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At least 19 recordsLinked to original sources
PubMed1997

Not so benign endometrial hyperplasia: endometrial cancer after endometrial ablation.

The masking or development of endometrial cancer after endometrial ablation is a concern often alluded to in discussions of complications of endometrial ablation. It is necessary to look for a common factor when this complication occurs. Six cases published in peer-reviewed literature were collected to establish a link between the development of endometrial cancer and endometrial ablation. Preexisting endometrial hyperplasia seems to be the common denominator, and should be considered a contraindication to endometrial ablation until more data are collected.

Adenocarcinoma↗
PubMed1989

[The effect of danazol and tamoxifen on endometrial hyperplasia].

Endometrial hyperplasia has been considered as a hormone dependent lesion. Besides atypical genital bleeding, the possibility of endometrial carcinoma is also of significance. In this study, we administered 400mg daily of Danazol in 29 cases or 20mg daily of tamoxifen in 20 cases, respectively, for climacteric or postmenopausal women with different types of endometrial hyperplasia, and discussed their effect. Genital bleeding due to hyperplasia disappeared within 10-28 days in the danazol group and within 7-30 days in the tamoxifen group. In the latter group also, 2 climacteric women experienced menopause. The tortuous gland of hyperplasia became smaller and rounder. At the end of the treatment the glandular epithelium was low and showed a very poor secretory phase. The nuclei mitosis both in the glandular and stromal cells disappeared. The regression of hyperplasia was obtained after 1, 3, 6 months of danazol therapy in 37.9%, 72.4%, 93.1% and with tamoxifen therapy in 65%, 80%, 90% respectively, without undesirable side effects. In conclusion, the control of the endometrial hyperplasia with danazol and tamoxifen was suggested, and the results of the use of the suggested method were no further occurrence and/or progression of the disease. Both of the drugs were effective and safe alternative therapy for endometrial hyperplasia to progesterone.

Danazol↗
PubMed1993

[Usefulness of transvaginal ultrasound and hysteroscopy in diagnosing endometrial hyperplasia and endometrial carcinoma].

Modern methods enabling evaluation of endometrium in all phases of the menstrual cycle were presented. Transvaginal ultrasound does not give characteristic pictures. The most frequently observed sonographic features in endometrial hyperplasia and endometrial carcinoma were compared. Most frequently, in 29% we observed the thickening of the endometrium. The enlargement of the uterine body was detected in 27%. The dominant feature in endometrial carcinoma was distortion or lack of medium-focus echo-90%. Different echogenicity was observed in 69% of all cases. Application of hysteroscopy enables us to visualize changed endometrium and also to sample focal lesions for histopathological examination. Endometrial carcinoma was detected in all analyzed cases with application of hysteroscopy and ultrasound. Pathological endometrial hyperplasia was diagnosed by ultrasound only in 44% and with application of hysteroscopy in 84% of all material.

Adult↗
PubMed2002

Microsatellite instability and immunohistochemical analysis of MLH1 and MSH2 in normal endometrium, endometrial hyperplasia and endometrial cancer from a hereditary nonpolyposis colorectal cancer patient.

Hereditary nonpolyposis colorectal cancer (HNPCC)-related endometrial cancer is associated with mutations in DNA mismatch repair genes. However, chronological changes of these genes in the endometrium have not been studied in women from HNPCC families. Tissue samples of normal endometrium, endometrial hyperplasia without atypia and endometrial cancer were collected at different times from a 41-year-old Japanese woman with a family history of HNPCC. Combined microsatellite instability (MSI) and immunohistochemical analysis of MLH1 and MSH2 predicted the presence of a mutation in MSH2 when she had endometrial hyperplasia without atypia 7 months before the diagnosis of endometrial cancer. Endometrial hyperplasia without atypia may indicate an early development of endometrial cancer in women from HNPCC families.

Adaptor Proteins, Signal Transducing↗
PubMed1989

[Diagnosis and treatment of endometrial hyperplasia].

Endometrial hyperplasia (EH) was found to coexist in 13 of 21 patients (cystic glandular hyperplasia, 13; adenomatous hyperplasia, 9) with endometrial adenocarcinoma (EC), but in only 44 of 940 patients with other than EC. In this study, blood type (A, B, H), c-myc translation products, estrogen receptor and DNA polymerase alpha were examined on endometrium of proliferative phase (EPP), EH and EC. Patient blood type products were shown in EH surrounding EC, and yet they were detected in only small portion or none of EC itself. H products were detected in EC of other than O type. c-myc translation products were shown in only a small portion of cancer cells. EPP had many ER positive cells and a few proliferating cells as they were shown by staining with anti-DNA polymerase alpha monoclonal antibody. EC can be divided into two types, one has few ER positive cells and many proliferating cells, other many ER positive cells and a few proliferating cells. In EH, the numbers of ER positive cells and DNA polymerase alpha positive cells were between those of EPP and EC. In a patient with atypical hyperplasia, high dose Medroxyprogesterone acetate (MPA) therapy induced that stratification and papillary growth of gland lining epithelia disappeared, and that cytoplasmic enlargement and vacuolation appeared. These findings were important histopathological changes in high dose MPA administration to EH and EC.

