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

Although an underlying endocrine-metabolic disorder has been implicated as causally related to the development of endometrial carcinoma, data to support such an association are ambiguous and/or contradictory. In this prospective study of 16 consecutive nonobese postmenopausal women with endometrial carcinoma and 16 cancer-free postmenopausal women matched for age and weight, fasting values for growth hormone (GH), insulin, prolactin, follicle-stimulating hormone, luteinizing hormone, estrone (E1), and estradiol (E2) were measured on 3 consecutive days. Intravenous glucose tolerance, pituitary GH release in response to arginine infusion, hyperglycemia, and hypoglycemia, and insulin secretion in response to arginine infusion and to hyperglycemia were analyzed. Our data show that these endocrine-metabolic profiles were not significantly different between the cancer patients and control subjects, suggesting that the postmenopausal women with endometrial cancer who is not obese exhibits no accountable endocrine or metabolic disorders.
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PMID:A study of endocrine and metabolic variables in postmenopausal women with endometrial carcinoma. 45 45

Electrophoresis of cytosol prepared from normal and malignant tissue samples of uterine cervix and endometrium revealed interesting differences which may be relevant to the characteristic alterations in glucose metabolism associated with tumour development. Hexokinase II was detected in 30% of the cancer material from both sources, but in none of the samples of normal cervix. A duplet band of 6-phosphogluconate dehydrognease was seen in the majority of the cancer samples but in no sample of normal cervix; it appeared to be partly due to ageing of the sample, and is not phenotypically related to the malignant process. Analysis of genetic variance for phosphoglucomutase at the PGM1 locus revealed a highly significant excess of the PGM1-1 phenotype in patients with cancer of the endometrium, which may reflect susceptibility to endometrial cancer in patients with this phenotype. At the PGM2 locus, samples of malignant cervix were deficient in "Band f" compared with normal cervix samples, all of which showed this band. Conversely, gene products of the PGM3 locus were found in most samples of malignant cervix and a small minority of normal cervix samples. Compared with the isomorphic distribution of lactate dehydrogenase enzymes in normal uterine tissue, cancers showed a shift towards either a more anodal or a more cathodal pattern. The former may be associated with tumours enjoying a good oxygen supply, and the latter with tumours which, because of their depth or poor blood supply have to function under less aerobic conditions.
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PMID:Isoenzymes of hexokinase, 6-phosphogluconate dehydrogenase, phosphoglucomutase and lactate dehydrogenase in uterine cancer. 50 67

Twelve enzymes related to the direct oxidative and glycolytic pathways of glucose metabolism were assayed in 88 cancers of the cervix and 48 cancers of the endometrium of the human uterus, and the activities compared with those obtained from a group of control tissues. Significant increases for all but one of the enzymes studied (alpha-glycerolphosphate dehydrogenase) were found in cancer of the cervix, when compared with normal cervix epithelium. Hexokinase, phoshofructokinase, and aldolase appear to be rate-limiting in normal cervix epithelium; however, since the increase in activity of the first two in cancers was least of all the glycolytic enzymes, redundant enzyme synthesis probably occurs in the malignant cell for the enzymes catalysing reversible reactions. There was virtually no correlation between the activity of any enzyme measured in the cancer sample and histological assessments of the degree of malignancy of the tumour, or the clinical stage of the disease. All enzymes except pyruvate kinase had significantly higher activity in normal endometrium than in normal cervix epithelium, presumably reflecting the greater metabolic requirements of the former tissue. Only phosphoglucose isomerase and pyruvate kinase were significantly higher in endometrial cancer than in normal endometrium, and there were few significant differences between cancers of the cervix and of the endometrium, despite the marked differences in their tissues of origin. These results suggest the changes occur during malignant transformation to the activities of both regulatory enzymes and those catalysing reversible reactions, in a manner justifying the conclusion that the general metabolism of tumours is convergent.
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PMID:Enzymes of glucose metabolism in carcinoma of the cervix and endometrium of the human uterus. 67 39

The risks and benefits of specific types of postmenopausal estrogens and progestogens are explored: those affecting serum lipids, clotting elements, hepatic proteins synthesis, blood pressure, glucose tolerance, endometrial, breast and cervical cancer. Ethinyl estradiol taken orally is the only estrogen likely to cause gall bladder disease. It also induces liver protein synthesis when taken orally or vaginally. Natural estrogens do not heighten coagulation factors, and may shift towards fibrinolysis. Both ethinyl estradiol and equine estrogens may increase blood pressure, while natural estrogens may decrease it. Similarly natural estrogens induce prostacyclin synthesis, while ethinyl estradiol activates both prostacyclin and thromboxanes. Progestagens, especially so the norprogestins, disturb carbohydrate metabolism and tend to reverse the beneficial effects of estrogens on serum lipids, a 40-70% reduction in risk of mortality from coronary heart disease. A meta- analysis of 23 studies concluded that menopausal estrogens do not increase the risk of breast cancer by a measurable degree, except in high doses and in those predisposed by family history. There is an increased risk of endometrial carcinoma for those taking unopposed estrogens for more than 3-6 years. This can be attenuated by taking combined estrogen-progestins, which will eventually result in absence of bleeding, or a 12-day progestogen course every 4-6 cycles. Oral micronized progesterone decreases blood pressure. The relative androgenic effects of progestins other than the norprogesterone derivatives are less significant. As an alternative to taking a progestogen, a woman could have regular endometrial sampling or abdominal or vaginal sonograms to detect endometrial cancer.
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PMID:Risks of estrogens and progestogens. 217 Aug 23

