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

Since Gusberg's description in 1947 of adenomatous hyperplasia (15), the role of precursors in the development of endometrial carcinoma has been well studied. There is now no doubt that in many patients histologic precursors can be demonstrated in the endometrial cavity prior to the development of invasive cancer. At this point in the continuum, interruption by hysterectomy or other therapy will insure the patient's health. We have discussed a wide variety of techniques designed to provide cytologic or histologic samples of the endometrium that are highly effective in the detection of early neoplasia. As a goal, universal endometrial sampling on a periodic basis is probably impractical and may be unecessary or undesirable. However, surely the patient at high risk for endometrial cancer requires close periodic screening. The high-risk category may be expanded to include others beyond the group of hypertensive, diabetic, obese, anovulatory, nulliparous women. It should include patients with irregular vaginal bleeding, those with a strong family history of genital and breast cancer, those patients receiving hormone therapy, and patients in the menopausal years who experience changes in the menstrual pattern. With intelligent and aggressive application of outpatient screening, uterine cancer can be diagnosed when patients are virtually completely curable, thus resulting in further reduction in mortality from this disease.
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PMID:Screening for endometrial cancer. 76 37

The study comprises 96042 cytologic cases within a period of 10 years. After screening women were admitted for biopsies. The histologic findings are reported. By 690 "right positive smears" 71 squamous cell cervical cancers stage Ib or more 87 microcarcinomata-1, 377 carcinomata-in-situ of the cervix, 100 dysplasias, 47 adenocarcinomata and 8 different malign tumors were found. 61 cases having histologic diagnosis outside are just mentioned. 629 cases which had been diagnosed in our hospital are described extensively. The first biopsy was nearly always taken by selective scraping of the ecto- and endocervix. Technical improvements of this method are explained. The efficiency of cytodiagnosis is especially pointed out by separating cases which could have been recognized or suspected by means of inspection or colposcopy only. 140 out of 282 carcinomata-in-situ and 7 invasive, mainly endocervical cancers (Ib-III), could only be diagnosed by a smear. In 17 woemn who turned out to have invasive cancer (Ib -III) a positive smear was the only reason for admission. Careful inspection of the cervix in the hospital, however, was sufficent to reveal the correct diagnosis. In our material the cervical smear could be of little help in cancer diagnosis of the upper genital tract such as adenocarcinoma of the corpus uteri, sarcoma and ovarian cancer. 39 of the 45 women with endometrial cancer cells in the specimen had bleeding anomalies, especially postmenopausal. The number of "false negative smears" mainly yields from histologic examination of 2415 uteri after hysterectomy and 4497 specimen after curettage of cervix and corpus uteri. In the first group 1 microcarcinoma-2 and 5 carcinomata-in-situ, in the second group which obviously is less representative 4 carcinomata-in-situ were found unexpectedly. It is also searched for cases which had a negative smear first and a positive or suspect smear later. This happened in 41 patients. The underlying lesion were 5 advanced cancers, 2 microcarcinomata-3 and 34 carcinomata-in-situ. Up to 30 months elapsed between the last negative cytologic finding and histologic diagnosis. 121 out of 811 suspect or positive smears were "false positive". Cytologic grouping III, IV and V inconsistently matched with the corresponding histologic results. The type and extension of squamous cell atypias are anticipated with little certainty. The great number of suspect specimen (group III) both in microcarcinoma-4 (6 in 78) and carcinoma-in-situ (33 in 344) was striking. Therefore we consider a histologic diagnosis to be necessary in this group as well as in group IV and V. The method of fractioned cervical scraping makes the decision of hospital admission easier. Low risk for the patient does not imply any loss in diagnostic security.
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PMID:[Review of cervical smears in a gynaecologic department after a period of ten years under the consideration of colposcopic findings(author's transl)]. 117 25

Endometrial carcinoma is the most common gynaecological invasive cancer. Since its incidence is increasing, more patients will develop recurrent disease. In an attempt to identify possible prognostic factors associated with survival, we reviewed the results of 45 patients treated in our department for recurrent clinical stage I endometrial carcinoma. All patients received primary therapy consisting of surgical resection. 16 patients developed recurrent disease after initial operative treatment and adjuvant radiotherapy. The minimum follow-up of 3 years was available in 43 patients and the actual 3-year survival rate was estimated 42% (median 16 months). Significant prognostic factors were recurrence site--vagina, 51% (17/33 pts) vs extravaginal, 20% (2/10 pts) (p = 0.01), and histological cell type--non-papillary carcinoma, 50% (17/34 pts) vs papillary adenocarcinoma, 22% (2/9 pts) (p = 0.02). Late recurrences have been reported to carry a better prognosis, than those that recur early. In the present study, time of onset did not appear to be a significant factor--recurrence occurs within 24 months, 36% (9/25 pts) vs recurrence appearing after 2 years, 55% (10/18 pts). We suggest, that systemic therapy should be prospectively evaluated in high-risk patients. Selected patients with recurrent disease--cases of non-papillary histological cell type and vaginal recurrence--can be cured by radiotherapy.
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PMID:[Recurrence of stage I endometrial cancer: effect of prognostic factors on therapeutic results]. 186 Jun 59

