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1.
Medicine (Baltimore) ; 98(47): e17818, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764773

RESUMO

To investigate preoperative platelet morphology parameters and other whole blood cells in patients of malignant endometrial carcinoma compared with benign disease.Retrospective analysis was performed through collecting patients' hematological parameters before performing total abdominal/vaginal hysterectomy and standard radical surgery due to benign and malignant endometrial disease between 2006 and 2017. Parameters required included white blood cell (WBC), hemoglobin, platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet thrombocytocrit (PCT). And neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. For malignant carcinoma, Ki-67 percentage and progesterone receptor (PR) status were further collected.A total of 288 patients were included with 145 benign cases and 143 malignant cases. Patients of confirmed endometrial carcinoma showed a significant lower value of PDW (55.21 ±â€Š4.72 vs 49.54 ±â€Š5.89, P < .001), meanwhile significant higher values of MPV (7.12 ±â€Š1.56 vs 8.89 ±â€Š1.67, P < .001) and PCT (24.18 ±â€Š6.89 vs 27.93 ±â€Š8.93, P = .003). Further analysis of endometrial carcinoma patients showed that no significant difference in platelet parameters was found between patients with stage I to II and stage III to IV (P > .05), while increased value in PDW and reduced value in MPV was found in PR negative compared with positive patients.Preoperative platelet morphology parameters seemed to be used as one kind of predictive factors to discriminate malignant and benign endometrial disease. Limited by present study design, further prospective studies are required to support this finding.


Assuntos
Plaquetas , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/patologia , Histerectomia , Receptores de Progesterona/análise , Neoplasias do Endométrio/química , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Testes de Função Plaquetária , Valor Preditivo dos Testes , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos
2.
Cancer Causes Control ; 30(11): 1201-1211, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31542834

RESUMO

PURPOSE: Menopausal hormone therapy (MHT) use induces alterations in circulating estrogens/estrogen metabolites, which may contribute to the altered risk of reproductive tract cancers among current users. Thus, the current study assessed associations between circulating estrogens/estrogen metabolites and ovarian and endometrial cancer risk among MHT users. METHODS: We conducted a nested case-control study among postmenopausal women using MHT at baseline in the Women's Health Initiative Observational Study (179 ovarian cancers, 396 controls; 230 endometrial cancers, 253 controls). Multivariable logistic regression was utilized to estimate odds ratios and 95% confidence intervals overall and by subtype. RESULTS: Estrogen/estrogen metabolite levels were not associated with overall or serous ovarian cancer risk, examined separately. However, unconjugated estradiol was positively associated with non-serous ovarian cancer risk [quintile 5 vs. quintile 1: 3.01 (1.17-7.73); p-trend = 0.03; p-het < 0.01]. Endometrial cancer risk was unrelated to estrogen/estrogen metabolite levels among women who took combined estrogen/progestin therapy (EPT). CONCLUSIONS: These findings provide novel evidence that may support a heterogeneous hormonal etiology across ovarian cancer subtypes. Circulating estrogens did not influence endometrial cancer risk among women with EPT-induced high-estrogen levels. Larger studies are needed to delineate the relationship between ovarian/endometrial cancer subtypes and estrogen levels in the context of MHT use.


Assuntos
Neoplasias do Endométrio/sangue , Estradiol/sangue , Estrogênios/sangue , Terapia de Reposição Hormonal , Neoplasias Ovarianas/sangue , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Risco
3.
Indian J Cancer ; 56(3): 216-221, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31389384

RESUMO

BACKGROUND: Epithelial ovarian cancer is the second most common gynecological cancer. Human Epididymis Protein 4 is a novel biomarker for ovarian cancer. This study aims to explore the role of HE4 in monitoring recurrence and prognostication of ovarian cancer by predicting overall survival (OS) and progression-free survival (PFS). MATERIALS AND METHODS: In total, 149 patients with ovarian carcinoma were enrolled in the study. Baseline and post-treatment 3 monthly biomarker levels were recorded. For analysis, patients were divided into primary debulking surgery (PDS) and interval debulking surgery (IDS) groups. Statistical analysis was done using SPSS 24. RESULTS: Median age of patients at diagnosis was 45 (19-75) years. Recurrence was seen in 68.5% (n = 102) patients. The sensitivity of serum HE4 in detecting recurrence was 85.3% (95%CI: 76.95%-91.5%) and specificity was 91.5% (95%CI: 89.5%-98.2%). A >80% decline in HE4 levels during treatment indicated a better PFS, which was statistically significant in both groups (P = 0.04 in PDS and P = <0.001 in IDS group). Multivariate analysis suggested that OS was influenced by optimal cytoreduction in both groups of patients and stage in the IDS group. On the contrary, PFS was influenced by stage and response in HE4 levels in both groups. CONCLUSION: HE4 levels have similar sensitivity but more specificity when compared with CA125 in diagnosing recurrent ovarian cancer. A >80% decline in HE4 levels during treatment predicts better PFS and can help in prognostication.


