on machine rescreening, came to light on second review of the residual 360 cases. The initial experience with the PAPNET system suggests that the instrument may be valuable in quality control and may assist in significantly reducing false-negative cervical smears in an efficient and timely manner. Further testing of the instrument on a much larger number of cervical smears is in progress.
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PMID:Evaluation of the PAPNET cytologic screening system for quality control of cervical smears. 811 79

The relationship between Quetelet's index and subsequent risk for cancer of endocrine target organs was studied in a cohort of 47,003 women, examined for height and weight in the years 1963-65, and followed up in the Swedish Cancer Register until 1987. High Quetelet's index was associated with a decreased risk for breast cancer among women less than 55 years of age at risk, while a high Quetelet's index predicted an increased risk among older women. Among women > or = 55 years of age, the excess relative risk for breast cancer associated with high Quetelet's index declined significantly during the follow-up period. Cancer of the ovaries and the uterine cervix were not significantly related to Quetelet's index in any age group. In women > or = 55 years of age, the relative risk for cancer of the uterine corpus associated to Quetelet's index was higher than that for breast cancer, and this association persisted during the entire follow-up period of more than 20 years. In spite of the fact that endometrial cancer is less common than breast cancer, because of the stronger relation between overweight and endometrial cancer, more endometrial cancer would be attributable to obesity than breast cancer.
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PMID:Relationship between Quetelet's index and cancer of breast and female genital tract in 47,000 women followed for 25 years. 829 35

The glutathione S-transferase (GST) pi has been studied in association with the mechanisms of multidrug resistance and as a marker for malignant tumors. In this study, specimens from 92 cases of cervical neoplasms and 10 cases of normal squamous epithelium adhering to myoma were stained immunohistochemically with a rabbit polyclonal antibody to GST-pi. In 6 cases of normal squamous epithelium, the intermediate layer was positively stained with the GST-pi antibody. In all 20 cases of dysplasia, the cells with koilocytotic atypia were stained positively. In all 10 cases of carcinoma in situ and all 16 cases of stage Ia squamous cell carcinoma, various intensities of GST-pi staining were demonstrated. Forty-six specimens of stage Ib or more squamous cell carcinoma were positive for GST-pi binding except only one case. In general, squamous cell carcinoma of the uterine cervix is resistant to chemotherapeutic agents. GST-pi is most frequently stained in cervical squamous cell carcinoma as compared with ovarian or endometrial carcinoma. In conclusion, these results suggest that GST-pi may be a marker for cervical squamous cell carcinoma.
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PMID:[An immunohistological study on expression of glutathione S-transferase pi (form) in dysplastic and neoplastic human uterine cervix lesions]. 875 94

The dose to the anterior rectal wall is a known limiting factor for the delivery of radical doses of radiation to the uterine cervix with brachytherapy. We developed a modification to the Fletcher-Suit afterloading applicator, consisting of two small inflatable balloons attached to the posterior end of each colpostat. The balloons are connected to catheters that emerge from the vagina attached to the colpostat's handles. The balloons were affixed to the colpostats with a plastic adaptor and are inserted empty. After an anterior radiograph is taken, the balloons are filled with radiological contrast material and a lateral orthogonal film is made. This lateral film taken with the balloons filled with contrast typically shows a significant posterior displacement of the anterior rectal wall away from the vaginal sources. The International Commission on Radiation Units (ICRU) rectal point is then determined 5 mm beyond the posterior boundary of the opacified balloons. We have performed 90 applications using this device, including brachytherapy applications for cervical cancer, as well as vaginal applications for endometrial carcinoma following TAH-BSO. On average, the ICRU rectal point was displaced 14 mm away from the colpostats, thus reducing the dose rate by 60% and resulting in an average dose sparing of about 1000 cGy to the anterior rectal wall.
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PMID:Reduction of the rectal dose in gynecological brachytherapy: modification to the Fletcher-Suit applicator. 889 77

To clarify the pattern of cytokeratin and vimentin expression in mixed adenocarcinoma and squamous cell carcinoma of the uterine cervix, twenty-three cases of formalin-fixed paraffin-embedded specimen were examined immunohistochemically using a panel of four different monoclonal anti-cytokeratin antibodies and anti-vimentin antibody. Fifty-seven cases of benign or malignant tissue were selected for controls. The results were summarized as follows. 1) In four cases of co-existing adenocarcinoma and squamous cell carcinoma, their immunostaining patterns were compatible with original histological cell type. 2) In four cases of adenoacanthoma, high molecular weight-cytokeratin (HCK) was positive in each acanthomatous component and only a small part of one adenocarcinomatous component. 3) In twelve cases of cervical adenosquamous carcinoma, HCK were positive in four adenocarcinomatous components. Out of eight cases with non-stained adenocarcinomatous components, six cases showed negativity for HCK even in the squamous cell carcinomatous component. 4) Though vimentin was negative in all cases of mixed type of cervical carcinoma, some cases of mixed type endometrial carcinoma were stained positively for vimentin. It was indicated from our study that adenosquamous carcinoma of the cervix could originate either in reserve cells or columunar epithelium and that vimentin positive cases could originate in the endometorial gland.
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PMID:[Immunohistochemical study of cytokeratin and vimentin expression in mixed type of adenocarcinoma and squamous cell carcinoma]. 892 18