The expression of Epidermal Growth Factor Receptor (EGF-R) in gynecological malignant tumors was investigated immunohistochemically. 1) With respect to the expression of EGF-R in the uterine cervix, it was seen in 20.0% with benign lesion. In cases of dysplasia, it was expressed in 62.5% of the cases with mild dysplasia, 81.8% with moderate dysplasia and 53.3% with severe dysplasia. In cases of CIS, it was seen in 46.7% and in cases of invasive cancer, it was seen in 22.2%. By hystological type, the expression rates were 27.3% for keratinized squamous cell carcinoma and 33.3% for large cell non-keratinized squamous cell carcinoma. No expression was seen in three cases of small cell non-keratinized squamous cell carcinoma or four cases of adenocarcinoma. In cases of benign lesions, EGF-R was localized in the cell walls of the basal layer, but in cases with dysplasia, it was found in the cell walls and also in the cytoplasm in all layers of the epithelium. 2) The expression rate in endometrial carcinoma was 14.3% and all of these cases were well-differentiated adenocarcinoma. There was no reverse correlation with estrogen receptors. 3) The expression rate for advanced malignant ovarian tumors was 31.4% and there was no clear correlation with the histological type. The prognosis tended to be better in cases expressing EGF-R than in those not. These results indicated that EGF-R appears to be related to the degree of advance of cervical dysplasia, but it was clear that the frequency of expression of EGF-R decreased when the cancer became invasive. In cases of malignant ovarian tumors, the expression of EGF-R tended to be related to the prognosis.
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PMID:[Immunohistochemical studies on epidermal growth factor receptor (EGF-R) in gynecological malignant tumor]. 206 13

Much evidence has been suggested that cystic, adenomatous, and atypical hyperplasia as well as adenocarcinoma in situ of the endometrium may ultimately progress to invasive cancer. Consequently, these lesions should be considered to be precursors of endometrial cancer. Twelve postmenopausal and three perimenopausal women with vaginal bleeding due to endometrial hyperplasia received 400 mg/d of danazol orally for 3 months. After 15 to 30 days of continuous danazol therapy, the endometrial glands ceased to grow and became smaller and rounder. The lumina of glands were narrow and contained no secretion. The nucleic mitosis of the glands disappeared. All women showed regression of hyperplastic endometrium within 2 to 3 months of initial treatment. In the 15 cases treated, endometrial hyperplasia could be controlled successfully with danazol without further recurrence and/or progression of the disease. In summary, danazol should be an effective and safe alternative therapy to progesterone for the treatment of endometrial hyperplasia.
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PMID:Clinical effects of danazol on endometrial hyperplasia in menopausal and postmenopausal women. 238 26

We examined the state of T and B cells in tissues from 61 cases of endometrial cancer by immunohistochemistry with monoclonal antibodies. In cancer tissues, T cells frequently appear in clusters at the tip of the infiltrating cancer. As to age, both T and B cells were rare in 9 out of 11 cases involving endometrial cancer in patients in their 40s. In the normal endometrium, infiltration of numerous T cells was seen in only 2 out of 27 cases (7.4%). However, it was seen in cancer tissues in 28 out of 61 cases (45.9%). Thus the infiltration of numerous T cells into cancer tissues was confirmed. Within the same uterus, T cells seldom infiltrated into the area of the benign endometrium while T cells were seen in large numbers in the cancer foci. This indicates that T cells infiltrate after having recognized cancer cells. Compared to stages I and II, T cell infiltration tended to decrease in stages III and IV. While no fixed relation was found between the degree of histologic differentiation and T cell infiltration, fewer T cells were observed in the cases where cancer penetrated to the depth of cancer invasion and where it occupied a large area. Thus, it was assumed that in the host-immune defence mechanism in particular, T cell infiltration played a key role in tumor immunology of patients with endometrial cancer.
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PMID:Immunohistological identification of T and B cells in normal and malignant tissues of the uterine endometrium. 265 92