Assuntos
Adenocarcinoma Mucinoso/patologia , Biomarcadores Tumorais/sangue , Cistadenocarcinoma Seroso/patologia , Neoplasias do Endométrio/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Ovarianas/patologia , /análise , Adenocarcinoma Mucinoso/sangue , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Antígeno Ca-125/sangue , Cistadenocarcinoma Seroso/sangue , Cistadenocarcinoma Seroso/cirurgia , Procedimentos Cirúrgicos de Citorredução , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/cirurgia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/cirurgia , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/cirurgia , Prognóstico , Estudos Prospectivos , Taxa de Sobrevida , Adulto Jovem
4.
Genet Test Mol Biomarkers ; 23(8): 580-588, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31373853

RESUMO

Objective: To evaluate the overall diagnostic value of human epididymis protein 4 (HE4) combined with carbohydrate antigen 125 (CA125) in endometrial carcinoma (EC) based on a meta-analysis of all eligible studies. Methods: The PubMed, Cochrane, Embase, CNKI, VANFUN, and VIP databases were searched by index words to identify eligible studies and also to search for relevant literature sources that had been published by January 2019. Eligible studies included prospective cohort studies or cross-sectional studies. The heterogeneity of the included studies was used to select appropriate effect models to calculate summary weighted sensitivity, specificity, and diagnostic odds ratios (DORs). The summary receiver operational characteristic (SROC) analysis was summarized for the EC. Results: In total, 25 studies that had explored the diagnostic accuracy of HE4 combined with CA125 for EC were included in this meta-analysis. Nine were from English language articles and 16 from Chinese language articles. The global sensitivity and specificity of HE4 combined with CA125 for EC were as follows: 66% (95% CI: 60-72) and 92% (95% CI: 88-95), respectively. The global positive likelihood ratio and global negative likelihood ratio of HE4 combined with CA125 for EC were as follows: 8.03 (95% CI: 5.36-12.04) and 0.37 (95% CI: 0.31-0.44), respectively. The global DOR was19.59 (95% CI: 12.25-31.32) for IL-6. The area under the SROC was high for HE4 combined with CA125 (AUC = 0.86; 95% CI: 0.83-0.89). Conclusion: This study provides a systematic review and meta-analysis of the diagnostic accuracy of HE4 combined with CA125 for EC. The results indicate that HE4 combined with CA125 is highly accurate for the diagnosis of EC.


Assuntos
Antígeno Ca-125/sangue , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/diagnóstico , Proteínas de Membrana/sangue , /metabolismo , Feminino , Humanos , Curva ROC
5.
J Obstet Gynaecol ; 39(8): 1112-1116, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31177876

RESUMO

We aimed to analyse the prognostic value of serum oxidative stress parameters and apoptotic markers of serum M30/65 levels in endometrial cancer patients. Serum M30/65 levels and oxidative stress parameters were evaluated in 52 women with stage I endometrial cancer (n = 26) and a control group of healthy females (n = 26). The total antioxidant status (p = .002), oxidative stress index (p = .003) and serum M30/65 levels (p < .001) were significantly higher in women with stage-I endometrial cancer in comparison to the control group. Furthermore, serum M30/65 levels were significantly lower on postoperative day 8, compared to preoperative levels (p = .001 and p < .001, respectively), in the endometrial cancer group. Although impaired apoptotic activity plays a crucial role in the aetiopathogenesis of endometrial cancer, oxidative stress may be instrumental in malignant transformation. We concluded that measurement of M30/65 levels would be beneficial in the follow-up of women with endometrial cancer. Impact Statement What is already known on this subject: Although M30 has been evaluated as a marker of apoptosis in tissue samples from women with endometrial cancer (EC), no previous studies have simultaneously analysed serum M30 and M65 levels and oxidative stress in patients with stage-I EC. What the results of this study add: Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) and serum M30/65 levels were significantly higher in women with stage I EC in comparison to the control group. Furthermore, serum M30/65 levels were significantly lower on postoperative day 8, compared to preoperative levels, in the EC group. The fact that pre-operative M30/M65 levels were higher than the post-operative levels may be very important in early-stage EC What the implications are of these findings for clinical practice and/or further research: Although impaired apoptotic activity plays a crucial role in the aetiopathogenesis of EC, oxidative stress may be instrumental in malignant transformation. The fact that serum M30/M65 levels decreased in accordance with the reduction of post-operative tumour burden led us to conclude that measurement of M30/65 levels would be beneficial in the follow-up of women with EC.


