National Cancer Institute®
Last Modified: June 1, 2002
UI - 11803862
AU - Ivanov S; Khadzhiolov N; Ivanov S
TI - [Expression of p53 protein in women with endometrial cancer]
SO - Akush Ginekol (Sofiia) 2001;40(4):14-5
Many oncogenes and tumour suppressor genes are connected with the steps of carcinogenesis. Fifteen patients with endometrial cancer were immunohistochemically examined for the presence of abnormal p53 protein. The immunopositivity was comparted in the cancer tissues and analyzed with the conventional clinicopathological prognostic factors as grade, stage, depth of myometrial invasion, lymph-vascular space invasion, metastases in the lymph nodes and metastases in the abdominal cavity. Abnormal expression of p53 was observed in 7 women with endometrial cancer and in 5 patients we observed moderate cytoplasmatic reaction for BCL-2. The correlation between the positive reaction reaction for p53 and BCL-2 means more aggressive tumor, respectively is a bad prognostic factor. The overexpression of p53 is a very important parameter for the progression of the endometrial cancer.
UI - 11803869
AU - Ivanova V; Karaivanov M; Marinov E; Gorchev G; Raicheva S
TI - [Umbilical metastasis - "Sister Joseph's nodule" of an endometrial adenocarcinoma: a case report and review of the literature]
SO - Akush Ginekol (Sofiia) 2001;40(4):33-6
The umbilical metastatic lesions have been termed the "Sister Joseph nodule" by Sir Hamilton Bailey in 1949. SJN is an important diagnostic finding, as it often is the first clue and sometimes the only physical indication of an advanced intra-abdominal malignancy. SJN is most often associated with malignancy of the stomach or ovary. It usually appears late in the course of neoplastic disease and suggests a poor prognosis. In our review of English language medical literature we could find only 27 reports of SJN in endometrial adenocarcinoma. We offer a case of SJN, presenting as umbilical hernia, in a female patient, who, 12 years previously, had undergone laparotomy with total hysterectomy and bilateral salpingo-oophorectomy for endometrial adenocarcinoma. Three years after the surgical excision of the umbilical lesion, the patient underwent surgery for a tumor located subcutaneously in the suprapubic area. Histologically, in the samples obtained with both surgical interventions, endometrioid adenocarcinoma with squamous differentiation was found. The clinical examination and imaging studies found no evidence of other metastases. On the basis of clinico-pathological analysis we offer a hypothesis about development of metastases and discuss their prognostic significance.
UI - 11932216
AU - Hoskin PJ; Bownes P; Summers A
TI - The influence of applicator angle on dosimetry in vaginal vault brachytherapy.
SO - Br J Radiol 2002 Mar;75(891):234-7
AD - Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK.
In vaginal vault brachytherapy, the critical normal tissues are bladder and rectum; doses to these tissues may be affected by the position of a single line applicator placed in the vagina. Dosimetry with the applicator lying at its "natural" angle in the vagina with the patient in the lithotomy position has been compared with the applicator held horizontal as defined by a spirit level in 30 consecutive patients. A mean change in angle of 19.7 degrees was found. This resulted in a mean decrease in ICRU (International Commission of Radiation Units and Measurements) rectal point dose when the applicator is horizontal of 12.9%, equivalent to a mean absolute dose reduction of 1.3 Gy for a prescription dose of 5.5 Gy at 5 mm depth. An increase in mean dose to the ICRU bladder point when the applicator is horizontal of 13.3%, equivalent to an absolute mean dose increase of 0.5 Gy per fraction for the same prescription dose, was also found. On the basis of these findings, it is recommended that vaginal vault brachytherapy is performed with a single line source held in the "corrected" horizontal position to reduce bowel dose as this is the most sensitive critical normal tissue.
UI - 11967486
AU - Montz FJ; Bristow RE; Bovicelli A; Tomacruz R; Kurman RJ
TI - Intrauterine progesterone treatment of early endometrial cancer.
SO - Am J Obstet Gynecol 2002 Apr;186(4):651-7
AD - Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Hospital and Medical Institutions, Baltimore, MD 21287, USA..
OBJECTIVE: Our purpose was to assess the feasibility of using a progesterone-containing intrauterine device (IUD) to treat presumed Federation Internationale Gynecologie et d'Obstetrique (FIGO) stage IA, grade 1 endometrioid cancer in women at high risk for perioperative complications. STUDY DESIGN: Candidates were women with American Society of Anesthesiologists class III or IV grade 1 endometrioid cancer and no imaging evidence of myometrial invasion. Subjects underwent hysteroscopy, curettage, and IUD placement, followed by endometrial biopsy every 3 months for 1 year. The records of similar patients treated surgically during the 3 years before protocol initiation were reviewed for comparison. RESULTS: Sixteen patients fulfilled study criteria. Fourteen consented to participation; one was excluded at the time of IUD placement (grade 2 disease identified) and one was lost to follow-up. Twelve subjects have been followed up to 36 months; results of biopsies were negative in 7 of 11 at 6 months and 6 of 8 at 12 months. No IUD-related complications, except for expulsion, occurred. Sixteen complications (one fatal) occurred in 9 of the 15 control patients. CONCLUSION: Intrauterine progesterone appears to eradicate some cases of presumed stage IA, grade 1 endometrioid cancer in women at high risk for perioperative morbidity.
