scholarly journals Evaluation of Serum Human Epididymis Secretory Protein 4 (HE4) in Benign Endometrial Disease and Endometrial Cancer

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S S Mohamed ◽  
M A Abdelhafeez ◽  
H F Mohamed ◽  
F M Abukra
Keyword(s):  
Endometrial Cancer ◽  
Abnormal Uterine Bleeding ◽  
Secretory Protein ◽  
Pelvic Lymphadenectomy ◽  
Younger Women ◽  
Human Epididymis ◽  
Significant Difference ◽  
Abnormal Bleeding ◽  
The Difference ◽  
Endometrial Pathology

Abstract Objective The incidence of endometrial cancer is constantly growing. More aggressive types of endometrial cancer as well as the incidence in younger women are being observed. More than 80% of cases are diagnosed in early stages due to early symptoms like abnormal bleeding. Aim of our study to evaluate the ability of serum HE4 concentration to differentiate between benign endometrial disease and endometrial cancer and ass’s correlation it with prognosis of EC. Material and methods Serum HE4 level was measured in 85 patients with abnormal uterine bleeding. Based on histology after curettage the study group was divided into the benign and malignant endometrial pathology groups. Statistical analysis was performed using Mann-Whitney test Results The difference of serum HE4 level between benign endometrial pathology and cancer was significant (p = 0.000) and the cut-off for identification of patients with endometrial cancer was 62 pmol/l. There was a significant difference between Stage (I – II) endometrial cancer, and Stage (III – IV) p = 0.01, Patients who needed lymphadenectomy had significantly higher HE4 level than those who had no indications for this procedure (p = 0,001). Conclusion HE4 is a useful biomarker in diagnosing endometrial cancer. HE4 is associated with high grade endometrial cancer. It can also serve as an useful preoperative counseling tool to identify patients, who may require pelvic lymphadenectomy.

scholarly journals The Connection of the Level of Estradiol in Serum and Obesity with the Endometrial Bleeding in Postmenopausal Women

2019 ◽  
Vol 7 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Valentina Tofiloska ◽  
Maria Krstevska ◽  
Ana Daneva-Markova ◽  
Viktorija Jovanovska
Keyword(s):  
Endometrial Cancer ◽  
Statistical Significance ◽  
Abnormal Uterine Bleeding ◽  
Control Group ◽  
Prospective Clinical Study ◽  
Study Group ◽  
Gynecology And Obstetrics ◽  
Increased Risk ◽  
Significant Difference ◽  
Post Menopausal

BACKGROUND: Postmenopausis is a period that begins one year after the last menstrual period. Abnormal uterine bleeding could be of different origins. AIM: This study aimed to determine the association of serum estrogen hormone levels and obesity with the occurrence of endometrial bleeding in post-menopausal women. MATERIAL AND METHODS: Prospective clinical study involving 120 postmenopausal patients treated at the University Clinic for Gynecology and Obstetrics-Skopje, divided into two groups: control and study. The control group consisted of 40 postmenopausal patients without endometrial bleeding, hospitalised and operated due to urogenital pathology. The study group consisted of 80 patients with endometrial bleeding who were divided into three subgroups according to the thickness of the endometrium: from 5-8 mm, 8-11 mm and above 11 mm. In all subjects, estradiol and BMI was determined. RESULTS: Estradiol levels were statistically higher in the study group compared to control while statistically significant difference among the three subgroups according to the thickness of the endometrium about the levels of estradiol in blood is not found. About BMI, the results showed that there was no statistical significance between the two examined groups. CONCLUSION: Patients with endometrial bleeding have increased levels of estradiol and are at increased risk of endometrial cancer about controls, the likelihood of endometrial cancer significantly increases by 1,108 times.

The role of human epididymis secretory protein E4 in patients with endometrial cancer and premalignant endometrial lesions

2016 ◽  
Vol 37 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Setenay Arzu Yılmaz ◽  
Sündüz Özlem Altınkaya ◽  
Özlem Seçilmiş Kerimoglu ◽  
Aybike Tazegül Pekin ◽  
Fikret Akyürek ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Secretory Protein ◽  
Human Epididymis

scholarly journals Correlation of body mass index and abnormal uterine bleeding in premenopausal women

2020 ◽  
Vol 9 (11) ◽  
pp. 4640
Author(s):  
Kumarasamy Akalyaa ◽  
Pattacheravanda Nanaiah Shakuntala ◽  
Ramaiah Renuka
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Body Mass ◽  
Endometrial Hyperplasia ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Significant Difference ◽  
Menstrual Patterns ◽  
The Mean