Assuntos
Neoplasias do Endométrio/sangue , Queratina-18/sangue , Fragmentos de Peptídeos/sangue , Apoptose , Neoplasias do Endométrio/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estresse Oxidativo , Prognóstico , Estudos Prospectivos
6.
BMC Cancer ; 19(1): 547, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174495

RESUMO

BACKGROUND: Obesity is an important cause of multiple cancer types, amongst which endometrial cancer (EC). The relation between obesity and cancer is complicated and involves alterations in insulin metabolism, response to inflammation and alterations in estradiol metabolism. Visceral obesity is assumed to play the most important role in the first two mechanisms, but its role in estradiol metabolism is unclear. Therefore, this retrospective study explores the relationship of body mass index (BMI), visceral fat volume (VAV) and subcutaneous fat volume (SAV) and serum levels of sex steroids and lipids in patients with endometrial cancer. METHODS: Thirty-nine postmenopausal EC patients with available BMI, blood serum and Computed Tomography (CT) scans were included. Serum was analyzed for estradiol, dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, cholesterol, triglycerides and high (HDL), low (LDL) and non-high density (NHDL) lipoprotein. VAV and SAV were quantified on abdominal CT scan images. Findings were interpreted using pearson correlation coefficient and linear regression with commonality analysis. RESULTS: Serum estradiol is moderately correlated with BMI (r = 0.62) and VAV (r = 0.58) and strongly correlated with SAV (r = 0.74) (p < 0.001 for all). SAV contributes more to estradiol levels than VAV (10.3% for SAV, 1.4% for VAV, 35.9% for SAV and VAV, p = 0.01). Other sex steroids and lipids have weak and moderate correlations with VAV or SAV. CONCLUSIONS: This study shows that serum estradiol is correlated with BMI and other fat-distribution measures in postmenopausal endometrial cancer patients. Subcutaneous fat tissue contributes more to the estradiol levels indicating that subcutaneous fat might be relevant in endometrial cancer carcinogenesis.


Assuntos
Tecido Adiposo/patologia , Adiposidade , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/patologia , Hormônios Esteroides Gonadais/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Índice de Massa Corporal , Comorbidade , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/etiologia , Feminino , Humanos , Lipídeos/sangue , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Obesidade/complicações , Obesidade/metabolismo , Tamanho do Órgão , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
7.
BMC Cancer ; 19(1): 401, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035965

RESUMO

BACKGROUND: Endometrial cancer (EC) is the most common malignancy of the female reproductive tract. Despite years of research, the accurate screening strategy is still not available in this disease and it is usually diagnosed only after the clinical signs are present. The recent technological advances in analytical methodologies enabled detection of multiple molecules in one, small sample of biological materials. Such approach was undertaken in the presented study. METHODS: Concentrations of aldehyde dehydrogenase 1 family, member A1 (ALDH1A1), carbonic anhydrase IX (CA9), CD44, epithelial cell adhesion molecule (EpCAM), hepsin, kallikrein-6, mesothelin, midkine, neural cell adhesion molecule L1 (L1CAM), and transglutaminase 2 (TGM2) were measured using MAGPIX®System in plasma samples of 45 EC, 20 healthy controls and 11 patients with endometriosis. RESULTS: Significantly increased concentration in EC as compared to healthy controls were found in case of CD44 (p <  0.001), EpCAM (p = 0.033) and TGM2 (p <  0.001). EpCAM and mesothelin concentrations differed based on FIGO stages. Regression analysis revealed marker panels with high accuracy in detection of EC. The highest AUC 0.937 was attributed to the 3-marker panel of CD44/TGM2/EpCAM (84% sensitivity, 100% specificity), FIGO IA samples were discriminated from more advanced stages of EC with the mesothelin/grade 1 model featuring AUC of 0.911 (95.24% sensitivity, 78.26% specificity). CONCLUSIONS: Novel plasma biomarkers presenting good accuracy in diagnosing EC were found with TGM2 reported for the first time as plasma marker. It was also revealed that endometriosis may share similarities in the pattern of markers alterations characteristic for EC.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias do Endométrio/sangue , Molécula de Adesão da Célula Epitelial/sangue , Proteínas de Ligação ao GTP/sangue , Receptores de Hialuronatos/sangue , Transglutaminases/sangue , Neoplasias do Endométrio/diagnóstico , Endometriose/sangue , Endometriose/diagnóstico , Feminino , Humanos , Modelos Logísticos , Gradação de Tumores , Estadiamento de Neoplasias , Curva ROC
8.
Ginekol Pol ; 90(3): 134-140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30950002