UI - 11967489
AU - Goldstein SR; Monteagudo A; Popiolek D; Mayberry P; Timor-Tritsch I
TI - Evaluation of endometrial polyps.
SO - Am J Obstet Gynecol 2002 Apr;186(4):669-74
AD - Department of Obstetrics & Gynecology, Division of Obstetrics and Gynecology Pathology, New York University School of Medicine, New York, NY, USA. firstname.lastname@example.org
OBJECTIVE: Endometrial polyps are relatively common in all groups of women. More polyps are being diagnosed with the widespread use of transvaginal ultrasound scanning and sonohysterography. The reported incidence of malignancy is low. The potential benefit of a noninvasive technique to distinguish benign from malignant polyps is obvious. This study was undertaken to evaluate endometrial polyps by color flow Doppler ultrasound scanning and histopathologic examination. STUDY DESIGN: This was an observational study of patients with an endometrial polyp on sonohysterography who underwent interrogation of their polyp with color Doppler ultrasound scanning and subsequently polypectomy. Polyp volume, resistive index, pulsatility index, indication for scan (bleeding vs incidental), and patient age were correlated with histopathologic type of the polyp (nonfunctional, proliferative, secretory, hyperplastic, or malignant). RESULTS: Of 61 patients studied, 42 patients (68.9%) were scanned for abnormal bleeding, and 19 patients (31.1%) had their polyps discovered incidentally. There were no statistically significant differences between histologic categories and the resistive index, pulsatility index, or size of the polyp. The age of patients with nonfunctional polyps was significantly greater than any other group (P <.001). Ninety-four percent of the functional polyps were discovered because of abnormal bleeding; 38% of the nonfunctional polyps were discovered incidentally (P <.001). CONCLUSION: The data suggest that the objective assessment of blood flow impedance (resistive index, pulsatility index) in endometrial polyps and the size of these polyps cannot replace surgical removal and pathologic evaluation to predict histologic type. Patients with nonfunctional polyps were older and less likely to have vaginal bleeding.
UI - 11967490
AU - Cain JM; Zaino R; Shearer D; Bennett RA; Olt G; Weisz J
TI - Expression of a retinol dehydrogenase (hRoDH-4), a member of the retinol/steroid dehydrogenase family implicated in retinoic acid biosynthesis, in normal and neoplastic endometria.
SO - Am J Obstet Gynecol 2002 Apr;186(4):675-83
AD - Department of Obstetrics and Gynecology, Pennsylvania State University College of Medicine, Hershey, USA.
OBJECTIVE: Retinoic acid plays an essential role in epithelial differentiation, and retinoid homeostasis is disrupted in cancers of epithelial origin. The goal of this study was to determine whether hRoDH-4, an enzyme that can catalyze the first and rate-limiting step in retinoic acid biosynthesis, is expressed in normal endometrium and, if so, whether its expression is altered in endometrial cancer. STUDY DESIGN: Proliferative, secretory, hyperplastic, and neoplastic endometria were examined by immunocytochemistry for hRoDH-4 protein and by reverse transcriptase-polymerase chain reaction for the hRoDH-4 transcript. RESULTS: In proliferative and secretory glandular epithelia, immunoreactive hRoDH-4 was uniformly present. In endometrial cancers, hRoDH-4 immunoreactivity was markedly reduced in many neoplastic epithelial cells. Expression of hRoDH-4 in normal and neoplastic endometrium was confirmed by findings on reverse transcriptase-polymerase chain reaction. CONCLUSION: These findings are consistent with the hypothesis that altered expression of enzymes essential for in situ retinoic acid biosynthesis is an important phenotypic change associated with the development of endometrial cancer.
UI - 11803101
AU - Vosse M; Renard F; Coibion M; Neven P; Nogaret JM; Hertens D
TI - Endometrial disorders in 406 breast cancer patients on tamoxifen: the case for less intensive monitoring.
SO - Eur J Obstet Gynecol Reprod Biol 2002 Feb 10;101(1):58-63
AD - Gynaecologic Surgery Department, Jules Bordet Institute, Brussels, Belgium.
OBJECTIVES: To describe the endometrial appearance in postmenopausal breast cancer patients on tamoxifen and to assess a routine surveillance scheme for endometrial lesions. STUDY DESIGN: Three hundred and seventeen postmenopausal breast cancer women already on tamoxifen at the start of the study (group I) and 89 breast cancer women assessed before any tamoxifen intake (group II) underwent an initial and then yearly scans with transvaginal ultrasonography, followed by an hysteroscopy and biopsy for women with an endometrium thickened above 8mm. Endometrial thickness was also measured in 823 women with no breast cancer nor tamoxifen intake (group III). RESULTS: Initial mean endometrial thickness was 8.2mm in group I, 4.4mm in group II and 3.4mm in group III (P<0.001). Eighteen percent endometrial lesions were found in group I and 3.3% in group II. We observed a significant association between endometrial pathology and both cumulated dose and total duration. Polyps were the most frequent and first to appear pathology. Five cancers were detected in group I, and all of them had taken tamoxifen for more than 3 years. CONCLUSION: Our surveillance scheme could be lightened; an acceptable screening scheme might include a baseline assessment before the start of tamoxifen and, if normal, yearly screening after 3 years of tamoxifen therapy, yearly surveillance for women with an abnormal baseline assessment and immediate investigation for symptomatic women.
