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

The clinical use of estrogens and progestogens for menopausal women is reviewed, discussing the indications, results of studies on effectiveness of various agents o each target organ, contraindications, risk-benefit ratio, and types of drug preparations available and used in European countries. The indications for menopausal hormone replacement are primarily to prevent myocardial infarction and osteoporosis, and also to treat early menopause, urogenital atrophy, and severe skin, mucous membrane and psychic disorders. Mechanisms of action of estrogens and progestins, and anticipated results are detailed for each of the indications. Contraindications typical of oral contraceptives usually do not apply for hormone replacement. For example, only severe acute liver disease, current thromboembolism, endometrial cancer other than I, and breast cancer within 3-5 years of primary treatment are contraindications. Neither cervical, ovarian or vulvar cancer, diabetes, varicose veins, hypertension, nor history of liver disease or thromboembolism are contraindications: in some cases progestins or transdermal estrogens are recommended. Estrogen side effects suggest overdosage. Progesterone or its derivatives rather than oral contraceptive progestins are prescribed. There is a clear benefit, comparing cost of medication to that of treating consequences of estrogen deficiency. The preparations currently used in Europe include oral micronized estradiol, conjugated estrogens, transdermal patches, local vaginal estrogens, and injectable estradiol esters for those who cannot tolerate oral or transdermal agents. Preparations should contain progesterone unless the woman has had a hysterectomy. Combinations designed to avoid withdrawal bleeding are available.
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PMID:Clinical use of oestrogens and progestogens. 221 69

Estrone sulfate (E1-S) has been shown to be quantitatively the most important estrogen in peripheral blood. But, the physiological and/or pathological role of E1-S is not yet clarified. At present, we tried to clarify it using tissue cultures. In tissue cultures of human endometrium, secretory endometrium showed higher activity of estrone sulfatase (E1----E1-S) than proliferative endometrium. Progesterone added in the medium induced an increase of estrone sulfotransferase in the proliferative endometrium. The results suggest a reducing effect of estrogen by progesterone in secretory endometrium in physiological conditions. Estrogen dependent malignant tumors (breast cancer, endometrial cancer) have high estrone sulfatase. It converts E1-S to E1 (----E2) which are abundant in these tumors. Ishikawa cell line increased estrone sulfotransferase activity with progesterone, somewhat like the physiological conditions. From out study in vivo, there is a possibility of some ameliorative effects of E1-S on the central nervous system of patients with senile dementia (Alzheimer's type). Effects of E1-S on central nerves were investigated using tissue cultures.
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PMID:[Tissue culture and estrogen, to clarify the roles of estrone sulfate]. 251 12

Estrogen biosynthesis (aromatase activity) was investigated in human adenomyosis tissue and compared with that of the normal myometrium, endometrium, and endometrial cancer tissues. Homogenates were incubated with [1,2,6,7-3H]androstenedione and NADPH at 37 degrees C for 1 h. After stopping the enzymatic reaction with ethyl acetate, [4-14C]estrone and [4-14C]estradiol-17 beta were added to the incubated sample. Estrone and estradiol were purified and identified by Bio-Rad AG1-X2 column chromatography, thin-layer chromatography and co-crystallization. Estrogen formed in the incubated sample was calculated from the 3H/14C ratio of the final crystal. The value for estrone formed from androstenedione was 52-132 fmol.h-1.g-1 wet weight. Aromatase activity in the adenomyosis tissues was higher than that in normal endometrial or myometrial tissues, but lower than that found in myometrial or endometrial tumour tissue. Furthermore, we investigated the effect of danazol, progesterone, and medroxyprogesterone acetate on adenomyosis cells in primary cultures. Aromatase activity in adenomyosis was blocked by danazol, but stimulated by progesterone and MPA. These results indicate that aromatase activity in adenomyosis may contribute to the growth of the ectopic endometrial tissue which occurs in this disease.
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PMID:Estrogen biosynthesis in human uterine adenomyosis. 252 61

Progesterone receptors (PR) were measured in 18 cases of endometrial carcinoma using the dextran-coated charcoal assay. The histological changes and PR levels of the endometrial carcinoma after the medroxyprogesterone acetate (MPA) treatment were studied. A higher PR levels were observed in well-differentiated tumors. After treatment with MPA, the PR content was reduced and histological appearance similar to normal endometrium was noticed. The histological changes of the tumor was closely related to the receptor levels.
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PMID:[Progesterone receptors in endometrial carcinoma and their response to medroxyprogesterone acetate]. 253 67

Specimens of endometrial carcinoma were obtained from 8 women, four of whom had previously been treated with oral medroxyprogesterone acetate 200 mg daily for 7 days. The activities of oestradiol-17 beta and isocitric dehydrogenases and nuclear oestradiol receptor concentrations were measured in the homogenised tissue and both enzymes were located histochemically. Histochemical evidence of oestradiol dehydrogenase activity was found in all but one of the specimens with biochemical activity. This anomalous specimen was obtained from a woman who had not been treated with MPA and whose endometrium exhibited only low levels of enzyme activity. The histochemical staining caused by isocitric dehydrogenase was intense but bore no relation to the biochemical measurement of enzyme activity in the homogenate. The modified technique for the histochemical demonstration of oestradiol dehydrogenase activity although not quantitative gave results similar to the biochemical methodology. It may therefore be useful as a simple test of the prediction of the sensitivity of endometrial carcinoma to progestogens.
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PMID:The histochemistry of oestradiol-17 beta and isocitric dehydrogenases in endometrial carcinoma. 260 29