Background: As the rate of obesity is increasing in women in the recent years, the incidence of endometrial cancer increases as the body mass index (BMI) increases. Despite the clear evidence linking endometrial cancer and obesity, there is limited public awareness of this relationship. This study was undertaken to evaluate the association of BMI and endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB).Methods: An analytical case control study was conducted in 100 women between the age group of 40 to 55, with AUB in the Department of Obstetrics and Gynecology, ESIC-PGIMSR Bangalore between January 2018 and June 2019. The menstrual patterns and endometrial pattern by histopathology were analysed in women with BMI of 18.5 to 24.99 and ≥25.Results: The mean age of women participated in the study group of between 40- 55 years was 44.83. The mean duration of symptoms was 10.18 months in the cases group and 8.52 months in the control group. The menstrual patterns were comparable and there was no significant difference in both the groups. The mean endometrial thickness, mean BMI, hyperplasia with or without atypia were all higher in the cases group. The frequency of occurrence of atypical endometrial hyperplasia was higher in women with increasing BMI.Conclusions: We found increased BMI to be an important independent risk factor for the development of endometrial hyperplasia with atypia which is a precursor to endometrial carcinoma in premenopausal women with AUB. 

Evaluation of Variances in VEGF-A-D and VEGFR-1-3 Expression in the Ishikawa Endometrial Cancer Cell Line Treated with Salinomycin and An-ti-Angiogenic/Lymphangiogenic Effect

2020 ◽  
Vol 21 ◽  
Author(s):  
Piotr Kras ◽  
Karol Talkowski ◽  
Beniamin Oskar Grabarek ◽  
Nina Dziobek ◽  
Dariusz Boroń ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cancer Cells ◽  
Expression Pattern ◽  
Lymphatic Vessels ◽  
Cancer Cell Line ◽  
Control Culture ◽  
Significant Difference ◽  
Correct Pattern ◽  
The Difference ◽  
Endothelial Growth Factor

Background: In cancer, an excessive and uncontrolled process of creating new blood and lymphatic vessels that play a key role in the metastasis process can be observed. The vascular endothelial growth factor (VEGF-A,-B,-C,-D) family together with their specific receptors (VEGFR-1,-2,-3) plays a key role in these processes, therefore it would be reasonable to determine the correct pattern of their expression. Objective: The study aimed to assess the use of salinomycin as an anti-angiogenic and anti-lymphangiogenic drug during endometrial cancer by examining changes in the expression pattern of VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGFR-1, VEGFR-2, VEGFR-3 depending on the treatment period of the Ishikawa endometrial cancer cells with salinomycin in comparison to the control culture. Materials and Methods: To determine how influential salinomycin was on the expression of both mRNAs, 1 µM of the drug was added to the cell culture and then it was cultured all together for 12,24 and 48 hour periods. The cells that made up the control culture were not treated with salinomycin. To determine the changes in the expression profile of the selected genes we used the microarray, techniques: RTqPCR and ELISA (p<0.05). Results: For all isoforms of VEGF-A-D as well as receptors of VEGFR-1-3, a decrease in expression under the influence of salinomycin was noted. For VEGF-A and VEGFR-1, the difference in the expression between the culture treated with salinomycin in comparison to the control was statistically significant (p=0.0004). In turn for VEGF-B, the difference between the culture exposed for 24 hours in comparison to the control (p=0.00000) as well as the comparison between H48 vs C (p=0.00000) was statistically significant. In reference to VEGF-C, VEGFR-2, VEGFR-3 the statistical analysis showed the significant difference in expression between the culture incubated with the drug for 12,24 and 48 hours in comparison to the control as well as between the selected times. For all of these comparisons, p=0.00000 was utilized. Conclusions: Salinomycin changes the expression pattern of VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGFR-1, VEGFR-2, and VEGFR-3 in endometrial cancer cells. The obtained results suggest that salinomycin might exert the effect via VEGF signaling pathways.