UI - 12014748
AU - Caporale A; Giuliani A; Cosenza UM; Cannaviello C; Benvenuto E; Angelico
TI - F Leiomyosarcoma of the rectum after pelvic radiation therapy for endometrial carcinoma.
SO - Am J Gastroenterol 2002 May;97(5):1270-1
UI - 11972382
AU - Brooks SE; Mullins CD; Guo C; Chen TT; Gardner JF; Baquet CR
TI - Resource utilization for patients undergoing hysterectomy with or without lymph node dissection for endometrial cancer.
SO - Gynecol Oncol 2002 May;85(2):242-9
AD - Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland Schools of Medicine and Pharmacy, 405 W. Redwood Street 3rd Floor, Baltimore, MD 21201, USA. email@example.com
OBJECTIVE: The objective was to study the association of age, comorbid illness, race, and type of hospital with resource use in patients undergoing hysterectomy and lymph node dissection for endometrial cancer. METHODS: The study was a population-based analysis of patients undergoing hysterectomy with a diagnosis of endometrial cancer in Maryland 1994-1996. Chi-square and t tests determined differences in means or proportions. Multivariate logistic regression methods were used to build predictive models. RESULTS: The 1281 women underwent total abdominal hysterectomy, 91%; total vaginal hysterectomy, 6%; radical hysterectomy, 2.5%, laparoscopically assisted total vaginal hysterectomy, 0.3%; 32% also underwent lymph node dissection. Neither age, nor race, nor comorbid illness influenced admission to teaching hospitals. Co-morbidity was documented in 56% of cases. African Americans were more likely to have one (P = 0.002) or >1 co-morbid illness (P = 0.045) than Caucasians. The most common complications were anemia (13.6%), infection/fever (12%), cardiac (9.4%), pneumonia (8%), ileus (5%), and bowel obstruction (5%). These complications occurred with higher frequency in teaching hospitals (P = 0.0001), In large hospitals (P = 0.0001), and in African American patients compared to Caucasians (P = 0.028). Multivariate regression analysis revealed that older age, admission to teaching or large hospitals, lymph node dissection, heart disease, and African American race were associated with significantly higher resource use. CONCLUSION: We documented age and racial/ethnic differences in comorbid illness, complications, and resource utilization for patients undergoing hysterectomy for endometrial cancer. The differences in resource use for teaching hospitals may be reflective of the severity of complications, which are indirectly determined by length of stay. Given the higher costs and skills required to care for elderly women with comorbid disease and complications, quantification of the complexity of care is of utmost importance for allocation of sufficient resources for the care of women with endometrial cancer. (c) 2002 Elsevier Science (USA).
UI - 11986776
AU - Terry PD; Miller AB; Rohan TE
TI - A prospective cohort study of cigarette smoking and the risk of endometrial cancer.
SO - Br J Cancer 2002 May 6;86(9):1430-5
AD - Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, NY 10461, USA. firstname.lastname@example.org
Case-control studies have shown inverse associations between cigarette smoking and endometrial cancer risk. However, two small prospective cohort studies have not clearly supported an association. Moreover, quantitative measures of smoking have been examined infrequently. Our aim was to study the association between smoking and endometrial cancer risk in a large prospective cohort. We used proportional hazards models to estimate hazard ratios relating cigarette smoking to endometrial cancer risk among 70 591 women aged 40-59 years at recruitment into a randomised controlled trial of mammography screening for breast cancer. During an average of 10.6 years of follow-up (751 833 person-years), a total of 403 women were diagnosed with incident endometrial cancer. We found that a reduced endometrial cancer risk was evident only among women who currently smoked 20 cigarettes per day or more (hazard ratio=0.62, 95% CI=0.42-0.92, P for trend=0.03). There was some suggestion of an inverse association with smoking duration, but this was less clear. The association did not vary with menopausal status, relative body weight, or the use of hormone replacement therapy, but it appeared to be stronger among parous than nulliparous women. The underlying biological mechanisms of this association remain unclear. Copyright 2002 Cancer Research UK
UI - 12032853
AU - Wang Z; Kyo S; Maida Y; Takakura M; Tanaka M; Yatabe N; Kanaya T;
TI - Nakamura M; Koike K; Hisamoto K; Ohmichi M; Inoue M Tamoxifen regulates human telomerase reverse transcriptase (hTERT) gene expression differently in breast and endometrial cancer cells.