RESUMO

OBJECTIVES: The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease. MATERIAL AND METHODS: The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method. RESULTS: In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients' age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients' OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group. CONCLUSIONS: High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer.


Assuntos
Antígenos de Neoplasias/sangue , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Análise de Sobrevida
9.
Exp Eye Res ; 184: 30-37, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30978346

RESUMO

A patient with bilateral diffuse uveal melanocytic proliferation (BDUMP) associated with endometrial cancer was treated with plasmapheresis, but failed therapy with progressive serous retinal detachment. We collected plasma before and after plasmapheresis therapy. Our goal was to determine if the cultured melanocyte elongation and proliferation (CMEP) factor and hepatocyte growth factor (HGF) was present in the IgG enriched fraction and understand why our patient failed plasmapheresis therapy. Melanocytes were cultured for 3-5 days in the presence of control medium, unfractionated pre-plasmapheresis BDUMP medium, IgG enriched or IgG depleted BDUMP medium, or unfractionated post-plasmapheresis BDUMP medium. Subretinal fluid was collected from patients with BDUMP and control retinal detachments and analyzed by electropheresis with immunoblotting. Medium with unfractionated BDUMP plasma stimulated melanocyte growth 1.4-1.5 fold compared to control medium on days 3-5 (p < 0.001 for all). Both IgG enriched and IgG depleted BDUMP medium mildly increased melanocyte growth 1.3 fold (p < 0.05 for enriched, p < 0.01 for depleted) compared to control. In comparison, unfractionated BDUMP medium caused a 1.7-fold increase in melanocyte growth, which was significantly more than the enriched (p < 0.01) and depleted (p < 0.05) fractions. Pre-plasmapheresis and post-plasmapheresis unfractionated BDUMP medium equally stimulated melanocyte growth 1.7-fold (p < 0.05) compared to control. HGF was present in IgG depleted, pre-plasmapheresis, and post-plasmapheresis samples, but absent in the IgG enriched fraction. There was no enrichment of IgG in the subretinal fluid from eyes with BDUMP. In conclusion, CMEP factor is not concentrated in the IgG enriched plasma fraction in our patient who failed plasmapheresis therapy. HGF levels have no correlation with melanocyte growth. Because plasmapheresis preferentially removes immunoglobulins from the plasma, our patient responded poorly to plasmapheresis treatment with worsening retinal detachment.


Assuntos
Adenocarcinoma de Células Claras/patologia , Neoplasias do Endométrio/patologia , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Melanócitos/patologia , Síndromes Paraneoplásicas Oculares/patologia , Úvea/patologia , Adenocarcinoma de Células Claras/sangue , Adenocarcinoma de Células Claras/terapia , Idoso , Proliferação de Células , Células Cultivadas , Eletroforese em Gel de Poliacrilamida , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/terapia , Feminino , Angiofluoresceinografia , Humanos , Immunoblotting , Imagem Multimodal , Síndromes Paraneoplásicas Oculares/sangue , Síndromes Paraneoplásicas Oculares/terapia , Plasmaferese , Líquido Sub-Retiniano , Falha de Tratamento
10.
Oncology ; 96(5): 259-267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30893700

