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

Endometrial cancer is the cause of considerable morbidity among women, but the disease has been underrated and its management more casual than its virulence warrants. Endometrial carcinoma is the most frequently diagnosed invasive neoplasm of the female genital tract in the US, and is third in incidence after breast and colonic cancer. The white population of the US has the highest age standardized incidence of endometrial cancer in the world, India and Japan have the lowest, and the European countries occupy intermediate positions. Between 75% and 80% of women diagnosed with endometrial cancer are postmenopausal, and the mean age at diagnosis is about 60 years. In many cases endometrial hyperplasia is misdiagnosed as frank malignancy. The predisposing factors for endometrial cancer seem to be obesity, hypertension, diabetes mellitus or an abnormal glucose tolerance curve, and prolonged or unopposed estrogen stimulation. Raised estrogen levels may occur in the following situations: 1) women with functioning ovarian tumors that produce estrogen; 2) women with polycystic ovarian disease; 3) women with ovarian dysgensis (Turner's syndrome) managed with estrogen replacement therapy; 4) women taking high estrogen sequential oral contraceptives (OCs); and 5) women undergoing estrogen replacement therapy. There is an increased risk of endometrial carcinoma associated with nulliparity. Carcinoma of the endometrium occurs in a variety of subtypes, the most frequent being adenocarcinoma, followed by adenocanthoma, adenosquamous carcinoma, clear cell carcinoma, papillary adenocarcinoma, and secretory carcinoma. Overall 5-year survival rates are 72% for adenocarcinoma, 68% for adenocanthoma, and 26% for adenosquamous carcinoma. The true extent of endometrial cancer can be ascertained only after exploratory laparotomy and then various therapies may be used according to the stage of the disease.
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PMID:Carcinoma of the endometrium. 637 16

Glycosylated hemoglobin was compared in 22 unselected endometrial carcinoma cases 1-10 years (mean +/- SD = 3.3 +/- 2.8) after diagnosis and in 939 controls, a representative population sample in the same age range tested for oral glucose tolerance. Relative weight was similar in patients and controls. Glycosylated hemoglobin was significantly increased (p less than 0.01) in the cases. The distribution of glycosylated hemoglobin indicated that most if not all of the cases had at least impaired glucose tolerance. These results support a true association of glucose intolerance and endometrial carcinoma.
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PMID:Increased rate of glucose intolerance in endometrial cancer--a community-based study. 651 Jul 78

Clinical, cytological and hormonal studies were performed on 86 cases of endometrial carcinoma and 34 cases of endometrial hyperplasia for their early diagnosis. 68.6% of the endometrial carcinomas were in patients aged 50 to 64 and 3.5% in patients under 45 ages. The figures 17.4% infertility, 20.9% no delivery and 19.8% only one delivery indicate that endometrial carcinoma is associated with no birth or the birth of few child. Almost all cases of endometrial carcinoma had existed for more than ten years since the last pregnancy, when the lesions were detected. 20.9% of endometrial carcinomas belonged to premenopause and 24.4% to within the first 5 years following menopause. In total, 45.3% of them range around menopause and hormonal imbalance in climacteric periods. Clinical stages of endometrial carcinoma revealed no relation to enlargement of the uterus. 61.4% of endometrial carcinoma were found in obese patients. 63.1% of them showed abnormal glucose tolerance titers and preclinical lesions. Hypertension was found in 28.0% of them, but we did not consider it very significant, considering their advanced age. The serum steroid level indicated no hyperestrogenism in endometrial carcinoma. Diagnostic data showing positive and suspecious smears in endometrial carcinoma were 36.5% in vaginal, 67.5% in cervical and 84.3% in endometrial cytology. This means that direct sampling of cells from the uterine cavity is essential in the detection of endometrial carcinoma. The cytological features of endometrial carcinoma were nuclear enlargement, anisokaryosis, irregular distribution of chromatin and prominent nucleoli. Undifferentiated types of endometrial carcinoma were more characterized by these factors than differentiated types.
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PMID:[Studies on the early diagnosis of endometrial carcinoma. Analysis of risk factors and cytological approach]. 674 77

Paradoxical hypersecretion of human growth hormone (HGH) followed a glucose load in patients with endometrial cancer and atypical hyperplasia of the endometrium. All patients had normal fasting plasma glucose and serum HGH concentration with a normal glucose tolerance curve. Their urinary estrogen concentrations were within the normal postmenopausal range. 6 months after abdominal total hysterectomy and bilateral oophorectomy, the glucose load was repeated. Following surgery all patients showed a normal suppression of HGH secretion during the hyperglycemic period. These findings suggest the existence of a HGH-releasing factor in the neoplastic and preneoplastic endometrial tissue. This factor might be related to the abnormal HGH responses observed.
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PMID:Paradoxical hypersecretion of growth hormone in patients with endometrial atypical hyperplasia and carcinoma. Effect of hysterectomy. 705 4