SO - Oncogene 2002 May 16;21(22):3517-24
AD - Department of Obstetrics and Gynecology, Kanazawa University, School of Medicine, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
Tamoxifen is widely applied as an antiestrogenic agent for adjuvant therapy in the treatment of breast cancer, while its estrogen-agonistic activity occasionally causes proliferative disorders or carcinogenesis at other sites, such as the uterus. We reported that estrogen activates telomerase in breast and endometrial cancer cells. The present study examines the effects of tamoxifen on the gene expression of human telomerase reverse transcriptase (hTERT) in breast and endometrial cancer cells. Tamoxifen inhibited the cell growth of MCF-7 cells, as well as hTERT mRNA expression in the presence of estrogen (E2), antagonizing the E2 effects. In contrast, tamoxifen stimulated the growth of Ishikawa cells and activated hTERT mRNA expression in the absence or presence of E2, exhibiting estrogen-agonistic action. Transient expression assays revealed that these actions of tamoxifen are achieved by transcriptional regulation of the hTERT promoter. An estrogen responsive element (ERE) in the hTERT 5' regulatory region was partly responsible for both the E2-antagonistic and -agonistic actions of tamoxifen. Tamoxifen activated the MAP kinase cascade in Ishikawa cells, but not in MCF-7 cells, and the activation of hTERT mRNA expression was effectively blocked by MEK inhibitor, suggesting that the MAP kinase pathway is involved in the tamoxifen-induced activation of hTERT. These findings indicate that tamoxifen regulates hTERT expression in a cell-type specific manner. Tamoxifen-induced activation of hTERT may be one component of estrogen agonistic function of tamoxifen that is involved in endometrial carcinogenesis induced by this agent.
UI - 12001116
AU - Salvesen HB; Stefansson I; Kalvenes MB; Das S; Akslen LA
TI - Loss of PTEN expression is associated with metastatic disease in patients with endometrial carcinoma.
SO - Cancer 2002 Apr 15;94(8):2185-91
AD - Department of Pathology, The Gade Institute, Haukeland University Hospital, Bergen, Norway. email@example.com
BACKGROUND: The PTEN tumor suppressor gene frequently is involved in endometrial carcinoma. Loss of heterozygosity and mutations reportedly are common, although the biologic importance of these changes remain largely unknown. The objective of this study was to assess the pattern of PTEN expression by immunohistochemistry in a large series of patients with endometrial carcinoma. METHODS: A population-based series of 316 patients with endometrial carcinoma who had long and complete follow-up was investigated for PTEN expression and its correlation with clinicopathologic variables, tumor markers, and survival. RESULTS: PTEN protein expression was mainly cytoplasmic in tumor cells, with no expression seen in 56 of 279 patients (20%) who had evaluable results. A heterogeneous staining pattern was found in 70 tumors (25%). A significant association between the loss of PTEN expression and metastatic disease was identified (P = 0.05). However, PTEN staining did not influence survival significantly. CONCLUSIONS: The loss of PTEN expression is relatively frequent in endometrial carcinoma and is associated significantly with metastatic disease. This indicates that the PTEN system plays an important role in some endometrial carcinomas, but further studies of PTEN protein expression related to various genetic alterations are necessary. Copyright 2002 American Cancer Society.
UI - 12001117
AU - Wang CB; Wang CJ; Huang HJ; Hsueh S; Chou HH; Soong YK; Lai CH
TI - Fertility-preserving treatment in young patients with endometrial adenocarcinoma.
SO - Cancer 2002 Apr 15;94(8):2192-8
AD - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
BACKGROUND: Hormone therapy alone for early-stage, low-grade endometrial carcinoma arising in young women has been reported occasionally in case reports or small series. However, a comprehensive guideline for selection, treatment, and follow-up is not available as yet. METHODS: In the current study, the authors' evaluated the outcome of a cohort of young women with clinically diagnosed endometrial adenocarcinoma Stage IA, Grade 1 who were selected for fertility-preserving treatment by stringent staging procedures and treated in a standard protocol using combinations of megestrol acetate, tamoxifen, and gonadotropin-releasing hormone analog (GnRHa). RESULTS: Nine eligible patients were treated between 1991 and 1999. The median age of the patients was 32 years (range, 30-39 years). Of the 9 patients, 8 (88.9%) achieved complete remission after hormone therapy. Four patients had ever conceived (two patients had three term pregnancies and underwent consolidation hysterectomy after completion of family planning). Only one patient underwent hysterectomy for failure to respond, whose tumor was estrogen receptor (ER)/progesterone receptor (PgR) positive by immunostaining but negative by ligand-binding method. Another patient, whose tumor was ER negative/PgR positive, had residual carcinoma on the first assessment and achieved complete remission after replacement of tamoxifen with a GnRHa. Four responders later developed recurrent endometrial carcinoma. One underwent immediate hysterectomy. Two were successfully re-treated with hormone therapy, but the other did not respond and underwent hysterectomy. All nine patients have been alive without evidence of disease 25-113 (median, 69) months from initial diagnosis. CONCLUSIONS: The treatment strategy described in the current study is feasible. A larger multicenter trial of fertility-preserving treatment is warranted for nulliparous young patients with well selected Stage I, Grade 1, endometrial adenocarcinoma. Copyright 2002 American Cancer Society.
UI - 11987573
AU - Kudela M; Pilka R; Dzvincuk P; Lubusky D; Duskova M
TI - [Risks in hysteroscopy in patients with endometrial carcinoma--a prospective clinical study]
SO - Ceska Gynekol 2002 Mar;67(2):74-8
AD - Gynekologicko-porodnicka klinika, UP LF a FN Olomouc.
