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

Progesterone has been the first isolated gestagen. After a short review on the physiology of secretion of progesterone some pharmacologic actions are considered by the authors. Among gestagens, derivatives of pregnane are of special interest, particularly because of fewer, notably androgenic, side effects. After reviewing commercial French and Swiss products the authors focus on three applications: the premenstrual syndrome where progesterone is of interest for local and systemic administration the perimenopause in which several pathologies treatable by gestagens occur Finally the menopause in which progesterone is important in view of its physiologic role. Among the reasons to use progesterone combined with estrogens during menopause, prevention of endometrial cancer is the most important but other advantages are also noted. The authors discuss risk factors for breast cancer during treatment with gestagens in menopause. Finally the authors review compliance and underline the importance of new treatment schedules for the menopause: Continuous treatment, on-demand treatment or menstruation every 3 months.
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PMID:[Progesterone, progestagens in premenstrual syndrome, the perimenopause and the menopause]. 784 31

Endometrial hyperplasia was proposed as a predecessor to endometrial carcinoma already at the end of the 19th century. However, there have been different opinions regarding this view. The treatment also varies, but generally cyclic progesterone at a dose of 10 mg a day is used. In order to investigate whether endometrial hyperplasia is a premalignant state and also whether a high-dose gestagen treatment would cure a high proportion of these patients, a prospective randomised study was started in 1982. We now present the 5 year follow-up consisting of 82 patients treated with high-dose gestagen. In this study 19 out of 82 patients had hysterectomies (2 due to hyperplasia and 11 due to bleeding), almost the same frequency as in a previous report with patients followed-up with abrasio only, but now mainly due to bleeding problems. In summary, no carcinoma developed and the hyperplasia was cured with 500 mg MPA i.m. twice weekly for three months. However, the bleeding problems, though almost always only spotting, remained, leading to a frequency of hysterectomy that was still too high. We find latter clinical problem an enigma. Further studies are therefore in progress in our group which try to identify other treatment modalities for those patients with bleeding problems or who redeveloped hyperplasia after abrasio, in order to avoid hysterectomies.
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PMID:Spontaneous endometrial hyperplasia. A 5 year follow-up of 82 patients after high-dose gestagen treatment. 787 26

An adequate calcium intake is important to attain peak bone mass and to oppose that component of age-related bone loss due to insufficient intestinal calcium absorption. Calcium and appropriate vitamin D supplements are particularly important for preventing cortical bone loss and associated hip fractures in the elderly (Type II osteoporosis). Within the initial 5 years following menopause, there is an accelerated loss of trabecular bone from the spine and distal radius (Type I osteoporosis). At that time, estrogen replacement is most effective for preventing the rapid trabecular bone loss that could otherwise result in vertebral or Colles' fractures. During this early period of estrogen deficiency when excessive bone turnover is releasing large amounts of calcium into the circulation, supplemental calcium is ineffective. Progesterone, often given with estrogen to prevent endometrial carcinoma, may itself have a trophic influence on bone.
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PMID:Calcium, estrogen, and progestin in the treatment of osteoporosis. 798 85

We reviewed 94 cases of complex endometrial hyperplasia (CH) with and without atypia to assess some of the clinical and pathologic changes observed on curettage and in hysterectomy specimens. Age, parity, height, weight and nomograms did not differ between CH with or without atypia, and CH associated with endometrial carcinoma. CH without atypia, however, predicted lesser degrees of malignancy as compared to CH with atypia. Progesterone or progestinlike treatment is indicated for CH without atypia along with endometrial monitoring, but CH with atypia necessitates diagnostic and therapeutic hysterectomy whenever fertility is not a priority.
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PMID:Complex hyperplasia of the endometrium. Predictive value of curettage vs. hysterectomy specimens. 799 30