RESUMO

OBJECTIVE: The pretreatment neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have been reported to be useful as markers for prognostic factors and metastasis in several cancers. The aim of this study was to identify the predictor of lymph node (LN) metastasis by pretreatment NLR and PLR in patients with endometrial cancer. METHODS: Medical charts of the patients with endometrial cancers that received primary surgery at our hospital between 2007 and 2013 were retrospectively analyzed. The cutoff value was calculated from the receiver operating characteristics (ROC) curve. Clinicopathological parameters including inflammatory markers were evaluated for LN metastasis using multiple logistic regression analysis. RESULTS: Among 197 patients enrolled in the study, LN metastasis was observed in 25 patients (13%). ROC curves demonstrated that the best cutoff value of NLR for predicting LN metastasis was 2.18 and that of PLR was 206. In univariate analysis, several pathological factors, NLR, and PLR were identified as predictors of LN metastasis. In multiple logistic regression analysis, lymphovascular invasion and NLR were found to be significantly correlated with LN metastasis (p = 0.002, 0.039). CONCLUSION: A higher pretreatment NLR was identified as a predictor of LN metastasis in endometrial cancers. Although further study is needed to confirm the results, NLR could be a candidate clinical marker for detection of LN metastasis.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias do Endométrio/sangue , Neutrófilos/citologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Modelos Logísticos , Metástase Linfática , Contagem de Linfócitos , Pessoa de Meia-Idade , Contagem de Plaquetas , Estudos Retrospectivos , Análise de Sobrevida
11.
Cancer Biomark ; 24(3): 315-324, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30829613

RESUMO

BACKGROUND: Endometrial cancer is one of the most common tumor of the woman genital organs. OBJECTIVE: The goal of this study was to determine the lipocalin-2 levels in patients with endometrial cancer compared to those with normal endometrium or mild endometrial pathologies. METHODS: Study included 123 patients with BMI > 21 kg/m2 who were admitted due to abnormal bleeding, in which 52 patients with endometrial cancer. The NGAL, CA125, HE4 serum levels were determined for all patients. RESULTS: Significantly lower median NGAL serum levels were found in a group of patients with normal endometrium compared to the endometrial cancer group, p= 0.006. NGAL protein area under ROC curves value as a diagnostic test, differentiating between endometrial cancer and other benign changes endometrium is AUC - 0.81 (p< 0.00001). The NGAL protein had a high sensitivity in all patients included in the analysis: 84% vs. 82% in pre-menopausal patients, and 81% in postmenopausal women with a specificity of 78%, 80% and 87%, respectively. The independent variable for FIGO and model logistic regression proves that NGAL is statistically significant (p= 0.000602), the odds ratio is 3.66. The model for grading shows, that NGAL increase by one ng/ml increases risk chances by 2.32 times in diagnosis with less cancer differentiation. CONCLUSIONS: Our preliminary studies demonstrate that lipocalin-2 may be of value in the diagnostics of uterine body cancers.


Assuntos
Biomarcadores Tumorais , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/diagnóstico , Lipocalina-2/sangue , Adulto , Idoso , Biomarcadores , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Curva ROC , Sensibilidade e Especificidade
12.
Kaohsiung J Med Sci ; 35(5): 303-309, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30887645

RESUMO

Raised triglycerides (TG) and reduced high density lipoprotein cholesterol (HDL-c) are components of metabolic syndrome. Both high TG and metabolic syndrome have been reported to be risk factors of endometrial cancer. Therefore, triglycerides-to-high density lipoprotein cholesterol ratio (TG/HDL-c ratio) may be a useful biological indicator in managing endometrial cancer. We aimed to explore the association between pretreatment TG/HDL-c ratio and endometrial cancer in postmenopausal women, and to evaluate its potential role in the disease. Pretreatment serum lipid profile and TG/HDL-c ratio were retrospectively analyzed for 167 postmenopausal women with endometrial cancer and 464 matched noncancer controls. Compared with controls, pretreatment TG/HDL-c ratio in endometrial cancer patients significantly elevated regardless of whether patients had diabetes or overweight/obesity (P < 0.05). Further analyses showed that pretreatment TG/HDL-c ratio increased significantly with advanced tumor stage. Interestingly, TG/HDL-c ratio of type I endometrial cancer patients was higher than those with type II endometrial cancer. A positive association was found between pretreatment TG/HDL-c ratio and tumor stage (adjusted r = 0.176, P = 0.027) in endometrial cancer group. Receiver operating characteristic curve analysis yielded the cut-off value of 1.52 for TG/HDL-c ratio to discriminate patients with cancer from controls (area under the curve, 0.689; sensitivity, 51.5%; specificity, 84.1%). Multivariate logistic regression model identified TG/HDL-c ratio ≥ 1.52 (odds ratio = 4.123; P < 0.001) as an independent predictor of endometrial cancer. TG/HDL-c ratio was positively associated with endometrial cancer clinical features, such as tumor stage and pathogenetic type. Accordingly, pretreatment TG/HDL-c ratio might be a potential marker for endometrial cancer.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Endometrioide/sangue , HDL-Colesterol/sangue , Diabetes Mellitus/sangue , Neoplasias do Endométrio/sangue , Síndrome Metabólica/sangue , Obesidade/sangue , Triglicerídeos/sangue , Idoso , Área Sob a Curva , Carcinoma Endometrioide/complicações , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/patologia , Estudos de Casos e Controles , Complicações do Diabetes , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/patologia , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/patologia , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/patologia , Pós-Menopausa/sangue , Curva ROC , Estudos Retrospectivos , Fatores de Risco
13.
Future Oncol ; 15(12): 1335-1346, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30887833