OBJECTIVE: The evaluation of the risk of hysteroscopy (HSC) in patients with endometrial carcinoma with regard to the dissemination of disease and the deterioration of its prognosis. DESIGN: A prospective multicentric study. SETTING: Department of Obstetrics and Gynaecology and Institute of Pathology of the Palacky Univerzity Medical School and University Hospital, Olomouc; Obstetrical and Gynecological Departments of collaborating hospitals. METHODS: Two groups of patients with endometrial carcinoma were compared on the basis of cytological examinations from the peritoneal cavity. The study group (n = 156) consisted of patients whose diagnosis was made on the base of HSC and targeted biopsy. The control group (n = 71) included patients with the classical D&C. Both groups were comparable as to the distribution of clinical stages of the disease (P < 0.05). Cytological examinations were performed from the fluid obtained by the puncture of the cul de sac at the end of the HSC procedure and from the peritoneal lavage at the beginning of the following operation. Results of both groups were compared and statistically evaluated. RESULTS AND CONCLUSIONS: The comparison of the cytological findings from the punctures of the cul de sac after the HSC and from the lavages at the following operation did not show an increased penetration of malignant cells from the uterus into the abdominal cavity. Similarly, the comparison of cytological findings from the peritoneal lavages after HSC and probatory curettage did not show a statistically significant difference between both groups. We assume that HSC does not increase the risk of dissemination of tumour cells into the peritoneal cavity and does not deteriorate the prognosis of the disease.
UI - 12015762
AU - Koul A; Willen R; Bendahl PO; Nilbert M; Borg A
TI - Distinct sets of gene alterations in endometrial carcinoma implicate alternate modes of tumorigenesis.
SO - Cancer 2002 May 1;94(9):2369-79
AD - Department of Oncology, Lund University Hospital, Lund, Sweden. firstname.lastname@example.org
BACKGROUND: Endometrial carcinomas seem to carry a different prognosis depending on the presence or absence of concomitant complex atypical hyperplasia (hyperplasia). The molecular genetic profile of these two pathogenetic types, based on the genes reportedly mutated in these cancers, remains to be defined. Although microsatellite inability is reported in approximately 25% of endometrial carcinomas, its relation with the 2 pathogenetic types is not investigated. METHODS: To elucidate their underlying genetic changes, we analyzed 53 sporadic endometrial tumors, including 19 with and 34 without hyperplasia, for microsatellite instability (MSI), DNA ploidy (by flow cytometry), and for mutations in different genes. RESULTS: Microsatellite instability was present in 21%, DNA nondiploidy in 15%, and mutations in the PTEN, KRAS, CTNNB1/beta-catenin, TP53, and CDKN2A genes were detected in 32, 11, 13, 17, and 0% of the tumors, respectively. Microsatellite instability and mutations in these genes were present in tumors both with and without complex atypical hyperplasia. All cases with complex atypical hyperplasia were early stage (I-II) endometrioid tumors and associated with long progression free disease (P = 0.0004). Furthermore, most tumors with hyperplasia had low World Health Organization or International Federation of Gynecology and Obstetrics grade, had less myometrial invasion, and showed expression of estrogen receptors. All MSI tumors were diploid and had a significantly higher rate of PTEN mutations, but similar rates of KRAS, beta-catenin, and TP53 mutations compared with microsatellite stable tumors. TP53 mutations more often were found in nondiploid tumors but never in tumors with PTEN, KRAS, or beta-catenin mutations, and all PTEN mutations occurred in diploid tumors. CONCLUSIONS: Thus, PTEN, KRAS, beta-catenin, and TP53 mutations occurred in tumors both with and without hyperplasia, but PTEN and TP53 mutations were more common in tumors without hyperplasia. However, none of these genes seems to clearly distinguish tumors with and without hyperplasia, suggesting that other factors may be involved. Conversely, alterations in the PTEN and TP53 genes seem to define distinct subgroups of endometrial carcinoma, the former associated with diploidy and MSI, the latter with macroscopic chromosomal instability. Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10498
UI - 12015776
AU - Planck M; Rambech E; Moslein G; Muller W; Olsson H; Nilbert M
TI - High frequency of microsatellite instability and loss of mismatch-repair protein expression in patients with double primary tumors of the endometrium and colorectum.
SO - Cancer 2002 May 1;94(9):2502-10
AD - Department of Oncology, the Jubileum Institution, University Hospital, Lund, Sweden. email@example.com
BACKGROUND: Patients with the familial syndrome hereditary nonpolyposis colorectal carcinoma (HNPCC) exhibit an increased risk for several tumor types, of which the greatest lifetime risk is for colorectal and endometrial carcinoma. HNPCC is caused by a germline mutation in one of several identified mismatch repair (MMR) genes and typically presents with microsatellite instability (MSI) and frequent loss of MMR protein expression in the tumor tissue. The objective of this study was to estimate the proportion of double primary tumors of the endometrium and colorectum that displays tumor characteristics suggestive of MMR deficiency. METHODS: The authors used the southern Sweden regional population-based Cancer Registry to identify women who developed double primary tumors of the endometrium and colorectum. Of the 256 women who were diagnosed with carcinoma at both of these sites during the period 1958-1998, 39 women had developed their first tumor before age 50 years. The authors successfully retrieved 67 tumors from 36 of these patients and analyzed them for MSI and immunohistochemical expression of the MMR genes, MLH1, MSH2, and MSH6. RESULTS: The MSI status of the 67 tumors was high MSI in 37 tumors, low MSI in 13 tumors, and microsatellite stable (MSS) in 17 tumors. Immunohistochemical loss of MMR protein expression was correlated with MSI status and was demonstrated in 29 high MSI tumors, in 1 low MSI tumor, and in 1 MSS tumor. A concordant loss of the same MMR protein in both tumors was found in 12 of 27 patients. CONCLUSIONS : The authors demonstrated a high frequency of MSI (75%) in tumors from women with endometrial and colorectal carcinoma who had their first tumor diagnosed before age 50 years and observed concordant immunohistochemical loss of MMR protein expression, suggestive of a possible underlying germline mutation, in 12 of 27 patients (44%). They concluded that double primary malignancies of the colorectum and endometrium at a young age should make the clinician suspect HNPCC. Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10501
UI - 12015544
AU - Chui YK; Bhal PS
TI - Role of hysteroscopy in the detection and extraction of endometrial polyps: results of a prospective study.