ABO Blood-Group System↗
PubMed1994

Invasive endometrial cancer in uteri resected for atypical endometrial hyperplasia.

Endometrial hyperplasia (EH) includes a spectrum of lesions with unclear malignant potential. To examine the association between the most advanced forms of hyperplasia and the occurrence of endometrial cancer, we compared the findings of endometrial biopsies or curettings with the subsequent hysterectomy specimens in 44 women who underwent hysterectomy for "atypical" EH in the 39-month period from January 1, 1989 through April 1, 1992. Endometrial cancer was found in 19 (43%) of 44 hysterectomy specimens obtained within a mean of 10 weeks of uterine sampling. Myometrial invasion was present in 17 (89%) of the 19 specimens with cancer, while significant myometrial invasion (FIGO Stage IC or higher) was present in 7 (37%), and 4 (21%) were Grade 2 or higher. Preoperative sampling method and type of atypical hyperplasia (simple vs complex) were not significantly associated with the finding of cancer at hysterectomy. Although over one-third of the cancers found were in the less than 50 age group, an age of 70 or greater was significantly associated with cancer at hysterectomy (P < 0.05, Fisher's exact test). In a limited set of hysterectomy specimens for which estrogen and progesterone receptor status was assayed (n = 11), there was no significant difference between the invasive cancer and EH subsets. Our findings suggest that women who are candidates for hysterectomy on the basis of atypical EH should be carefully evaluated for the possibility of advanced disease. The specimens in these circumstances should be opened upon removal to determine if myometrial invasion is present and if further surgical staging is indicated.

Adenocarcinoma↗
PubMed1999

[Analysis of the frequency of prevalence of endometrial hyperplasia and endometrial adenocarcinoma based on own material in the year 1975, 1985 and 1995].

We analysed the frequency of prevalence of endometrial hyperplasia and endometrial adenocarcinoma in the years 1975, 1985 and 1995. Significant differences between endometrial simple hyperplasia and complex hyperplasia with atypia was found. There were no statistic differences in the frequency of the prevalence of endometrial adenocarcinoma between analysed years.

Adenocarcinoma↗
PubMed1993

[Evaluation of the degree of biological behavior in endometrial hyperplasia and endometrial carcinoma: an investigation of proliferative activity, oncogene, and extracellular matrix].

Endometrial cancers have been considered to be less prevalent in Japan than in Western countries. However, with the increase in life expectancy, the Westernization of the Japanese diet, and changes in the hormonal environment, the prevalence of the disease has gradually increased even in our country. Similar increases in cancers of the breasts, lungs, colons, and ovaries have been noted in recent years. Much is still unknown regarding the pathogenesis and natural history of endometrial cancer. Although endometrial hyperplasia is considered to be a precancerous lesion of endometrial carcinoma, the relationship between those diseases has not been elucidated to the same degree as that between cervical cancer and cervical dysplasia, or carcinoma in situ. Research findings in genetic oncology have revealed that tumorigenesis involves a multi-step process. It is probable that activation of multiple genes, inactivation of anti-oncogenes, and disappearance of normal inhibitor genes occur in the process of the development of endometrial cancer. The purpose of this study is to elucidate the relationship between oncogenes and the development of endometrial cancer. In addition, the significance of endometrial hyperplasia as a clinical entity is also be evaluated. The roles played by oncogenes in endometrial cancers and endometrial hyperplasias were examined using the most recent molecular biological and immunohistochemical methods. Also, the differences in cellular proliferation and tissue invasiveness were discussed. Results obtained were as follows. Evaluation of cell proliferation (PCNA, FCM) revealed that there was no difference in proliferative activity between atypical hyperplasia and well differentiated adenocarcinoma. Evaluation of oncogene abnormalities (c-myc,c-erbB-2,K-ras,p53) revealed that the development of endometrial cancer was a multistep process involving several oncogenes, as it has been noted in the development of other cancers. Evaluation of extracellular matrix and related factors (cathepsin D, laminin, type IV collagen, tenascin, CD44) showed that tissue invasiveness differed between atypical hyperplasia and well differentiated adenocarcinoma.