A group of 70 female patients with adenocarcinoma of the uterine cervix treated between 1976 and 1995 at the 2nd Department of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University and General Hospital, Prague, was evaluated retrospectively. They represented 8.6% of all patients with cervical cancer in this period. The mean age was 57.9 years and increased according to the clinical stage of disease. Some features of the patient history were similar to those of endometrial cancer. The most frequent symptom was abnormal bleeding (70%). The limited importance of praebioptic diagnostic methods was confirmed. Better treatment results were achieved by the surgical or combined treatment in comparison with radiotherapy alone. From histological types the worst results had a clear cell carcinoma. The recurrence rate was 13.4%. The overall 5-year survival was 43.1% (68% for the stage 1, 40% for the stage 2 and 22% for the stages 3 + 4). The average survival time was 96.1 months.
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PMID:[Adenocarcinoma of the uterine cervix--retrospective clinico-pathologic study]. 892 61

This review focuses on etiologic factors and hormonal correlates of the three major gynecologic cancers-uterine cervix, uterine corpus and ovary- and breast cancer. The incidence rate of the three gynecologic cancers combined is only 40 percent of the breast cancer rate (43.6 vs 109.5 per 100,000), whereas the combined mortality rate is half that for breast cancer (14.3 vs 27.3 per 100,000). Cervical cancer is distinctive in that it's hormonal correlates are few; it exhibits the epidemiologic characteristics of a sexually transmitted disease. Integration of Human Papilloma Virus DNA types 16, 18 (or other) within the cellular genome has been identified in more than 80% of high grade cervical intraepithelial neoplasias and invasive carcinomas. Epithelial ovarian cancers occur most commonly in nulliparous, infertile women and familial carriers of BRCA1. Oral contraceptive (OC) use reduces ovarian cancer risk by at least one-half, a benefit which increases with increasing duration of use and persists for at least 15 years after discontinuation. Pregnancy and OCs suppress gonadotropin secretion, whereas fertility drugs enhance follicle-stimulating hormone production. These indicators of alterations in the hypothalmic-pituitary-ovarian axis provide some support for both the excess gonadotropin and the incessant ovulation theories of ovarian carcinogenesis. Endometrial carcinoma is the prototype hormonally-determined disease. Increased estrogen from either endogenous or exogenous sources increases risk. Lowering the estrogen load or adding progestin reduces risk. This explains the marked protection achieved by combined estrogen/progestin OC's and the dramatic increased risk uncurred by long-term estrogen replacement therapy (ERT). Breast tissue, also a target for sex steroid hormones, displays a more complex risk profile. Current ERT use increases breast cancer risk by about 30%; adding a progestin to the estrogen does not improve the situation (40% increased risk). Furthermore, OCs do not reduce breast cancer risk, but may increase it for current OC users under age 45. The magnitude of these hormonal effects is much smaller than that exhibited with endometrial cancer.
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PMID:Epidemiologic analysis of breast and gynecologic cancers. 910 87

CD44 is known as an adhesion molecule which is involved in lymphocyte activation and lymphocyte homing. In recent years, its role in the invasion and metastasis of malignant tumors has attracted the attention of investigators. In this study, the expression of CD44 variants was investigated in primary lesions and metastasis into the lymph node in 53 patients with gynecological cancer. The following patients with various types of gynecological carcinoma, established by operation and pre-treatment biopsy, were included in this study: 19 patients with cancer of the uterine cervix, 23 with cancer of the uterine endometrium, and 11 with ovarian cancer. Tissue samples were obtained from a primary lesion and a nodal metastasis of each patient, and immunohistochemical staining was performed by the ABC method through the use of monoclonal antibodies against CD44v1-10. Specimens proving CD44v1-10 positive were then submitted to immunohistochemical staining through the use of monoclonal antibodies against CD44v6 and CD44v9. Expression of CD44v was judged positive when DAB revealed color development, irrespective of the degree of staining intensity. CD44v were all expressed in the cancer cell membrane. In normal endometrium, expression of CD44v1-10 and v9 was observed in the endometrial gland cell membrane. In normal ovarian tissues, CD44v6 and v9 were not detected. The expression of CD44v6 in patients with endometrial cancer was noted in 13 (72.2%) of 18 patients with vascular invasion and in one (20.0%) of 5 patients without it, indicating a significant relation to vascular invasion. It was also remarkably higher in those for whom the invasion exceeded 1/2 of the myometrium than in those for whom the invasion did not exceed 1/2 of the myometrium, and was higher too in advanced stages and in node-positive patients. In one patient, CD44v6 was detected not in the primary lesion but in the nodal metastasis. The expression of CD44v6 in patients with ovarian cancer occurred more frequently in node-positive patients. Our study results suggest that the expression of CD44v6 in endometrial adenocarcinoma cells is involved in the progression of the carcinoma, nodal metastasis, myometrial invasion, and vascular invasion, and that in ovarian cancer, the expression of CD44v6 is involved in nodal metastasis.
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PMID:Expression of CD44 alternative splicing variants in primary and lymph node metastatic lesions of gynecological cancer. 911 64


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