RESUMO

Aim: To compare endocrine characteristics of  endometrial cancer (EC) patients based on recent molecular EC types classification. Materials & methods: A total of 234 treatment-naive EC patients as well their tumors were studied. Results: Patients with POLE mutations demonstrated tendency to lower body mass index (BMI) and higher serum estradiol. Patients with p53 overexpression were older and had higher diabetes incidence. In the without characteristic molecular profile group there was no difference in fasting serum insulin, estradiol and testosterone levels between women with BMI ≥30.0 and <30.0. The mismatch repair deficient group patients had a tendency toward later menarche compared with the without characteristic molecular profile group one. Conclusion: Studied endocrine characteristics are associated with BMI or tumor molecular-biological type that might be relevant to EC genesis, course and prognosis.


Assuntos
Índice de Massa Corporal , Sistema Endócrino/metabolismo , Neoplasias do Endométrio/metabolismo , Endométrio/patologia , Obesidade/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Reparo de Erro de Pareamento de DNA/genética , DNA Polimerase II/genética , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/patologia , Endométrio/cirurgia , Estradiol/sangue , Feminino , Humanos , Histerectomia , Insulina/sangue , Leptina/sangue , Pessoa de Meia-Idade , Mutação , Obesidade/sangue , Obesidade/genética , Proteínas de Ligação a Poli-ADP-Ribose/genética , Testosterona/sangue
14.
Int J Gynaecol Obstet ; 145(1): 34-39, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30702161

RESUMO

OBJECTIVE: To investigate serum adiponectin and visfatin levels, and their ratio, in patients with endometrial cancer. METHODS: A retrospective case-control study of 53 patients with endometrial cancer admitted to Dalian Municipal Women and Children's Medical Center, China, between May 1, 2009, and January 31, 2013. Ninety-eight healthy women who underwent physical examination at the same time served as the control group. Serum adiponectin and visfatin levels were measured by ELISA. RESULTS: Serum adiponectin level in the endometrial cancer group was significantly lower than in the control group (2.09 ± 1.24 µg/mL vs 7.59 ± 2.29 µg/mL; P<0.001). Serum adiponectin was positively correlated with visfatin level (Spearman correlation coefficient 0.472). The visfatin:adiponectin ratio in the endometrial cancer group was significantly higher than the control group (0.28 ± 0.10 vs 0.11 ± 0.09; P=0.047). Multivariate logistic regression showed that decreased serum adiponectin (odds ratio 0.998, 95% CI 0.996-0.999; P=0.045) and increased visfatin (1.010, 1.003-1.017; P=0.042) levels were independent risk factors for the onset of endometrial cancer. CONCLUSION: Decreased serum adiponectin or increased visfatin levels are independent risk factors for endometrial cancer. The visfatin:adiponectin ratio has a certain reference value for the diagnosis of endometrial cancer.


