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

The endometrial carcinoma shows an increasing incidence and represents today the most frequent malignoma of the female pelvis. Until now all techniques of detection of this carcinoma or its precursors are invasive and thus are not suitable for screening investigations. Vaginosonography, as the first non-invasive diagnostic method, now supplies knowledge about the state of the endometrium. At the Gynaecological Department of the University of Homburg/Saar, West Germany, 221 patients had been preoperatively subjected to vaginosonography before they underwent surgery. Sonographical and histological findings corresponded in atrophic endometrium in 82%, in regular, perimenopausal endometrium in 91%, in endometrial polyps and hyperplasia of the endometrium in 56%, and in endometrial carcinoma in 79%. With regard to the detection of endometrial cancer, a specificity of 96%, a sensitivity of 93%, a positive predictive value of 79% and an accuracy of 96% were established. Thus, according to our experience, vaginosonography represents a valid, non-invasive diagnostical method as a suitable instrument for screening the endometrium.
Geburtshilfe Frauenheilkd 1991 Sep
PMID:[Value of vaginal ultrasonography in noninvasive assessment of the endometrium of the postmenopausal uterus]. 174 74

This is a retrospective study of 37 patients with endometrial carcinoma and presence of tumor on endocervical curettage (clinical Stage II). We intended to correlate the presence or absence of endocervical stromal invasion with the clinical behavior and other prognostic factors. Based on the endocervical curettage, three categories (CAT) were defined: CAT I: tumor fragments only (seven cases); CAT II: endocervical tissue and free-floating tumor fragments (13 cases); and CAT III: endocervical tissue and tumor with evidence of stromal invasion (17 cases). Five tumors were partly of clear cell and/or papillary serous types and three of them belonged to CAT I. Six of seven tumors with a nuclear Grade 3 were in CAT III (p less than 0.05). Nine patients had local recurrence, metastases, or died of their disease (median follow-up: 56 mo) and seven of them were in the CAT III (p less than 0.05). We conclude that despite the presence of tumor on the endocervical curettage, the lack of endocervical tissue invasion is associated with a lower nuclear grade and a less aggressive behavior. These tumors should be regarded and treated as Stage I disease. Special attention must be paid to staging of clear cell and papillary serous adenocarcinomas because of the tendency for these tumors to contaminate the endocervical curettage.
Mod Pathol 1991 Sep
PMID:Endocervical involvement by endometrial carcinoma on fractional curettage: a clinicopathological study of 37 cases. 175 76

A prospective, routine histologic assessment of the omentum during primary surgery was conducted on 84 women with stage I endometrial carcinoma between February 1986 and June 1989. The purpose of the study was to determine the true incidence of omental involvement in early endometrial cancer and to detect risk variables associated with such metastases. Omental metastases were found in 7 (8.3%) of 84 patients with stage I endometrial carcinoma. A majority of the metastases (five) consisted of microscopic disease. Factors statistically significantly associated with omental metastasis were adnexal spread, cul-de-sac implantation, papillary serous carcinoma, a positive retroperitoneal lymph node and grade 3 tumor. The study indicated that silent metastases to the omentum frequently are neglected clinically in patients with stage I endometrial carcinoma during primary surgery and that a routine omental biopsy should be part of the procedure. Furthermore, for patients with high-risk variables, a complete omentectomy ought to be considered.
J Reprod Med 1991 Sep
PMID:Stage I endometrial carcinoma. Role of omental biopsy and omentectomy. 177 22

90 patients with endometrial carcinoma treated from 1958 to 1984 by radiotherapy alone are presented. They constituted 18.7% of all cases of endometrial carcinoma treated in the same period. According to the clinical staging system of FIGO, there were 28.89% Stage Ia, 8.89% Stage Ib, 38.89% Stage II, 20% Stage III and 3.33% Stage IV lesions. In this series, 82 patients suffered from adenocarcinoma and 8 patients from adenoacanthoma. Two treatment regimens were adopted: 1. intracavitary Ra (137Cs or 60Co) as the major form of treatment supplemented by external irradiation in 82 patients (including 5 by intracavitary 137Cs afterloading), 2. external irradiation supplemented by intracavitary Ra (or 137Cs) radiation in 8 patients. The overall 5-year survival rate was 48.89% (Stage I 58.82%, Stage II 51.42%, Stage III 33.3% and Stage IV 0%). Complications were proctitis in 17 cases hematuria in 4 and rectovaginal fistula in 1. The 5 patients treated by intracavitary afterloading radiation with high doses at reference points A and F all survived for more than 5 years. This may imply a bright future for this form of radiotherapy in the treatment of endometrial carcinoma.
Zhonghua Zhong Liu Za Zhi 1991 Sep
PMID:[Endometrial carcinoma treated by radiotherapy alone]. 178 52