Endometrial biopsy in women with abnormal uterine bleeding: inadequate and unassessable categorisation is not clinically relevant

2014 ◽  
Vol 67 (8) ◽  
pp. 673-677 ◽  
Author(s):  
Ayman A A Ewies ◽  
Kadry A A Shaaban ◽  
Reena Merard ◽  
Ulises Zanetto
Keyword(s):  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Final Diagnosis ◽  
Median Number ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Initial Finding ◽  
Significant Difference ◽  
The Difference ◽  
Clinical Records

AimsInadequate endometrial biopsy comprises a dilemma for gynaecologists and histopathologists alike. This study was conducted to assess the clinical merit of classifying scant endometrial biopsy into inadequate and unassessable using McCluggage criteria.MethodsWe retrospectively classified 268 endometrial biopsies, initially reported as inadequate, into inadequate (n=74) and unassessable (n=174) using McCluggage criteria after excluding 20 cases; all taken from patients aged ≥50 years with abnormal uterine bleeding attending Sandwell and West Birmingham Hospitals, UK from 1 January 2007 until 30 September 2012. The electronic clinical records were reviewed to find out the consequent clinical decisions and final outcomes. The follow-up period was 15 months after including the last patient.ResultsThe median age was 57 years (range: 50–97), and the median number of visits to hospital till the diagnosis was achieved was 2 (range: 1–4). The final diagnosis of endometrial hyperplasia or cancer was reported in 9 cases; 5 (7.1%) with an initial finding of inadequate and 4 with unassessable (2.4%); the difference was statistically insignificant (p=0.13). More patients in the inadequate category (82.4%) underwent further investigations when compared with the unassessable category (68.4%); the difference was statistically significant (p=0.029). There was no statistically significant difference in the inadequate to unassessable ratio when the endometrial thickness was ≥5 mm or <5 mm within the Pipelle group (p=0.46) or the curettage group (p=0.34).ConclusionsOur findings suggest that categorising scant endometrial specimens into inadequate or unassessable has no clinical implications. The gynaecologist should interpret the histopathology report in the light of clinical scenario.

scholarly journals Relação entre o espessamento endometrial e o sangramento uterino anormal no diagnóstico de câncer de endométrio em pacientes na pós-menopausa / Relationship among endometrial thickening and abnormal uterine bleeding in the diagnosis of endometrial cancer in postmenopausal patients

2019 ◽  
Vol 64 (3) ◽  
pp. 208
Author(s):  
Carmen Mayanna Jamur ◽  
Grace Kelly Rodrigues ◽  
Eduardo Schunemann Junior
Keyword(s):  
Endometrial Cancer ◽  
Gynecological Cancer ◽  
Abnormal Uterine Bleeding ◽  
Total Sample ◽  
Uterine Bleeding ◽  
Incidence Of Cancer ◽  
Endometrial Thickening ◽  
Uterine Curettage ◽  
Abnormal Bleeding ◽  
The Relationship

Introdução: O câncer de endométrio é o terceiro câncer ginecológico mais frequente em mulheres no Brasil. O sangramento uterino anormal e o espessamento endometrial são as apresentações mais comuns da doença. O objetivo desse estudo foi encontrar a relação entre sangramento, espessamento endometrial e  obesidade no diagnóstico do câncer de endométrio na paciente na pós-menopausa. Métodos: Trata-se de um estudo retrospectivo no qual foi realizado o levantamento de dados das pacientes na pós-menopausa submetidas à curetagem uterina de prova (CUP) devido à queixa de sangramento anormal e/ou apresentarem espessamento endometrial, no Hospital de Clínicas da UFPR no período de Janeiro de 2012 a Dezembro de 2014.  Resultados: Das 157 pacientes na pós-menopausa avaliadas, foram diagnosticados 33 casos de câncer de endométrio e dois de sarcoma. Da amostra total (157), 112 apresentavam espessamento endometrial e sangramento, 40 somente espessamento e  5 somente sangramento. Das 112 com sangramento e espessamento, foram encontrados 31 (27,7%) casos de câncer de endométrio. Das 40 que apresentavam apenas espessamento, uma (2,5%) apresentou câncer. Das 5 que apresentavam sangramento isolado, foi diagnosticado um caso de câncer de endométrio (20%). A incidência de câncer de endométrio também mostrou relação com o aumento de IMC (com maior incidência acima de 25) e com o nível de espessamento endometrial a partir de 15mm. Conclusão: O sinal mais importante relacionado ao câncer de endométrio, sem dúvida é o sangramento. Mulher no período da pós-menopausa que apresente sangramento uterino anormal deve ser investigada criteriosamente em busca de exclusão de diagnóstico oncológico, pela alta possibilidade (OR = 14.03) de ter câncer de endométrio.Descritores: Neoplasias do endométrio, Metrorragia, Hemorragia uterina, Pós-menopausa, Obesidade, CuretagemAbstractIntroduction: Endometrial cancer is one of the most common types of gynecological cancer, and it is the fourth leading cause of death by cancer among women in Brazil. Abnormal uterine bleeding and endometrial thickening are the most frequent presentations of this disease. The objective of this study was to find the relationship among abnormal bleeding, thickening and obesity in the diagnosis of endometrial cancer in postmenopausal patients. Methods: This is a retrospective study in which was collect data of patients that underwent uterine curettage (D&C) complaining about abnormal bleeding and/or presenting endometrial thickening, at Hospital de Clínicas from UFPR on the period of January 2012 to December 2014. Results: From all the 157 postmenopausal patients evaluated, 33 cases of endometrial cancer and two of sarcoma were diagnosed. In the total sample (157), 112 presented endometrial thickening and bleeding, and 40 presented thickening and five presented isolated bleeding. Within the 112 patients with abnormal bleeding and endometrial thickening, 31 (27.7%) cases of endometrial cancer were found. From the 40 patients with only thickening, one (2.5%) presented cancer. From the five patient isolated bleeding, one (20%) case of endometrial cancer was diagnosed. The incidence of cancer also showed relationship with BMI increasing (mores incidence of cancer with BMI over 25) and with endometrial thickening starting from 15mm. Conclusion: The most important factor related to endometrial cancer beyond doubt is abnormal bleeding. Postmenopausal women with abnormal uterine bleeding should be carefully investigated for exclusion of an oncological diagnosis, because of the high possibility (OR = 14.03) of having endometrial cancer.Keywords: Endometrial neoplasms, Metrorrhagia, Postmenopause, Uterine hemorrhage, Obesity, Curettage