Soskin, in his 1946 textbook, stated that insulin may be regarded as the dominant instrument in the symphony of endocrine action that results in normal carbohydrate metabolism. After almost half a century, great progress in the medical field has revealed that insulin plays more than even he described. Some aspects of important actions of insulin in our field as investigated in our laboratory are summarized below. 1. Role of insulin in reproductive endocrinology. (1) Correlation of insulin and testosterone in normal young women and patients with polycystic ovary syndrome (PCO). The sum of serum insulin values during 75g OGTT and serum testosterone values were positively correlated in normal women and patients with PCO. Glucose transport activities in isolated adipocytes from a typical PCO patient were decreased, but insulin binding activities were not, which indicates that insulin resistance in this patients is due to some post-receptor defects. (2) Insulin may be a risk factor of endometrial carcinoma. It is well-recognized that several diseases associate with hyperinsulinemia, such as obesity, PCO, diabetes mellitus, and hypertension are risk factors for endometrial carcinoma. The sum of the insulin values during OGTT was significantly higher in patients with endometrial carcinoma than in those without. 2. Role of insulin in perinatal medicine. (1) Increase in insulin secretion during pregnancy. High serum insulin concentration during OGTT, increased secretion of urinary C-peptide, and enhanced staining of insulin in B cells by the PAP method suggest that insulin secretion is enhanced during pregnancy. (2) Insulin resistance during pregnancy. Glucose utilization rate in both pregnant and progesterone-treated rats, as assessed by a glucose clamp technique, is significantly decreased as compared to nonpregnant rats. The technique of 2-deoxyglucose injection revealed that whole body insulin resistance is due to insulin resistance in individual insulin-sensitive tissues. The activities of 3-0-methyl-D-glucose transport in isolated rat skeletal muscle and human adipocytes were found to decrease during late pregnancy, but insulin binding activities were not. These results suggest that insulin resistance during pregnancy is due to some post-receptor mechanisms. (3) Physiological meaning of insulin in fetal growth.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The role of insulin in reproductive endocrinology and perinatal medicine]. 223 Apr 12

Amylase activity was studied in 70 specimens of normal endometrium, 21 normal endocervices, 19 endometrial carcinomas, and 20 endocervical adenocarcinomas. Amylase was observed in the secretory (8.7 per cent) but not in the proliferative phase of the menstrual cycle. It is possible that the presence of amylase activity may serve a functional role in the degradation of glycogen to glucose in the secretory endometrium. The great majority (90.5 per cent) of uterine cervices showed strong and extensive staining of the endocervical glands for amylase. No glycogen was demonstrated and the role of amylase in endocervical glands remains obscure. Amylase was observed in one (5.3 per cent) out of 19 cases of endometrial carcinoma, and the presence of this enzyme may be considered a eutopic rather than an ectopic expression. Amylase was not detected in any of the endocervical adenocarcinomas examined. This study has shown a complete loss of amylase activity in malignant transformation of endocervical glands and this could be attributable to the immature nature of de-differentiated neoplastic cells.
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PMID:The expression and localization of amylase in normal and malignant glands of the endometrium and endocervix. 245 71

The risks and benefits of the newer oral contraceptives are evaluated, considering cancer, teratogenicity, drug interactions, cardiovascular risks, and carbohydrate metabolism. Oral contraceptives confer the lowest mortality risk of all contraceptives, except sexual abstinence, in all women under 30 and in nonsmokers through age 40 in developed countries. In less developed countries where maternal mortality can be as high as 5-10%, the risks of even nonmedically supervised oral contraceptives are dwarfed. The pill protects against ovarian cancer even after the pill is discontinued because it suppresses ovulation, and endometrial cancer because it blocks estrogen receptors. The relationship of oral contraception to breast cancer is still in dispute, but no good evidence exists for increased risk, especially with new low- dose pills. There may be a slightly increased risk of cervical cancer, although it is difficult to separate out other risk factors co-existing in pill users, such as earlier sexarche, more partners and more frequent screening. The incidence of pelvic inflammatory disease, functional ovarian cysts and ectopic pregnancy is reduced by pills. There is only 1 report of increased incidence of congenital heart disease in infants whose mothers took pills during pregnancy. Drug interactions are common, and must be managed by the physician. Among currently popular pills, only the norgestrel and levonorgestrel-containing multiphasic pills are said to decrease HDL2 and impair glucose tolerance, because they are androgenic enough to overcome the low dose of estrogen.
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PMID:Oral contraceptives: a reassessment. 267 44