An attempt was made to examine the efficiency of the progesterone test and uterus sonography for ten-years period. The progesterone test was used for 621 patients, most of them from the University Obstetrics and Gynaecological Hospital in the town of Varna. Department of Obstetrics and Gynaecology as well as at the National Oncological Centre, Gynaecological Clinic--Sofia during the last few years. There have been found out deep knowledge in epidemiology, etiology and the present possibilities for early diagnostics of the endometrial cancer. All patients of a total number of 621 were in the postmenopausal period and received Progesterone as one-time medical administration. In 44 women bleeding occurred, and 31 of them agreed to undergo abrasio probatoria. 354 out of these 621 patients were examined by ultrasound B-picture after about 6 months to 1 year. 31 cases needed to be cleared-out additionally. The abrasio probatoria done later showed full correspondence to the ultrasound images with the exception of 6 cases. In 15 cases was found polyps endometrial, in 9 cases--atypical glandular hyperplasia, in one case--carcinoma in situ and in 6 cases--early endometrial cancer.
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PMID:[The early detection and screening of endometrial carcinoma by the progesterone test and uterine sonography]. 801 Mar 94

Hormonal agents have been used to treat endometrial cancer since the early 1960s. The response rate for patients with advanced or recurrent endometrial cancer subjected to gestagen therapy has been reported to be about 30%. However, the analysis of the action mechanism of gestagen on endometrial cancer is not complete. Since oral administration of high dose MPA has begun, thrombosis has been reported as an uncommon but severe side effect. The risk factors for thrombosis in patients having gestagen therapy were clarified in the report published by the Ministry of Welfare in 1992. This report emphasized the importance of patient selection for gestagen therapy and cautious management. Besides gestagen therapy, antiestrogen therapy has been tried for the treatment of endometrial cancer. However, tamoxifen therapy was not so effective compared with gestagen. Moreover, antiestrogen-gestagen combination therapy and chemo-endocrine therapy are on trial recently. These trials are attempts to find a more effective regimen for the treatment of endometrial cancer. A recent theme in the study of hormonal therapy is basic investigation concerning the effect of MPA upon the action of growth factor and oncogene expression in endometrial cancer cells. These studies may lead to a molecular biological explanation of the action mechanism of gestagen therapy in future.
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PMID:[Hormonal therapy in endometrial cancer]. 825 43

Paraffin-embedded materials obtained from 117 cases of endometrial hyperplasia and 84 cases of carcinoma were used for measurement of both ki-ras and p53 gene mutation and aromatase (ARO) and TGF-alpha immunostaining. The overall incidence of ki-ras mutations in the hyperplasia specimens (16%) was similar to the incidence detected in carcinomas (18%). None of 117 endometrial hyperplasias were found to have mutations in the p53 gene, whereas mutations were seen in 3 (13.3%) endometrial carcinomas. The intensity of both ARO and TGF-alpha immunostaining was increased in glands of both hyperplasia and carcinoma, and also in the interstitium of carcinoma. The positive sites of both ARO and TGF-alpha were almost the same, with an incidence below 40% in both hyperplasias and carcinomas. The cultured cells of endometrial carcinoma showed aromatase activity below MCF-7 cells, because testosterone was converted to estradiol (E2). TGF-alpha induced cell growth with at an optimal concentration. In HEC-59 cells, TGF-alpha increased both ARO-activity and mRNA. Some promoters on ARO-exon 1 in HEC-59 cells were different from those in BeWo cells. Progesterone inhibited the E2-induced excretion of pre TGF-alpha in endometrial carcinoma cells. These findings suggest that endometrial hyperplasia can be a premalignant condition of carcinoma, and can be initiated by both ki-ras codon 12 mutation and abnormal activity of ARO induced by TGF-alpha. In addition, HEC-59 cells may possess autocrine/paracrine properties involving ARO, E2 and TGF-alpha.
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PMID:[Aromatase activities of endometrial carcinomas and both basic and clinical analyses of endometrial hyperplasia as a premalignant disease]. 837 Oct 7