Assuntos
Adiponectina/sangue , Citocinas/sangue , Neoplasias do Endométrio/sangue , Nicotinamida Fosforribosiltransferase/sangue , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , China , Neoplasias do Endométrio/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco
15.
BMC Cancer ; 19(1): 73, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30646853

RESUMO

BACKGROUND: Several previous studies have confirmed that thrombocytosis was related to reduced survival in many solid tumors. However, the prognostic significance of thrombocytosis in endometrial carcinoma (EC) was still controversy. Therefore, we conducted this study to assess the prognostic value of thrombocytosis in EC. METHODS: The database including PubMed, MEDLINE, EMBASE, and Web of Science was searched to explore available literature. Above all, the hazard ratio (HR), odds ratios (OR) with 95% confidence intervals (CIs) was used to investigate the correlation between thrombocytosis and overall survival (OS) and disease-free survival (DFS). Moreover, the association between thrombocytosis and patient clinicopathological characteristics was explored. Publication bias and sensitivity analysis also were conducted in this study. RESULTS: Overall, 11 studies involving 3439 patients were contained in this study. The results revealed that pretreatment thrombocytosis was significantly related to a decreased OS (pooled HR = 2.99; 95% CI = 2.35-3.8; P < 0.001) and DFS (pooled HR = 2.86; 95% CI = 2.27-3.6; P <  0.001) in patients with EC. Moreover, thrombocytosis was correlated with adverse clinicopathological parameters. CONCLUSIONS: Pretreatment thrombocytosis is an adverse prognostic marker in patients with EC.


Assuntos
Neoplasias do Endométrio/mortalidade , Trombocitose/epidemiologia , Intervalo Livre de Doença , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/cirurgia , Endométrio/patologia , Endométrio/cirurgia , Feminino , Humanos , Histerectomia , Incidência , Contagem de Plaquetas , Prognóstico , Trombocitose/sangue , Trombocitose/etiologia
16.
Gynecol Endocrinol ; 35(5): 370-375, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30668178

RESUMO

Endometrial carcinoma (EC) often expresses estrogen receptors (ER), and the growth of EC is stimulated by estrogen. Therefore, EC is considered to be an estrogen-dependent tumor. However, the role of estrogen in endometrial carcinogenesis is somewhat unclear because the majority of EC occurs at peri- or post menopause when serum estrogen levels are generally decreased. In this article, we describe the double-edged role of estrogen in the genesis of EC, especially in terms of mismatch repair functions in vitro and in vivo, i.e. when serum estradiol (E2) levels are relatively low (approximately less than 90 pg/ml), and E2 enhance the carcinogenesis, whereas high E2 levels may suppress the carcinogenesis. This will deepen mechanistic insight into unopposed estrogen.


Assuntos
Carcinogênese/patologia , Carcinoma/patologia , Neoplasias do Endométrio/patologia , Endométrio/patologia , Estrogênios/sangue , Carcinoma/sangue , Neoplasias do Endométrio/sangue , Feminino , Humanos
18.
PLoS One ; 14(1): e0210585, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30645608

RESUMO

OBJECTIVE: Better biomarkers are needed in order to identify patients with endometrial carcinoma at risk of recurrence and who may profit from a more aggressive treatment regimen. Our objective was to explore the applicability of plasma growth differentiation factor 15 (GDF-15) as a marker for recurrent disease, as well as a marker for poor prognosis and lymph node metastases. METHODS: EDTA-blood samples were obtained from 235 patients with endometrial cancer before primary surgery. For 36 of these patients, matching blood samples were collected at time of recurrence. Blood samples were also collected from 78 patients with endometrial hyperplasia. Plasma GDF-15 was measured by an enzyme-linked immunosorbent assay (ELISA). Preoperative pelvic MRI scans for 141 patients were investigated in parallel for imaging variables. RESULTS: Preoperative plasma level of GDF-15 was significantly higher for patients who experienced recurrence (1780 ng/L; 95% CI; 518-9475 ng/L) than for patients who did not develop recurrent disease (1236 ng/L; 95% CI; 307-7030 ng/L) (p<0.001). Plasma levels of GDF-15 at recurrence (2818 ng/L, 95% CI 2088-3548 ng/L) were significantly higher than plasma levels of GDF-15 measured at time of primary diagnosis (1857 ng/L, 95% CI; 1317-2398 ng/L) (p = 0.001). High plasma level GDF-15 independently predicts recurrent disease (OR = 3.14; 95% CI 2.10-4.76) and lymph node metastases (OR = 2.64; 95% CI 1.52-4.61). Patients with high plasma level of GDF-15 had significantly larger tumor volume (p = 0.008). CONCLUSION: Elevated plasma level of GDF-15 is associated with aggressive disease and lymph node metastasis in endometrial carcinoma. GDF-15 may be helpful in indicating recurrent disease.