It has been proposed that a nonsteroidal hormone such as insulin may directly exert an influence through estrogen receptors and alter the biologic behavior of steroid hormone target tissue. The implication of such a proposal is that diabetes may alter the outcome of estrogen receptor-positive tumors such as breast or endometrial carcinomas. To evaluate the effect of insulin on a receptor-positive tumor, we examined the direct effect of insulin on an estrogen receptor and its subsequent biologic effect on a receptor-positive endometrial carcinoma model in vitro and in vivo. An in vitro experiment demonstrated that when the estrogen receptor-positive cell line was grown in serum-free media with low insulin, there was a loss of intracellular receptors for estrogen. This loss of estrogen receptors was also associated with increased growth rate as reflected by increased thymidine uptake. Similarly, in vivo experiments demonstrated that a diabetic host with a high blood glucose level and a low insulin level exhibited development of growth of a receptor-negative tumor with accelerated growth rate in contrast to growth of a receptor-positive tumor with slower growth rate in a normal host with normal serum insulin and blood glucose levels. Data suggest that insulin may modulate the growth of estrogen receptor-positive tumors through its direct effect on estrogen receptors.
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PMID:Modulation of estrogen receptor by insulin and its biologic significance. 294 76

A longitudinal population study of 1462 women, aged 38-60 years, was carried out in Gothenburg, Sweden, in 1968-69. In univariate analysis anthropometric variables indicating centrally localized adipose tissue (waist circumference, the ratio of waist to hip circumference and the subscapular skinfold) showed significant age-standardized positive associations with the occurrence (prevalence + incidence data) of endometrial carcinoma. Incidence data suggested that measurements of centrally localized adipose tissue might be of predictive value for this malignancy as well as for ovarian carcinoma. In contrast, measurements of generalized obesity (body weight or body mass index) or peripherally localized adipose tissue (triceps skinfold) showed no associations to these malignancies. No relationship was observed between the anthropometric variables studied and breast carcinoma. The association observed between endometrial and ovarian carcinomas with central adipose tissue did, however, not remain in multivariate analysis when generalized obesity was taken into account. Centrally localized adipose tissue is known to be associated with endocrine abberations including irregular ovulation and menstruation, re-emphasizing the importance of endocrine factors for the pathogenesis of endometrial and ovarian carcinomas. No positive association was found between development of the carcinomas and initial measurements of blood glucose, serum lipids or blood pressure, found to be elevated in cross-sectional studies. An increase in these variables therefore probably are parallel phenomena rather than predictors. The women with endometrial or breast carcinomas smoked more than the remaining women. Although the number of end-points observed was limited these results suggest that measurements of adipose tissue distribution might be a valuable addition to the predictors of endometrial and ovarian carcinomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adipose tissue distribution and female carcinomas. A 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. 305 18

Mechanism of action, indications, side effects and contraindications of oral contraceptive agents (OCA) are reviewed. OCA can be divided into two groups: consecutive and combined agents. Combined OCA contain both estrogens and gestagens and are taken for 3 weeks, while consecutive OCA contain only estrogens and are taken for 2 weeks followed by 1 week of combined OCA until the onset of menstruation. Biological activity of synthetic gestagens is estimated by a dosage which results in a delay of menstruation by 2 weeks. Gestagens norethindrone and norethynodrel were shown to be equally effective, while ethinodiol diacetate and norgestrel were 15-30 times more effective. Estrogen component of OCA is represented by ethinyl estradiol or mestranol. Combined OCA are more effective than consecutive OCA; probability of undesirable pregnancy during administration of combined OCA does not exceed 0.2%. The most frequent side-effects of OCA include nausea, headache, uterine hemorrhage, and changes in libido. OCA can affect the endocrine and reproductive systems. Major endocrine effects of OCA include changes in the cortisol metabolism in the adrenal glands, increase in the level of thyroid-binding globulin in the thyroid gland, changes in the glucose metabolism in the pancreas, inhibition of the luteinizing hormone releasing hormone in the hypothalamus with simultaneous decrease in the production of pituitary gonadotropins and inhibition of the ovulation. The most serious side-effects of OCA include cholelithiasis, thrombophlebitis, thromboembolism, liver adenoma, and myocardial infarction. Absolute contraindications to the use of OCA include hypertension, hyperlipidemia, breast or endometrial cancer, pregnancy, cardio-vascular diseases, liver diseases, and kidney insufficiency.
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PMID:[Principles of the use of oral contraceptive preparations]. 307 80


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