Combination oral contraceptive (COC) users have reduced risks of ovarian and endometrial cancer, but COCs have not reduced breast cancer risk. We have previously argued that a hormonal contraceptive with substantially lower doses of sex-steroids should reduce breast cancer risk by decreasing the breast epithelial cell proliferation below usual premenopausal levels. We report here the preliminary results of a pilot trial with such a prototype contraceptive consisting of an agonist of gonadotropin releasing hormone (GnRHA) administered with low doses of an oral estrogen (0.625 mg of conjugated estrogen, CE, for 6 days every week) and intermittent oral progestogen (10 mg of medroxyprogesterone acetate, MPA, for 13 days every 4 months). Eighteen subjects at five-fold or greater increased breast cancer risk were entered and randomized -12 to the contraceptive arm and 6 to a control arm. The principal endpoints included tolerance of the regimen, vaginal bleeding patterns, and the regimen's effect on the endometrium, bone metabolism, and lipids. A symptom questionnaire was used to assess tolerance; the contraceptive subjects had fewer symptoms following initiation of the regimen. This results from the elimination of symptoms associated with the luteal phase of the menstrual cycle, commonly referred to collectively as premenstrual syndrome, PMS. The few occurrences of hot flushes or vaginal dryness that did occur were eliminated by small increases in estrogen dose (0.9 mg CE). Scheduled vaginal bleeding occurred associated with most periods of progestogen administration. Unscheduled bleeding or spotting was infrequent and decreased with time on the regimen. A beneficial rise in high-density lipoprotein cholesterol was evident in the contraceptive subjects. Despite the use of an estrogen dose which is known to prevent loss of bone mineral density in normal postmenopausal women, an annualized loss of 1.9% was seen in contraceptive subjects. It is hypothesized that this is secondary to inhibition of ovarian androgen production by the GnRHA, which may additionally account for changes in libido occasionally reported with GnRHA. The study continues with the addition of a small dose of androgen to replace that lost by the action of the GnRHA.
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PMID:Pilot trial of a gonadotropin hormone agonist with replacement hormones as a prototype contraceptive to prevent breast cancer. 839 Mar 40

To study the early effects of steroid hormones on cells we investigated the influence of the sex steroids and tamoxifen on phospholipid turnover in endometrial carcinoma and breast cancer cells. Studies were performed on 19 human uterine adenocarcinomas and 29 breast cancer tumors. Progesterone in a final concentration of 10(-7) mol/l caused a twofold decrease of 32P incorporation into phospholipids (phosphatidylcholine and phosphoinositides) in 85% of the uterine adenocarcinomas where the progesterone receptor (PR) content was more than 100 nmol/kg and only in 30% of the tumors where the PR content was less than 100 nmol/kg. Treatment of the cells with 10(-8) mol/l 17 beta-estradiol or 10(-8) mol/l epidermal growth factor led to an increase in 32P incorporation into phospholipids. Analysis of the hormonal responsiveness of 29 human breast cancers showed that 17 beta-estradiol increased 32P incorporation into phospholipids in 47% of the tumors where the estradiol receptor (ER) content was more than 10 nmol/kg and in 21% of the receptor-negative tumors (ER < 10 nmol/kg) The results show that phospholipid turnover in uterine and breast cells can be regulated by sex steroids. Treatment of the breast cancer cells with the antiestrogen tamoxifen (10(-6) mol/l) led to an increase of 32P incorporation into phosphoinositides and a decrease of 32P incorporation into phosphatidylcholine. Addition of an activator of protein kinase C, i.e. 2 x 10(-7) mol/l 12-0-tetradecanoylphorbol-13-acetate, weakened the inhibitory effect of tamoxifen on phosphatidylcholine turnover. These findings suggest that tamoxifen action can be mediated via an alteration of the growth signal transducing system.
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PMID:Regulation of phospholipid turnover by steroid hormones in endometrial carcinoma and breast cancer cells. 839 60

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


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