Insulin is a major regulator of circulating insulin-like growth factor (IGF)-binding protein-1 (IGFBP-1), suppressing the hepatic production of IGFBP-1. Postmenopausal age, obesity, hypertension, and impaired glucose tolerance, which are known risk factors for endometrial cancer, are all associated with hyperinsulinemia and insulin resistance. In this study, we investigated the relationship among serum insulin, glucose, insulin-like growth factors (IGF-I and IGF-II), and IGFBP-, -2, and -3 in 32 nondiabetic postmenopausal women with endometrial cancer and in 18 healthy controls. The mean fasting levels of glucose and insulin were higher, whereas the mean basal IGF-I, IGF-II, and IGFBP-3 levels were lower in the endometrial cancer patients than in the healthy control subjects. The mean fasting IGFBP-1 and IGFBP-2 levels did not differ between the groups, and no correlation was found between fasting insulin and IGFBP-1 concentrations or between insulin and IGFBP-2 concentrations in either of the study groups. During an oral glucose tolerance test, the mean glucose levels at 1 and 3 h as well as the mean insulin level at 3 h were significantly higher in the endometrial cancer patients than in the controls, and the area under the glucose curve was larger in the first group. An oral glucose load resulted in a similar fall in serum IGFBP-1 levels in endometrial cancer patients and controls (51% and 55% at 3 h). When the cancer patients were divided into two subgroups according to the body mass index (kilograms per m2), the obese group had higher glucose and insulin indices than the nonobese group. No difference was found by the same measures in healthy controls. The fasting serum IGFBP-1 levels tended to be lower in the obese than in the normal weight subjects, but the difference did not reach statistical significance. In summary, these results provide preliminary evidence that the inverse relation between fasting insulin and IGFBP-1, well established in children and young adults, disappears in elderly women, although short term suppression by insulin still occurs. Further, our data indicate that in addition to carbohydrate metabolism, postmenopausal women with endometrial cancer have alterations in their circulating IGF system compared to controls.
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PMID:Relationship between carbohydrate metabolism and serum insulin-like growth factor system in postmenopausal women: comparison of endometrial cancer patients with healthy controls. 768 14

The triphenylethylene drug tamoxifen is a hepatocarcinogen in rats, has genotoxic potential and may produce carcinoma of the endometrium in humans, while the structurally closely related toremifene has no carcinogenic or genotoxic potential. We have investigated the effects of long-term treatment with tamoxifen and toremifene on the activities of drug metabolizing and antioxidant enzymes in rat liver. Female Sprague-Dawley rats were dosed with equimolar doses of tamoxifen (11.3 and 45 mg/kg) and toremifene (12 and 48 mg/kg) for 12 months and were killed after 2 days, 5 weeks, 3, 6 and 12 months of treatment. After 12 months most rats treated with the high dose of tamoxifen had hyperplastic nodules and hepatocellular carcinomas, while in rats given toremifene or the low dose of tamoxifen, only foci were observed. A striking observation was strong inhibition of the hexose monophosphate shunt (HMS) by tamoxifen and toremifene, which, except in the group given the high dose of tamoxifen, lasted throughout the treatment period. Both antiestrogens induced susceptibility to oxidative stress, as indicated by decreased hepatic contents of reduced glutathione and by increased peroxidation potential of microsomal preparations. The activity of glutathione S-transferase was permanently induced by the high dose of tamoxifen from 5 weeks onwards and was greater in tamoxifen-induced liver tumors than in corresponding macroscopically normal tissue. Similarly, the activity of HMS was elevated by the high dose of tamoxifen at the latest time points, and a further elevation was seen in tamoxifen-induced liver tumors. No such alteration in glutathione S-transferase or HMS activity was seen in animals treated with toremifene or with the low dose of tamoxifen. In conclusion, tamoxifen and toremifene differ markedly with respect to production of liver tumors, and this difference in hepatocarcinogenic potential is reflected in differential effects on glutathione-S-transferase and HMS activities in rat liver.
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PMID:Alterations of drug metabolizing and antioxidant enzyme activities during tamoxifen-induced hepatocarcinogenesis in the rat. 820 88