This is a report of results from a case-control study of the relationship of the long-acting progestational contraceptive, depot-medroxyprogesterone acetate (DMPA) to risk of endometrial carcinoma. Prior use of DMPA and information on known and suspected risk factors for endometrial cancer were ascertained in personal interviews with 122 women with histologically confirmed disease and 939 controls selected from 2 hospitals in Bangkok and 1 in Chiang Mai, Thailand. Based on 3 exposed cases and 84 exposed controls, the relative risk of endometrial cancer was estimated to be 0.21 (95% confidence interval = 0.06, 0.79) in women who had ever used DMPA (but who had not first used DMPA in the year prior to diagnosis). All 3 exposed cases had also received estrogens pre-menopausally. Exposure to such estrogens enhanced risk of endometrial cancer and reduced the apparent protective effect of DMPA. Although based on small numbers of exposed women, the protective effect of DMPA appeared to last for at least 8 years after cessation of use. The reduction in risk of endometrial cancer is at least as great for DMPA as for combined oral contraceptives.
Int J Cancer 1991 Sep 09
PMID:Depot-medroxyprogesterone acetate (DMPA) and risk of endometrial cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. 183 2

Progestins have biological effects of regression and differentiation on human endometrial adenocarcinoma. We investigated the effects of progestin on the induction of macrophage-colony-stimulating factor (M-CSF) and its receptor messenger RNAs in the human endometrial adenocarcinoma cell line Ishikawa which has receptors for both estrogen and progesterone. Poly(A)+RNA extracted from Ishikawa cells cultured with or without synthetic progestin R5020 was subjected to Northern blot hybridization using M-CSF and c-fms cDNA probes. The expression of M-CSF mRNA in Ishikawa cells increased about 2.3 times following treatment with R5020 at 10(-7) M. Induction of M-CSF mRNA by R5020 was antagonized by anti-progestin RU486 in a dose-dependent manner. However, c-fms mRNA, coding the M-CSF receptor, was expressed constitutively in Ishikawa cells and its expression was not affected by hormonal treatment. We further examined the biological effects of M-CSF on endometrial cancer cells. Colony formation of Ishikawa cells in soft agar, which represents anchorage-independent cell growth, was inhibited by M-CSF treatment. On the other hand, accumulation of glycogen granules in cytoplasm detected by periodicacid-Schiff staining was observed in Ishikawa cells treated with M-CSF. These results indicate that M-CSF, whose gene expression was enhanced by progestin, suppressed growth and induced differentiation of endometrial adenocarcinoma cells. These effects of M-CSF on endometrial cancer cells are similar to those of progestins, so the effects of progestins on these cells are, at least in part, probably mediated by M-CSF in an autocrine or paracrine manner.
Int J Cancer 1991 Sep 09
PMID:The biological effects of macrophage-colony-stimulating factor induced by progestin on growth and differentiation of endometrial adenocarcinoma cells. 183 4

PP-4, a recently characterized glycoprotein from human placenta was studied using a specific double-antibody radioimmunoassay in sera of 130 volunteers, 74 cervical cancer patients and 43 endometrial cancer patients. Elevated levels (greater than 3 micrograms/l) were found in 35 (47.3%) cervical cancer patients and in 18 (41.9%) endometrial cancer patients. Degree of elevation were not correlated with clinical stage, histology, and histological degree of differentiation. 36 patients with cervical cancer and 20 patients with endometrial cancer were monitored on two to seven occasions during four to 50 weeks. Rising, remaining unchanged of falling levels of PP-4 correlated with progression, stabilization or regression of disease 55.5% in patients with cervical and 65.0% in patients with endometrial cancer. During and some months after external telecobalt irradiation therapy wide range of PP-4 levels were observed in some patients. The study suggest that PP-4 can be regarded as a tumor associated protein which most likely can serve as tumor marker in cervical and endometrial cancer.
Strahlenther Onkol 1991 Sep
PMID:Initial experience with placental protein 4 (PP-4) as tumor marker in cervical and endometrial cancer. 183 44