Assuntos
Biomarcadores/sangue , Hiperplasia Endometrial/sangue , Neoplasias do Endométrio/sangue , Fator 15 de Diferenciação de Crescimento/sangue , Idoso , Hiperplasia Endometrial/diagnóstico , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Período Pré-Operatório
19.
Arch Gynecol Obstet ; 299(1): 229-237, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30341503

RESUMO

PURPOSE: To examine the clinical significance of an autoantibody (AAb) against a novel tumor-associated antigen (TAA) derived from human DNA-topoisomerase I, termed as TOPO48 AAb, and peripheral blood survivin-expressing circulating cells (CCC) in patients with early stage endometrial cancer (EC). METHODS: Blood samples were collected from 80 patients with early stage EC and 80 age-matched healthy subjects. Plasma levels of the TOPO48 AAb were measured with a specific antibody capture enzyme-linked immunosorbent assay (ELISA) and blood survivin-expressing CCC assessed with a reverse transcription-polymerase chain reaction products based on a hybridization-enzyme-linked immunosorbent assay (RT-PCR-ELISA). Sixty patients were followed up for 36 months after the initial assay test. RESULTS: There were 75% and 60% samples with positive levels of the TOPO48 AAb and survivin-expressing CCC in the cancer patients, respectively. However, the cumulative positive rate of combination of the two markers was increased to 93.3% with 0.927 (95% CI 0.871-0.984) of area under the curve (AUC) in receiver operating characteristic (ROC) curve analysis. During the follow-up period, patients with positive TOPO48 AAb but negative surviving-expressing CCC had a higher survival rate and a longer survival time than those with negative AAb but positive CCC (P = 0.01). CONCLUSIONS: The combination of TOPO48 AAb and survivin-expressing CCC may be used as a novel recipe to improve the efficiency of early diagnosis and provide more accurate prognostic prediction in patients with early stage EC.


Assuntos
Autoanticorpos/sangue , DNA Topoisomerases Tipo I/sangue , Neoplasias do Endométrio/sangue , Células Neoplásicas Circulantes/metabolismo , Survivina/sangue , Adulto , Antígenos de Neoplasias , Neoplasias do Endométrio/mortalidade , Neoplasias do Endométrio/patologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Pessoa de Meia-Idade , Células Neoplásicas Circulantes/patologia , Prognóstico , Taxa de Sobrevida
20.
Mod Pathol ; 32(3): 405-414, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30315273

RESUMO

There is currently no blood-based marker in routine use for endometrial cancer patients. Such a marker could potentially be used for early detection, but it could also help to track tumor recurrence following hysterectomy. This is important, as extra-vaginal recurrence of endometrial endometrioid adenocarcinoma is usually incurable. This proof-of-principle study was designed to determine if tumor-associated mutations could be detected in cell-free DNA from the peripheral blood of early and late stage endometrial endometrioid carcinoma patients. Approximately 90% of endometrioid carcinomas have at least one mutation in the genes CTNNB1, KRAS, PTEN, or PIK3CA. Using a custom panel targeting 30 hotspot amplicons in these four genes, next-generation sequencing was performed on cell-free DNA extracted from plasma obtained from a peripheral blood draw at the time of hysterectomy and the matching tumor DNA from 48 patients with endometrioid endometrial carcinomas. At least one mutation in the tumor was detected in 45/48 (94%) of patients. Fifteen of 45 patients (33%) had a mutation in the plasma that matched a mutation in the tumor. These same mutations were not detected in the matched negative control buffy coat. Presence of a plasma mutation was significantly associated with advanced stage at hysterectomy, deep myometrial invasion, lymphatic/vascular invasion, and primary tumor size. Detecting a plasma-based mutation was independent of the amount of cell-free DNA isolated from the plasma. Overall, 18% of early stage patients had a mutation detected in the plasma. These results demonstrate that mutations in genes relevant to endometrial cancer can be identified in the peripheral blood of patients at the time of surgery. Future studies can help to determine the post-operative time course of mutation clearance from the peripheral blood and if mutation re-emergence is predictive of recurrence.


Assuntos
Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Carcinoma Endometrioide/genética , DNA Tumoral Circulante/genética , Neoplasias do Endométrio/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Endometrioide/sangue , Carcinoma Endometrioide/diagnóstico , DNA Tumoral Circulante/sangue , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/diagnóstico , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Pessoa de Meia-Idade , Mutação , Recidiva Local de Neoplasia/diagnóstico
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