DNA, Neoplasm↗
PubMed1997

Telomerase expression in normal endometrium, endometrial hyperplasia, and endometrial adenocarcinoma.

Telomerase activity has been detected in a broad range of human cancers and its expression could be an important step in tumor progression. Here, telomerase activity by the telomeric repeat amplification protocol in cases of benign endometrium, endometrial hyperplasia, and endometrial adenocarcinoma was tested. Telomerase expression was detected in 13 of 14 cases of proliferative phase endometrium, in 7 of 12 cases of secretory phase endometrium, but was not detected in any of 7 cases of atrophic endometrium. Three of three cases with evidence of luteal phase defect and one of four cases of chronic endometritis also expressed telomerase activity. Hyperplastic endometrium was positive for telomerase in 13 of 17 cases. Telomerase activity was detected in 40 of 48 cases of endometrial adenocarcinoma, which included 36 of 43 cases of endometrioid adenocarcinoma and four of five cases of papillary serous carcinoma. The detection of telomerase in endometrial adenocarcinoma was not associated with either architectural grade, myometrial invasion, or stage. There was statistically significant association, however, between telomerase activity in benign atrophic endometrium versus any endometrial abnormality in women 52 years of age or older.

Adenocarcinoma↗
PubMed2001

Biomarkers of intrinsic angiogenic and anti-angiogenic activity in patients with endometrial hyperplasia and endometrial cancer.

Serum vascular endothelial growth factor (VEGF) and endostatin were determined in postmenopausal women, including 72 with endometrial cancer, 27 with endometrial hyperplasia and 30 healthy controls. Serum VEGF levels in endometrial hyperplasia (142+/-18 ng/ml, mean +/- SE) and endometrial cancer stages I (291+/-22), II (623+/-68) and stage III-IV (1527+/-119) were significantly higher than the mean for controls (12+/-1.6). Serum endostatin levels in endometrial hyperplasia (149+/-19 ng/ml), endometrial cancer stages I (320+/-41), II (644+/-86) and stage III-IV (1253+/-114) were also significantly higher than the mean for controls (13+/-2.4). Elevated values of VEGF above the non-malignant level were encountered in 7% (stage I), 37% (stage II) and 100% (stage III-IV) of endometrial cancers. The corresponding figures for endostatin were 37%, 59 and 100%, respectively. These results demonstrate that the circulating levels of both markers correlated with tumor stage and apparently tumor burden. Serum VEGF and endostatin levels decreased significantly after treatment, followed by marked elevations at clinical relapse. The VEGF endostatin ratio was higher in the advanced stages ( > 1.0) than in the early stages of endometrial carcinoma (< 1.0). indicating that the balance of angiogenic stimulators and inhibitors may regulate metastasis and access tumor progression.

Aged↗
PubMed2001

[Significance on expressions of Annexin-I and its correlative gene proteins in endometrial hyperplasia, atypical hyperplasia and endometrial carcinoma].

OBJECTIVE: To investigate expression of Annexin-I in various endometrial lesions and its significance in differential diagnosis of endometrial borderline lesions. METHODS: We collected 37 specimens with different endometrial lesions, and reclassified them according to China and FIGO's standard, which included 12 cases of endometrial hyperplasia (EH), 10 cases of atypical hyperplasia (ATH) and 15 cases of endometrial carcinoma (EC). Immunohistochemical staining for AX-I, c-erbB-2, p53 protein, ER, PR, EGF and IGF were performed by LSAB. RESULTS: The results showed that for AX-I, 1 cases of EH was weakly positive and others were negative; 9 cases of ATH showed strong positivity in the cytoplasm and the cell membrane, and 1 weakly positive; 7 cases of EC were positive and 8 negative. c-erbB-2 was expressed in 9 cases of ATH and 1 was negative. Expressions of EGFR, ER and PR were strong in all cases, but IGFR was negative in almost all cases. P53 expression was higher in EC than in ATH. CONCLUSIONS: AX-I expression suggests that (1) AX-I protein may play an important role in the pathogenesis of cancer, the expression decreased and disappeared after malignant change. (2) High expression for AX-I can be used to differentiate ATH and EC. In addition, c-erbB-2 expression appeared to parallel the expression of AX-I in both ATH and EC, but in ATH it was higher than that in EC.

Annexin A1↗
PubMed2004

Loss of cables, a cyclin-dependent kinase regulatory protein, is associated with the development of endometrial hyperplasia and endometrial cancer.