At the present time in the Netherlands, mainly oral contraceptives (OCs) with 3-35 mcg of ethinyl estradiol are used with progestagen components of levonorgestrel, norethindrone, and lynestrol. The modern progestagens gestodene, norgestimate, and desogestrel have fewer androgenic side effects and less effect on the serum lipids and glucose metabolism. Alleged carcinogenic effects of OCs have not been proven, in contrast, their protective effects against certain tumors have been discovered. The progestagen in OCs eliminates endometrial hyperplasia and reduces the chance of endometrial cancer. The high-dose estrogen pills without use of equally high dose progestagens increase the risk of endometrial cancer, and in women under 45 who developed this cancer, the use of such sequential preparations was relatively high. A 1980 study found that the use of combination OCs compared to nonusers reduces the risk of endometrial cancer by 50%. The protective effect lasts 5-15 years even after discontinuation of OC use. The risk factors for ovarian cancer are advanced age, early menarche, late menopause, race, nulliparity, low number of pregnancies, and family history. Even the short-term use of OCs significantly diminishes the risk of ovarian cancer, and the protective effect lasts 5-10 years. A 1983 study indicated that women using OCs had more risk of dysplasia and cancer of the cervix. The relative risk was 1.5 up to 5 years of use and 2.1 =or 10 years. Nevertheless, the causal link was neither proven nor denied, thus, such women are advised not smoke. Several investigations hinted at an increased risk of breast cancer and long-term OC use (over 8 years) with earlier preparations containing 50 mcg of EE or more. In a large study in 1986 no link was found, however, in a World Health Organization control study, a slightly significant risk was ascertained in women under 25 years who had used OC before the birth of the first child.
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PMID:[The pill and cancer of the female sex organs and breast]. 828 52

The US Food and Drug Administration finally approved the injectable contraceptive Depo-Provera (DMPA) in October 1992, 25 years after its introduction. Women return to a health facility every 90 days for an intramuscular injection of 150 mg DMPA, which provides them 99% effective contraception. Menstrual changes and spotting are the leading reasons for DMPA discontinuation. Eventually, more than 50% of DMPA users develop amenorrhea. During the first year, women gain about 2 kg and weight increases as time passes. Weight gain is the second leading reason for DMPA discontinuation. DMPA may adversely affect glucose tolerance in women at risk for diabetes, but it does not affect cardiovascular or metabolic functions. It may increase the risk of osteoporosis. A rare side effect is convulsions. 1-10% of DMPA users have other central nervous system effects, such as headaches, dizziness, and depression. Itching and rashes may develop. Fertility returns within 1 year after discontinuation. DMPA is linked to low birth weight. It apparently does not harm breast-fed infants or hinder lactation. A World Health Organization study shows that DMPA users less than 35 years old experience a slight increase in breast cancer but a reduced incidence of endometrial cancer. Nurses are instrumental in guiding women as they choose DMPA and in informing them about its potential side effects, including breast cancer risk. They must screen women for pregnancy and evaluate their risk of breast cancer. They must determine whether women are able to return every 3 months for DMPA injections. Women who select DMPA must use other contraception, e.g., barrier protection, within the first 24 hours after initial injection. Nurses should counsel them about the likely menstrual changes to reduce the likelihood of dissatisfaction. They should recommend a daily dose of 1200 mg of elemental calcium and daily exercise of long bones to minimize the risk of developing osteoporosis.
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PMID:Depo-Provera. 849 47

In 22 patients with endometrial carcinoma, Stage I-III (mean age 57.8 years) with obesity, initial and reactive hyperinsulinemia (during glucose load) was revealed. Significant correlations between values of "peak" and field-square of the insulin secretion curve and cytoplasmatic receptors to Estradiol and Progesterone in the tumor were found. In a group of the patients with high values of reactive hyperinsulinemia significantly larger amounts of steroid hormone receptors in the tumor were determined as compared to the group of the patients who had low insulinemia values. On considering these data a possible conclusion was reached as to the modifying influence of hyperinsulinemia on sensitivity of endometrial carcinoma to hormone receptor synthesis in the tumor by insulin.
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PMID:Hyperinsulinemia as a factor modifying sensitivity of endometrial carcinoma to hormonal influences. 850 Apr 94

Blood insulin level was measured in 113 breast cancer (BC) patients, 18 endometrial cancer (EC) patients, and 35 women with benign breast disease (BBD), after fasting and after 120 min of oral glucose tolerance test (OGTT). A significant increase in reactive insulin level was shown in postmenopausal BC patients with abdominal obesity (waist/hip ratio > 0.85) and no differences in insulin level were found between BC and BBD patients. Menstrual status and overweight (Quetelet index) did not influence significantly blood insulin concentration in BC patients, but the basal insulin level was lower in those patients who had been moderate smokers. In EC patients, the level of insulin after fasting and following 120 min OGTT was much higher than in BC and BBD patients although they had a similar body mass to these groups of patients. The effect of age on insulin secretion in BC patients is discussed as well as the possible causes and consequences of hyperinsulinemia developing in EC and BC patients.
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PMID:Comparative study of blood insulin levels in breast and endometrial cancer patients. 920 Dec 92


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