In this discussion of Depo-Provera (DMPA) attention is directed to the following: pharmacology and mode of action; clinical considerations; cervical dysplasia; breast cancer; and endometrial carcinoma. DMPA, a microcrystalline suspension of medroxy-progesterone acetate, is used widely around the world as a contraceptive, particularly in developing countries. MPA (medroxy-progesterone acetate) is a synthetic progesterone which in its mycrocrystalline depot form can be delivered by simple intramuscular injection or jet injector to that depending on the dose administered plateau contraceptive blood levels will be maintained for 90-180 days when doses of 150 mg and 300 mg respectively are used. The effect of DMPA in suppressing ovulation is at the hypothalmic level where it inhibits the gonadotrophic release responsible for the midcycle surge in luteinizing hormone responsible for ovulation. When 150 mg is administered every 3 months pregnancy rates range from 0.0-1.2/100 women years. The pregnancy rates range from 0.0-3.8/100 women years when 300 mg is administered every 6 months. The drug is usually administered initially in the first 7 days of the menstrual cycle to avoid possible effects on an established pregnancy. Menstrual disturbances are the major reason for discontinuation of DMPA. The usual side effects are amenorrhea, irregular but infrequent bleeding, and a few instances of prolonged or heavy bleeding. There is no evidence to suggest that DMPA increases the risk of invasive cancer of the cervix, but the evidence regarding the incidence of cervical dysplasia is ambiguous. There have not been any cases of breast cancer that can be related to DMPA use, but DMPA toxicology studies on beagle bitches revealed an increased incidence of benign and malignant breast tumors. It is well established that in adenocarcinoma of the endometrium DMPA is effective in causing regression and preventing recurrence of this tumor.
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PMID:Depo provera in perspective. 646 84

Cancer prevention as related to the problem of cervical and endometrial cancer involves a great number of factors that are considered contributory to the development of neoplasms in the uterus. Lifestyles encouraging the development of cervical cancer are different from those encouraging endometrial cancer. Cancer of the cervix is a disease of the inner city. It is seen in those staring intercourse in their teens, having multiple partners, having many children, and coming from the low socioeconomic groups. Semen and herpes virus II may have an adverse effect on immature cells, but there are no hard data to confirm these roles. Cancer of the endometrium is a disease of suburbia. The American Cancer Society estimates that there will be 38,000 new cases of endometrial carcinoma in 1980, making it the most common female genital cancer. Women at highest risk for later carcinoma of the endometrium are those who have obesity, diabetes, infertility, irregular menses and failure of ovulation, adenomatous hyperplasia, and/or prolonged estrogen administration. For both cervical and endometrial cancers, it is possible to identify the high-risk patient, to detect changes at an early stage, and, by instituting appropriate therapy, to prevent a more serious problem. It is obvious that prevention, detection, and treatment are all closely intertwined. This paper identifies the patient at high risk and makes suggestions for correcting any imbalance that may predipose to the development of invasive cancer.
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PMID:Uterine cancer (prevention). 723 68

Any approach to the control of endometrial cancer must include a consideration of the individual at high risk; this will include the obese, the infertile, those with failure of ovulation and dysfunctional bleeding; and those postmenopausal women who ae chronic estrogen users. The detection of adenomatous hyperplasia offers us the opportunity to recognize the developmental phase of the disease before invasion is established. The cytologic method of Papanicolaou, used in the conventional way, is inefficient for the detection of endometrial cancer. Cell studies taken by cannula from the endometrial cavity can be more accurate for the diagnosis of invasive cancer but fail in the hands of most pathologists to detect adenomatous hyperplasia. We have found the highest rate of accuracy in the aspiration curettage histologic method, both for endometrial cancer and adenomatous hyperplasia. It is quick, relatively painless in most, and an outpatient procedure that does not require anesthetic. It offers the pathologist a sample that is readily interpreted. Our public education effort must include the warning that a negative Pap smear does not rule out endometrial carcinoma.
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PMID:Detection of endometrial cancer and its precursors. 723 74

We report a histochemical study of alkaline phosphatase (ALP) in normal cells of the female reproductive system, in pre-cancerous and cancerous lesions of the uterine cervix and in endometrial cancer to ascertain the incidence of ALP and its isoenzyme type. For this purpose, serial sections were subjected to heat stability and L-phenylalanine (LP) inhibition tests. The Regan-like isoenzyme, a heat-stable and LP-sensitive ALP, which has been thought to derive only from cancer or the placenta, was found in uterine cervical reserve cells and endometrial luminal surface lining cells. In contrast, ALP activity in endometrial glandular cells was found to be heat and LP sensitive. Of 183 cases of cervical neoplasia, 60 (33%) manifested non-specific ALP activity. One dysplasia and two invasive cancer cases manifested the Regan-like isoenzyme. The other 36 classifiable lesions had small-intestine ALP-like activity (marked heat and LP sensitivity) or a liver ALP-like isoenzyme (marked heat and slight LP sensitivity). Of 42 cases of endometrial cancer, all cases manifested non-specific ALP activity. Seven endometrial cancers exhibited the Regan-like isoenzyme. The other 19 cases manifested either small intestine or liver ALP-like isoenzyme. Our findings indicate that in the course of uterine carinogenesis, the ALP isoenzyme of reserve cell and endometrial glandular cells undergo a change and that enzyme deviation occurs.
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PMID:Heat-stable alkaline phosphatase in uterine cancer, with special reference to its histochemical heat-stability and the L-phenylalanine inhibition test. 733 83


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