SO - Am J Obstet Gynecol 2002 May;186(5):1104; discussion 1104
UI - 12015494
AU - Pohlod-Miller S; Fanning J; Gu P; Crist KA; You M
TI - Detection of genomic alterations in human endometrial cancer by two-dimensional gel electrophoresis.
SO - Am J Obstet Gynecol 2002 May;186(5):855-7
AD - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo 43614-5809, USA.
OBJECTIVE: The purpose of this study was to detect genomic alterations in human endometrial cancer by two-dimensional gel electrophoresis. STUDY DESIGN: With use of a newly developed two-dimensional gel electrophoresis assay, we scanned 19 high-risk DNA fragments for alterations in human endometrial hyperplasias and adenocarcinomas. This method includes cleaving of high-molecular-weight DNA, radioactive labeling, and separating DNA fragments by two-dimensional gel electrophoresis. By comparing the two-dimensional gel electrophoresis profile (spots) of neoplastic with normal endometrium, genetic alterations such as amplification, allelic loss, and hypermethylation or hypomethylation can be detected. RESULTS: Seven of 8 human endometrial adenocarcinoma (88%) and 1 of 2 hyperplasias (50%) revealed changes in spot density. The number of spots changed per specimen was 4. The median percentage of specimens with changes in an individual spot was 30%. Eleven spots had a reduction or loss of spot density, and 8 spots had an increase in spot density. CONCLUSION: By use of a novel two-dimensional gel electrophoresis assay, we identified genetic alterations in 50% of hyperplasias and 88% of endometrial adenocarcinomas.
UI - 11994390
AU - Yoshida S; Harada T; Iwabe T; Taniguchi F; Fujii A; Sakamoto Y; Yamauchi
TI - N; Shiota G; Terakawa N Induction of hepatocyte growth factor in stromal cells by tumor-derived basic fibroblast growth factor enhances growth and invasion of endometrial cancer.
SO - J Clin Endocrinol Metab 2002 May;87(5):2376-83
AD - Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago 683-8504, Japan. firstname.lastname@example.org
Tumor progression is often regulated through interactions between carcinoma cells and host stromal cells. In this study of endometrial cancer, we investigated one mechanism potentially involved in hepatocyte growth factor (HGF)-mediated cancer-stromal interactions. Endometrial cancer cells (HEC-1 and ISHIKAWA) expressed the c-met receptor, but HGF did not. HGF, however, did stimulate the proliferation and invasion of these cells. The HGF gene was expressed in stromal cells, which had been separated from primary cultures of endometrial cancers, 6.4 times more than in isolated normal endometrial stromal cells. Immunohistochemical staining revealed immunoreactive HGF in cancer stromal cells, the staining intensity being more pronounced in cancer tissue than in normal endometrium. The conditioned medium from normal epithelial cells and cancer cell lines induced HGF production in normal stromal cells. We identified basic fibroblast growth factor as an HGF inducer derived from endometrial cancer cell lines. Basic fibroblast growth factor derived from tumor cells may induce HGF in endometrial stromal cells, whereas stromal cell-derived HGF leads to the invasive growth of carcinoma cells. These interactions, mediated by HGF and HGF inducers, may play a significant role in the progression of endometrial cancer.
UI - 11992393
AU - Pellizzon AC; Fogarolli RC; Miziara M; Baraldi H; Soares CR
TI - Morbidity of adjuvant high-dose-rate brachytherapy for low to intermediate risk endometrial adenocarcinoma completely resected.
SO - Int J Cancer 2001;96 Suppl():105-8
AD - Radiation Therapy Service, Arnaldo Vieira de Carvalho Cancer Institute, Sao Paulo, Brazil. email@example.com
The aim of this retrospective analysis was to evaluate bowel and urinary acute and late morbidity in patients with low to intermediate risk endometrial carcinoma, submitted to total abdominal hysterectomy and bilateral salpingo-oophorectomy, without lymphadenectomy, and postoperative high-dose-rate brachytherapy (HDR-B) as the sole outpatient basis, to a total dose of 30-50 Gy, given in two fractions per week. A total of 4-5 fractions of 6-10 GY was delivered. Three patients (4.2%) developed severe bowel complications, with one patient experiencing severe rectal bleeding. Local control was observed in 68 (97.1%) patients. Five-year actuarial disease and complication-free survival were 94.3% and 96.8%, respectively. In conclusion, it seems that a modest dose fraction schedule of HDR-B yields very high local control rates and low morbidity rates. Copyright 2002 Wiley-Liss, Inc.
UI - 11136577
AU - Patsner B
TI - Primary endodermal sinus tumor of the endometrium presenting as "recurrent" endometrial adenocarcinoma.