Seventy-four patients with Stage II endometrial cancer were treated by a combination of preoperative radiation therapy followed by extrafascial hysterectomy, bilateral salpingo-oophorectomy, and paraaortic lymph node sampling at the University of Kentucky Medical Center from 1967 to 1988. All patients had histologically confirmed endometrial cancer with involvement of the endocervix. The cell types and numbers of the tumors treated were as follows: adenocarcinoma, 58; adenoacanthoma, six; adenosquamous carcinoma, nine; and clear cell carcinoma, one. Preoperative radiation consisted of 4500 cGy external therapy followed by one intracavitary implant providing an additional 2000 cGy to point A. Surgery was done 4 to 6 weeks after completion of radiation therapy. Five patients (7.1%) had paraaortic lymph node metastases. Four were treated with extended-field radiation therapy and one with platinum-based combination chemotherapy. After treatment, the patients were followed at regular intervals from 2 to 22 years (mean, 5.4 years). Eleven patients (15%) had recurrent cancer, with the vagina and upper abdomen being the most common sites of spread. The estimated 5-year and 10-year disease-free survival rates of these patients are 88% and 76%, respectively. Cell type, depth of myometrial invasion, and lymph node status were the most important prognostic variables in the patients evaluated. These data confirm that the combination of preoperative radiation therapy and surgery produces excellent long-term survival in patients with Stage II endometrial cancer.
Cancer 1991 Sep 15
PMID:Preoperative radiation therapy followed by extrafascial hysterectomy in patients with stage II endometrial carcinoma. 187 79

A distinct type of cervical involvement by endometrial cancer is reported and termed cervical implantation metastasis. It is believed to result from implantation of endometrial cancer on the denuded endocervix after fractional dilatation and curettage (D & C). The histologic criteria for diagnosis are: (1) the cervical implantation metastasis must be imbedded in the endocervical epithelium or superficial stroma surrounded by an implantation site of inflammatory cells and granulation tissue (free-floating cancer cells above the cervical mucosa are not acceptable as implantation tissue), (2) the histologic findings of the cervical implantation metastasis must be similar to those of the endometrial adenocarcinoma in the uterine corpus, (3) the cervical implantation metastasis must be separate from the primary tumor with no evidence of direct extension, and (4) the cervical implantation metastasis should be surrounded by nonneoplastic endocervical glands with no transition between the two. Of the 176 patients who underwent fractional D & C before hysterectomy, nine (5%) were found to have cervical implantation metastasis. No patients had cervical implantation metastasis who did not undergo fractional D & C before hysterectomy. When stratified according to stage, grade, and myometrial invasion, there was no statistically significant difference in the recurrence rate between patients with or without cervical implantation metastasis. It appears that cervical implantation metastasis does not alter prognosis or require specific treatment.
Cancer 1991 Sep 15
PMID:Cervical implantation metastasis by endometrial adenocarcinoma. 187 85

RU-486 is a progesterone antagonist (antiprogestin), an antiglucocorticoid, and noncompetitive antiestrogen. Further, it is 1 of 400 antiprogestins produced by at least 6 pharmaceutical companies. Research shows that RU-486 has the potential to treat endometriosis in addition to its already proven ability to terminate pregnancy. Indeed more conclusive research on antiprogestins should continue because they may have many other clinical indications. They may initiate cervical dilation and myometrial contractility adjunctive to labor and delivery. They may eventually be used as a contraceptive by preventing ovulation. Moreover, antiprogestins may slow growth of some estrogen dependent neoplasias, such as breast and endometrial cancer. They may even regulate cortisol production in Cushing's syndrome. Lastly they can evacuate a fetus who died in utero in advance pregnancy. Even though there are these potential benefits of antiprogestins that are unrelated to abortion, the politics of abortion hinder research in the US. Intimidation techniques are used to coerce the Food and Drug Administration, pharmaceutical companies, and researchers not to develop or sell any antiprogestins, especially RU-486. Narrow zealousness of 1 view point which excludes all other appropriate motives challenges logic and reason. The time has come for governmental agencies, pharmaceutical companies, researchers, and those who only consider the abortion issue to see the scientific agenda on antiprogestins more broadly. There are people other than those interested in their abortifacient qualities who need to know more about them.
Fertil Steril 1991 Sep
PMID:Antiprogestins: the political chemistry of RU486. 157 87


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