Oxyprogesterone capronate (OPC) was administered preoperatively to 46 patients with endometrial tumors and tamoxifen (T) + OPC--to 72 patients. Complex treatment was followed by more pronounced pathomorphosis in tumor. Both schedules inhibited gonadotropin secretion and lowered colpocytoscopic indexes. Dual effect of complex treatment (T + OPC) on the level of cytoplasmic receptors to progesterone was observed. Initially low levels rose while high ones dropped by the end of a 20-day course. Progestin treatment in endometrial carcinoma patients with relatively low estrogen levels should be complemented with tamoxifen to stimulate tumor sensitivity to progestagens.
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PMID:[The effect of hydroxyprogesterone caproate and its combination with tamoxifen on steroid hormone receptors in the tumor and on the basic parameters of reproductive homeostasis in patients with cancer of the corpus uteri]. 281 95

Current evidence is reviewed here on risks and benefits of estrogen and progestin use by peri- and postmenopausal women in relation to the following conditions: endometrial cancer, breast cancer, osteoporosis, and coronary artery disease (CAD). On balance, estrogen therapy appears to be beneficial for menopausal women, as it probably reduces the risks of CAD and osteoporosis, two of the major causes of mortality and morbidity. Although unopposed estrogen therapy increases the risk of endometrial cancer, that cancer is relatively rare and is not fatal in the vast majority of cases associated with estrogen use. Definitive conclusions about the relation of menopausal estrogens to breast cancer cannot be drawn due to inconsistent evidence to date. Although evidence from randomized controlled trials is lacking, biochemical and clinical evidence suggest that progestin supplementation is associated with a reduction in endometrial cancer risk in women taking menopausal estrogens. Progestin supplementation also may augment the beneficial effects of estrogens in providing protection against osteoporosis, although this effect is not yet well established. There is little direct evidence bearing on the relation of menopausal progestins to breast cancer. Although studies of CAD per se are lacking at present, progestins probably unfavorably alter lipoprotein profiles, thereby increasing a user's risk of CAD. Given the relatively high incidence and mortality of CAD in postmenopausal women, any negative effects on CAD risk could potentially counterbalance beneficial effects on other causes. We conclude that estrogen replacement therapy is of potential benefit to postmenopausal women, but that the question of progestin supplementation requires further study, particularly for CAD risk.
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PMID:Benefits and risks of menopausal estrogen and/or progestin hormone use. 284 46

High-dose medroxyprogesterone acetate (HD-MPA) has been successfully employed in the treatment of hormone-related tumors, especially advanced breast cancer. However, progestins in general and MPA in particular are considered a useful treatment also in other types of tumors such as endometrial, prostatic and renal cancer. Furthermore, MPA has been evaluated in tumors which are not classically considered hormone-related, such as ovarian cancer. Therapy with one of a number of progestational agents has been the conventional approach to the management of endometrial carcinoma not amenable to surgery or radiation therapy. Among the various synthetic progestins, MPA has been the most widely employed both by i.m. and oral routes, according to a variety of doses and schedules. Objective responses have been obtained in a percentage of women varying between 30 and 50% in the different series. While the role of MPA in the palliative treatment of advanced disease is well accepted, opinion is divided on the role of progestins in the adjuvant setting. On the basis of available data, it should be concluded that the usefulness of adjuvant therapy with progestins in high risk, early-stage endometrial cancer has not yet been clearly demonstrated. As far as prostatic cancer is concerned, data coming from comparative trials show that MPA is less effective than diethylstilbestrol (DES), and therefore should not be considered the first choice for previously untreated patients. However, it can achieve responses in patients who no longer respond or who are refractory to DES, and represents the treatment of choice for those patients who, due to their cardiovascular conditions, cannot be given estrogens.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An overview of clinical trials with high-dose medroxyprogesterone acetate (HD-MPA) in endocrine-related tumors other than breast cancer. 294 Nov 73

Because of its rare occurrence in the human, the endocrinologic and receptor-related aspects of an uterine leiomyosarcoma (LMS) are poorly understood when compared to what is known of, say, human endometrial cancer. Thus, to increase our understanding, we have succeeded, by the string method, in inducing an uterine LMS in the mouse and have studied the possibility of hormonal therapy as a method of treatment. The findings of our study are enumerated as follows: 1. The induced uterine LMS had an estrogen receptor, which was confirmed by a biochemical assay and, morphologically, by a PAP (the peroxidase anti-peroxidase technique); 2. The growth of this tumor was significantly inhibited by MPA (medroxyprogesterone acetate) therapy (100 mg/kg); 3. After MPA therapy, the estrogen receptor levels were increased, especially in the nucleus; and, 4. The growth of a secondary tumor, transplanted after the initial hormone therapy, was not inhibited by the readministration of MPA. Our results suggest that this experimentally-induced uterine LMS in the mouse provides a useful means to study therapeutic treatment, and may assist in furthering our understanding of human uterine LMS and lead to finding an effective therapy.
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PMID:[Experimental study of the treatment of uterine leiomyosarcoma in the mouse with progestogen]. 297 92

The Authors studied the concentration of cytosolic and nuclear receptor for Estradiol and Progesterone in endometrial hyperplasia and carcinoma, compared with a control group. Comparative study of hormone receptor concentrations in different populations shows: 1) A significant increase in Estradiol receptors in endometrial hyperplasia (p less than 0.01); 2) A decreasing concentration of estradiol receptors with the decreasing of cellular differentiation in endometrial carcinoma (p less than 0.01); 3) A similar tendency and significance for Progesterone receptors; 4) For both receptors the tendency in the nuclear compartment is similar to that in cytosol but the significance is smaller (p less than 0.05).
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PMID:Hormonal receptors in endometrial neoplasias. 297 93


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