SO - Gynecol Oncol 2001 Jan;80(1):93-5
AD - New Jersey Gynecologic Oncology, P.A., 180 White Road, Suite 102, Little Silver, New Jersey 07739, USA.
BACKGROUND: Primary endodermal sinus tumor of the endometrium is an extremely rare malignancy with few reports in the world literature. CASE: A case of primary endodermal sinus tumor of the endometrium is presented. The case is unusual in several aspects: it occurred in a patient with a history of breast cancer and long-standing tamoxifen use, and was diagnosed only after presenting as an apparent unexpected recurrence of endometrial adenocarcinoma. The tumor recurred despite initial cytoreductive surgery and combination chemotherapy. CONCLUSION: Rare types of endometrial cancers may present as unexpected recurrences of previously resected endometrial adenocarcinomas. Appropriate therapy depends on obtaining sufficient tissue to establish an accurate diagnosis to ensure selection of proper chemotherapeutic agents. Copyright 2001 Academic Press.
UI - 11519319
AU - Lazarov L; Mang'rova S; Lazarov N
TI - [Hysteroscopic diagnosis of endometrial carcinoma]
SO - Akush Ginekol (Sofiia) 2001;41 Suppl 4():25-7
Searching of more effective methods for early diagnosis of Endometrial Cancer has confirmed the hysteroscopy as most complete and sufficient manner in this direction. In the present exposition the authors are sharing their experience and making some practical conclusions that may be useful for the physicians applying this method.
UI - 11263938
AU - Levine DA; Lin O; Barakat RR; Robson ME; McDermott D; Cohen L; Satagopan
TI - J; Offit K; Boyd J Risk of endometrial carcinoma associated with BRCA mutation.
SO - Gynecol Oncol 2001 Mar;80(3):395-8
AD - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
OBJECTIVE: Inherited mutations in the BRCA1 or BRCA2 genes are associated with a greatly increased lifetime risk of breast and ovarian cancers and a modestly increased risk of several other cancer types. Several case reports of endometrial carcinoma in women with a BRCA mutation have led to speculation regarding the effect of these genes on the risk of endometrial cancer. The purpose of this study was to test the hypothesis that germline mutation of a BRCA gene is associated with an increased risk of endometrial carcinoma. METHODS: A retrospective cohort of 199 consecutive Ashkenazi Jewish patients with endometrial carcinoma was identified from a 12-year period at this institution. All were genotyped for the three BRCA founder mutations (185delAG and 5382insC in BRCA1 and 6174delT in BRCA2) that exist in this population, and the case frequency was compared to the known population frequency of these mutations. Additionally, endometrial carcinomas occurring in patients with BRCA mutations were assessed for somatic loss of the wild-type BRCA allele. RESULTS: Germline BRCA mutations were identified in 3 (1 in BRCA1 and two in BRCA2) of 199 (1.5%) patients, compared to a frequency of 2.0% in this population generally. A relative risk of endometrial carcinoma associated with BRCA mutation, as estimated by the odds ratio, was calculated as 0.75 (95% CI = 0.24--2.34; P = 0.6). Loss of the wild-type BRCA allele was observed in two of three tumors associated with a BRCA mutation. CONCLUSIONS: For individuals with a germline BRCA mutation, the lifetime risk of endometrial carcinoma is not increased. Copyright 2001 Academic Press.
UI - 11977333
AU - Olech-Fudali E; Chibowski D; Skomra D; Walczyna B
TI - The expression analysis of the estrogen and progesterone receptors in endometrial carcinomas.
SO - Ann Univ Mariae Curie Sklodowska [Med] 2001;56():319-25
AD - Department of Pathomorphology, Medical University of Lublin.
The aim of the study was the analysis of expression of estrogen (ER) and progesterone (PR) receptors in endometrial carcinomas. The expression of each of the receptors was examined with reference to such parameters as: patients' age, the relation to menopause, histological type and grading, the depth of myometrial infiltration and the presence of endometrial hyperplasia adjacent to the tumour. There were found very significant correlations between the degree of histological grading and expression of ER and PR and between values of index ER and PR. There was obtained correlation between the expression and endometrial hyperplasia only for PR.
UI - 12027821
AU - Ebina Y; Sakuragi N; Hareyama H; Todo Y; Nomura E; Takeda M; Okamoto K;
TI - Yamada H; Yamamoto R; Fujimoto S Para-aortic lymph node metastasis in relation to serum CA 125 levels and nuclear grade in endometrial carcinoma.
SO - Acta Obstet Gynecol Scand 2002 May;81(5):458-65
AD - Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.
BACKGROUND: To investigate the relationship between preoperative serum CA 125 levels and para-aortic lymph node (PAN) metastasis as determined by systematic pelvic and para-aortic lymph node dissection in endometrial carcinoma. METHODS: This study included 180 patients (n = 55, premenopausal; n = 125, postmenopausal) with endometrial carcinoma treated by complete surgical staging. Cut-off values of preoperative serum CA 125 levels for PAN metastasis were determined by receiver characteristic curve (ROC) analysis. Logistic regression analysis was used to determine independent predictors for PAN metastasis. RESULTS: The median serum CA 125 levels of patients with PAN metastasis were significantly higher than the levels of those with no metastasis in both premenopausal and postmenopausal groups. Based on ROC analysis, we could determine four cut-off values (70 and 210 U/mL for premenopausal patients, 20 and 60 U/mL for postmenopausal patients) and categorize the serum CA 125 levels into low, moderate and high groups. By logistic regression analysis, the CA 125 level and nuclear grade were found to be significant predictors of PAN metastasis, respectively. Using this model, the patients were stratified into three risk groups. The probabilities of PAN metastasis for patients in the low-risk, intermediate-risk and high-risk groups were less than 2%, 2-25% and more than 50%, respectively. CONCLUSIONS: Serum CA 125 levels and nuclear grade are important risk factors for PAN metastasis in endometrial carcinoma.