scholarly journals Is It Rational to Study Coagulations Test Routinely before Operations and Invasive Procedure: Single Center Retrospective Study

2019 ◽  
Author(s):  
Fergün Yılmaz ◽  
Tuğçe Karslı ◽  
Demet Kiper ◽  
Fusun Gediz ◽  
Bahriye Payzın
Keyword(s):  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Bleeding Risk ◽  
University Hospital ◽  
Coagulation Cascade ◽  
Significant Difference ◽  
Coagulation Tests ◽  
Life Threatening ◽  
Abnormal Bleeding ◽  
Bleeding History

Background: Detailed history taking, physical examination and laboratory tests are useful tools to document any abnormal bleeding risk before an operation or an invasive procedure. Although coagulation tests are routinely used to demonstrate the pathological situations at the coagulation cascade or to follow-up the anticoagulation therapies, their role in determining the bleeding risk in preoperative patients is controversial. Materials and Methods: In this study, we aimed to evaluate the patients referring to our hematology clinic at Izmir Katip Celebi University Hospital for preoperative consultation due to elevated levels of coagulation tests. Results: Fifty-six patients with high PT/PTT levels were enrolled in this study. Twenty-six (46.4%) patients were male and 30 (53.6%) were female. The median age was 34 (18-75) years. We documented bleeding history in 12 (21.4%) patients. The patients having a bleeding history revealed mostly abnormal uterine bleeding, epistaxis, and gingival bleeding. Life threatening bleeding was not reported in any of the patients.  The operations were cancelled or postponed at least one month in 38 (67.8%) and 10 (17.8%) patients, respectively. Per-operative or post-operative abnormal bleeding was not documented. We did not find any statistically significant difference between groups with or without elevated coagulation tests in terms of abnormal bleeding in the operations. Conclusion: Coagulations tests should be studied in selected group of patients. Additionally, mildly elevated results should be interpreted carefully to decrease the rate of cancellation and delay in operations and unnecessary increase in costs.

A Retrospective Analysis of Postoperative Complications With or Without Para-aortic Lymphadenectomy in Endometrial Cancer

2011 ◽  
Vol 21 (2) ◽  
pp. 385-390 ◽  
Author(s):  
Yosuke Konno ◽  
Yukiharu Todo ◽  
Shinichiro Minobe ◽  
Hidenori Kato ◽  
Kazuhira Okamoto ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Postoperative Complications ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Incidence Rates ◽  
Pelvic Lymphadenectomy ◽  
The Other ◽  
Organ Injury ◽  
Systematic Lymphadenectomy ◽  
Significant Difference