Endometrial cancer is the most common gynecological cancer in Western industrialized countries. Cables, a cyclin-dependent kinase binding protein, plays a role in proliferation and/or differentiation. Cables mutant mice are viable, but develop endometrial hyperplasia and carcinoma in situ at a young age. Exposure to chronic low levels of estrogen results in development of endometrial cancer, similar to that observed in the postmenopausal female. In vitro and in vivo studies demonstrate that levels of Cables mRNA in benign human endometrial epithelium are up-regulated by progesterone and down-regulated by estrogen. Furthermore, nuclear immunostaining for Cables is lost in a high percentage of cases of human endometrial hyperplasia and adenocarcinoma, which are likely the product of unopposed estrogen. The loss of Cables immunostaining in the human endometrial cancer samples correlates with a marked decrease in Cables mRNA. Ectopic expression of Cables in human endometrial cells dramatically slows cell proliferation. Collectively, these data provide evidence that Cables is hormonally regulated and is involved in regulating endometrial cell proliferation. In addition, loss or suppression of Cables may be an early step in the development of endometrial cancer.

Animals↗
PubMed2003

Conservative treatment may be beneficial for young women with atypical endometrial hyperplasia or endometrial adenocarcinoma.

OBJECTIVE: To evaluate whether an alternative treatment to radical hysterectomy exists for young women with endometrial adenocarcinoma. DESIGN: A review of the literature (70 articles) plus personal results. SETTING: University hospital. PATIENT(S): Women with atypical endometrial hyperplasia or adenocarcinoma. MAIN OUTCOME MEASURE(S): The recurrence rate and the pregnancy rate after conservative therapy. CONCLUSION(S): Conservative treatment of well-differentiated stage I endometrial adenocarcinoma can be considered in young patients, with close surveillance to diagnose any possible recurrence.

Adenocarcinoma↗
PubMed2003

Expression of cold-inducible RNA-binding protein in the normal endometrium, endometrial hyperplasia, and endometrial carcinoma.

Cold-inducible RNA-binding protein (CIRP), an 18-kD protein in the mouse and human, is induced by lowering the temperature of cultured cells. CIRP is possibly a cell cycle regulator because its overexpression results in prolongation of G1 phase in vitro. We investigated the immunohistochemical expression of CIRP in 39 endometrial carcinomas, 12 endometrial hyperplasias, and 27 normal endometria using polyclonal antibody against CIRP and confirmed by Western blot analysis. CIRP was localized in the nuclei of glandular, stromal, and endothelial cells. The intensity of CIRP expression in glandular cells during the menstrual cycle was inversely proportional to its proliferative (Ki-67) activity, whereas it remained unchanged in stromal and vascular endothelial cells. The intensity of CIRP expression in hyperplastic glands was variable, whereas CIRP expression was absent or markedly reduced in most of the endometrial carcinomas. These results suggest that CIRP may participate in the cell cycle regulation of normal endometrium and the loss of its expression may be involved in endometrial carcinogenesis.

Adult↗
PubMedDate not supplied

[Treatment of benign uterine hemorrhage and simple endometrial hyperplasia by endometrial ablation].

BACKGROUND AND AIMS: The technique of endometrial resection by resectoscope represents a valid alternative to hysterectomy in patients with a high operating risk suffering from benign uterine bleeding and simple endometrial hyperplasia refractory to medical treatment or uterine curettage. The aim of this study was to demonstrate the validity of the resectoscopic technique of endometrial ablation. METHODS: The authors performed endometrial ablation using a loop and roller resectoscope in a group of 24 women with refractory menorrhagia which failed to respond to other techniques of first choice. RESULTS AND CONCLUSIONS: The results obtained show the good tolerability of resectoscopic surgery by the patients who, for medical reasons, represented a high operating risk if subject to laparohysterectomy.

Adult↗
PubMed1997

The behavior of endometrial hyperplasia: a prospective study. Endometrial Hyperplasia Study Group.

OBJECTIVE: To clarify the behavior of endometrial hyperplasia in a prospective study. METHOD: Fifty-one patients with endometrial hyperplasia were followed up for 6 months. Samples of endometrial tissues were taken by uterine endometrial biopsy every 4 weeks during the first 3 months and at the end of follow-up. RESULTS: In 69% (35/51) of the patients histological picture of the endometrium became normal during the observation period. The lesions persisted in 17% (6/35) of the patients with simple hyperplasia, in 25% (1/4) of those with complex hyperplasia, in 14% (1/7) of those with simple atypical hyperplasia, and in 80% (4/5) of the patients with complex atypical hyperplasia. In the remaining 3 patients with simple hyperplasia, the lesions progressed to complex atypical hyperplasia by the end of follow-up, after showing a normal endometrium. CONCLUSION: Most cases of endometrial hyperplasia, except for complex atypical hyperplasia, disappeared spontaneously within a short period of time.

Adult↗