[Hormonal-metabolic status of cancer patients with late-onset menopause]. / Gormonal'no-metabolicheskii status onkologicheskikh bol'nykh pri pozdno nastupivshei menopauze.

Late-onset of menopause is a marker of risk factor for neoplasia in the reproductive system and, conversely, anti-risk for certain non-infectious diseases, such as cardio-vascular disease or osteoporosis. We studied 118 postmenopausal patients with early endometrial and breast cancers. The investigation was particularly concerned with hormonal-metabolic status versus age at menopause age at. While a Quetelet index/age was irrelevant, blood cholesterol and insulin (120 min) concentrations and tumor estrogen/progesterone receptor ratios were relatively higher in the late-onset group ((52 yrs). This group showed a correlation with age at menopause while the other one--with its duration. Insulin/body weight ratios were higher in the late-onset group while LH/FSH--lower. Hence, patients of the same age but differing in age at menopause age at may show differences in hormonal-metabolic status as well. This feature may be significant in identifying both biological distinctions of associated tumors and their clinical course.

[Tumor tissue aromatase and estrogen levels versus clinical course of endometrial cancer]. / Aktivnost' aromatazy, tkanevoe soderzhanie éstrogenov i osobennosti techeniia raka éndometriia.

Levels of aromatase, a key enzyme in estrogen biosynthesis, were assayed in tumor tissue sampled from 25 patients with endometrial cancer. In addition, estradiol concentrations were compared in normal and altered endometrial tissue from 78 patients suffering uterine cancer. Unlike breast cancer, aromatase was not detectable in altered endometrium unless tissue estrogens could be identified in both normal and tumor tissue. Hence, aromatase presence served as an indicator of malignant transformation. Its concentration in samples of uterine tissue varied 0-28.4 fM/mg protein/hr (an average of 12.9(1.7 fM/mg protein/hr). There was hardly any correlation between this level, on the one hand, and menopause and body mass, on the other. Yet, it tended to increase in step with stage of disease and cell differentiation decline. Estradiol concentrations in malignant endometrium in both reproductive and menopausal patients were higher than in macroscopically normal ones, while still cycling women tended to show higher values than menopausal ones. Although there was no significant difference in estradiol levels in the altered endomentrium of patients with pathogenetical patterns of uterine cancer stage I and II, they did show a direct correlation with clinical stage of tumor process and depth of invasion into the underlying myometrium. Hence, unlike estrogens circulating in blood, those contained in tissue ("intratumor") ones did enhance the aggressiveness of endometrial cancer course. It will be for further investigations to show whether it is due to an estrogen fraction being carried away by tumor from the circulation, or estrogens being synthesized by aromatase in tumor itself.

[Genetic polymorphism of steroid 17 alpha-hydroxylase/17,20-lyase (CYP17) and hyperinsulinemia in endometrial carcinoma]. / Polymorfism gena steroid-17-al'fa-gidroksilazy/17,20-liazy (CYP17) i giperinsulinemiia pri rake tela matki.

Initiation and/or promotion of endometrial carcinoma is considered to be associated with estrogens and androgens (androstendione) excess as well as hyperinsulinemia and resistance to insulin. It is possible that certain polymorphisms of the genes involved in steroidogenesis or steroid metabolism contribute to carcinoma susceptibility. In the current study, we compared the role of CYP17 biallelic MspA1) polymorphism in 114 endometrial carcinoma patients and 182 healthy women. According to our data, A2/A2 CYP17 genotype traditionally regarded as "unfavorable" was less frequent in cancer patients than in control which confirmed the results of two previous publications. For the first time, carriers of the genotype were shown to have relatively low levels of blood insulin and C-peptide. No significant difference was found between mean concentrations of testosterone, dehydroepiandrosterone sulfate and those of estradiol in the carriers of various CYP17 genotypes with endometrial cancer. Hence, CYP17 polymorphism which is represented by the "normal" A1/A1 genotype might be a factor of risk for endometrial carcinoma. Since this genetic variety may develop through an unconventional (nonsteroid) pathway, taking relevant preventive measures in high-risk groups should be recommended.

[Minimal endometrial cancer and its detection in selective screening programs]. / Minimal'nyi rak èndometriia i ego vyiavlenie v programmakh selektivnogo skrininga.

The study involved 1,256 cases of endometrial carcinoma. Minimal tumor (up to 2 cm in diameter, invasion- up to 0.5 cm) was diagnosed in 30%. This pattern showed a low potential for progression and metastasis spreading. Feasibility of identification of minimal cancer of the endometrium in the course of screening for hormone-dependent tumors of the reproductive system is discussed.