UI - 11820598
AU - Mazurek U; Witek A; Olejek A; Paul M; Skalba P; Wilczok T
TI - Expression of telomerase genes as potential marker of neoplastic changes.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():183-4
AD - Department of Molecular Biology, Biochemistry and Biopharmacy, Medical University of Silesia, Katowice. firstname.lastname@example.org
We conducted a quantitative analysis of TERT, TP1 and hTR mRNA expression in various types of endometrial hyperplasia in perimenopausal women, taking advantage of the real-time PCR assay. All women underwent hysterectomy for gynecological reasons. Endometrial dating was determined from the patomorphology of the endometrium and classified into endometrial hyperplasia: simplex, complex and atypica. Our data suggest that only hTR was observed in each normal and hyperplastic endometrium specimens, suggesting that this factor constitutively expressed in endometrium. The results obtained indicate that the expression activity of the TERT subunit changes but not significantly, depending on the stage of development of the hyperplasia.
UI - 11820604
AU - Terlikowski S; Lenczewski A; Famulski W; Sulkowska M; Dobrzycka B;
TI - Stasiuk-Barmuta A; Kulikowski M Patterns of immunohistochemical staining for p53 expression in hyperplastic endometrium and adenocarcinoma.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():195-6
AD - Department of Pathophysiology of Pregnancy, Medical Academy, Bialystok, Poland.
The p53, a tumour suppressor gene, is the most commonly mutated gene human cancer. In this study, we performed immunohistochemical investigations of the expression of p53 protein in hyperplastic endometrium and adenocarcinoma. Positive immunostaining was detected in 7 (30%) cases of invasive adenocarcinoma, 2 (12%) cases of simple hyperplasia with atypia and 2 (14%) cases of complex hyperplasia with atypia. In simple and complex hyperplasia without atypia staining was seen in occasional cells. The results suggested that endometrial hyperplasia is not always accompanied by p53 protein accumulation, hence its expression is not an early exponent of the neoplastic process.
UI - 11953087
AU - Zhang X; Wei L; Wang J; Tu Z
TI - [Time-dependent and dose-dependent regulation of human progesterone receptor isoforms A and B in uterine endometrial carcinoma by human insulin-like growth factor-I]
SO - Zhonghua Fu Chan Ke Za Zhi 2002 Mar;37(3):164-7
AD - Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
OBJECTIVE: We study the regulation of human progesterone receptor isoforms A and B in uterine endometrial carcinoma cell line by different concentration of human insulin-like growth factor-I (IGF-I) for different time, to investigate the roles of IGF-I and progesterone receptor isoforms in uterine endometrial carcinoma. METHODS: The uterine endometrial adenocarcinoma cell line HEC-IB was cultured in vitro and the breast cancer cell line MCF-7 was used as control. Western blot was applied to examine the changes of the two isoforms by different concentration IGF-I for different time. RESULTS: (1) In HEC-IB cell line, 10 ng/ml IGF-I made hPRB up-regulated in the first 24 h. But according to lager concentration and longer time, human progesterone receptor (hPR) B became down-regulated, which were significant at 20 ng/ml IGF-I for 72 h and 40 ng/ml IGF-I for 48 - 72 h.The change of hPRA was like hPRB. (2) In MCF-7 cell line, 10 ng/ml and 40 ng/ml IGF-I made hPRA and hPRB significantly up-regulated in 24, 48, 72 h. Twenty ng/ml IGF-I made hPRB up-regulated also in the first 24 h. But in 48 h and 72 h, down-regulation of hPRB was detected. Twenty ng/ml IGF-I made hPRA down-regulated in 24, 48, 72 h. CONCLUSIONS: (1) The regulation of IGF-I to hPR isoforms has cell-type specific and dose-dependent and time-dependent. (2) In HEC-IB cell line, 10 ng/ml IGF-I made hPRB significantly up-regulated in 24 h. But following exposure to IGF-I at larger concentration and longer time, hPRB became down-regulated. The change of hPRA is like hPRB.
UI - 12052590
AU - Clark TJ; Bakour SH; Gupta JK; Khan KS
TI - Evaluation of outpatient hysteroscopy and ultrasonography in the diagnosis of endometrial disease.
SO - Obstet Gynecol 2002 Jun;99(6):1001-7
AD - Minimal Access and Surgical Training (MAST) Centre, Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham, United Kingdom. email@example.com
OBJECTIVE: To develop a multivariable approach to determine the added value of tests in routine practice where some diagnostic information is already available from clinical history. METHODS: Multivariable logistic regression models were built in a stepwise fashion, considering the clinical sequence used in the rapid access ambulatory diagnosis clinic (clinical history followed