Introduction:Although para-aortic lymphadenectomy (PALX) has not been accepted as a standard treatment for patients with endometrial cancer, it is possible that systematic lymphadenectomy including PALX has therapeutic significance for patients with intermediate-/high-risk endometrial cancer. On the other hand, a consensus regarding the safety of PALX has not been reached. The aim of this study was to compare the incidence rates of postoperative complications after pelvic lymphadenectomy (PLX) with or without PALX in patients with uterine corpus cancer.Methods:A retrospective chart review was carried out for all patients with endometrial cancer treated at 2 tertiary centers between 1998 and 2004. Surgery at one institute included both PLX and PALX, whereas PLX alone was routinely performed at the other institute. A total of 142 patients underwent PLX + PALX and 138 patients underwent PLX alone. We evaluated postoperative complications including intraoperative injury, ileus, lymphedema, lymphocyst, and thrombosis.Results:There was no fatal accident associated with surgery. Lymphedema was the most frequent complication. Comparing the PLX + PALX group and the PLX group, there were no significant differences in the rate of cases of lymphedema (23.2% vs 28.3%), lymphocyst (9.2% vs 9.4%), and thrombosis (4.9% vs 2.2%). The rate of cases of mild/moderate ileus in the PLX + PALX group was significantly higher than that in the PLX group (10.5% vs 2.9%; P = 0.011). However, no significant difference in the rates of cases of severe ileus was found between the 2 groups (1.4% vs 0.7%). There were also no significant differences between the 2 groups in the rates of intraoperative organ injury (2.8% vs 2.2%) and secondary operation for postoperative complications (4.9% vs 4.3%).Conclusions:Para-aortic lymphadenectomy can be performed with an acceptable morbidity under the conditions in which it is performed by experienced surgeons, and measures to prevent complications are properly taken.

scholarly journals Presentation of endometrial carcinoma in young women

2016 ◽  
Author(s):  
Anshika Lekhi ◽  
Rahul Manchanda ◽  
Nidhi Jain ◽  
Sravani Chithra ◽  
Hena Kausar
Keyword(s):  
Endometrial Carcinoma ◽  
Young Patients ◽  
Abnormal Uterine Bleeding ◽  
Pelvic Lymphadenectomy ◽  
Low Grade ◽  
Management Options ◽  
Young Females ◽  
Lower Stage ◽  
Abnormal Bleeding ◽  
Endometrial Carcinomas

Background: Endometrial carcinoma is a disease of older postmenopausal women, and is relatively uncommon in patients younger than 40 years. Endometrial carcinomas in this age group may be familial, associated with Lynch syndrome, or sporadic. Patient usually has increased exposure to estrogen. In 2%–14% of cases, it occurs in young patients (less than 40 years of age) who are eager to preserve their fertility. Its treatment includes hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy and in some cases, radiation therapy. Prevention of fertility is major challenge encountered in such cases. Aim: To present a case of young woman with endometrial carcinoma and through it to review the literature of its presentation and management in such groups. Case: We report a case of endometrial cancer in a 35-year-old woman with previous 3 cesarean treated for abnormal uterine bleeding and cared for in our department. Conclusion: Most endometrial carcinomas presenting in this young age are associated with estrogen excess. Pathologically they are usually low-grade endometrioid carcinomas with lower stage and are associated with favorable clinical outcomes. With this case the authors emphasize the need of endometrial reckoning in young females with abnormal bleeding before starting any medical treatment. Also highlighting the management options in such cases where fertility preservation holds challenge.

scholarly journals The Accuracy of an Intraoperative Frozen Section for Premalignant Endometrial Pathology

2019 ◽  
pp. 1
Author(s):  
Ergul Demircivi Bor ◽  
Esra Akdeniz ◽  
Yucel Nurettin Ceylan ◽  
Taner Gunay ◽  
Meryem Hocaoglu ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Confidence Interval ◽  
Postmenopausal Women ◽  
Frozen Section ◽  
Abnormal Uterine Bleeding ◽  
Kappa Coefficient ◽  
Uterine Bleeding ◽  
Valuable Method ◽  
Endometrial Pathology ◽  
Rule Out

<p><strong>OBJECTIVE</strong>: Abnormal uterine bleeding which is the most frequent complaint among pre- and postmenopausal women should be investigated to rule out endometrial cancer. An intra-operative frozen section can be taken to examine the suspicious of the malignancy. The study aims to investigate the accuracy of frozen section in suspicious of endometrial malignancy.</p><p><strong>STUDY DESIGN:</strong> Fifty patients with pre-malign endometrial pathology and malignant ultrasound characteristics were included in this study and their preoperative biopsy, frozen and postoperative pathological results were examined. </p><p><strong>RESULTS:</strong> The kappa coefficient between postoperative pathology and frozen section was 0.88 (p&lt;0.05) and 95% confidence interval was (0.63-1.12). This indicates that the amount of agreement between the two tests was strong, thus the frozen section would be considered as a valid indicator of postoperative pathology results.</p><p><strong>CONCLUSIONS:</strong> Frozen section is a valuable method to investigate the suspicious of malignancy in endometrial pre-malign lesions.</p>

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