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[PMID]:29254314
[Au] Autor:Shi ZM; Liu YN; Fu B; Shen YF; Li LM
[Ad] Endereço:Pathological Staff Room, School of Medicine and Affiliated Hospital of HeBei University of Engineering, Handan, HeBei, China.
[Ti] Título:Expression profile of eukaryotic translation initiation factor and matrix metalloproteinase 9 in endometrial cancer tissue.
[So] Source:J Biol Regul Homeost Agents;31(4):1053-1059, 2017 Oct-Dec.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:The aim of the present study was to provide a novel method for the diagnosis, prevention and treatment of endometrial cancer by the determination of the characteristic expression of the eukaryotic translation initiation factor 4E (eIF4E) and the enzyme matrix metalloproteinase 9 (MMP9) in endometrial cancer tissue. Three types of endometrial tissue specimens were selected (including 20 cases of normal endometrial tissue specimens, 15 cases of hyperplastic endometrial tissue specimens and 45 cases of endometrial cancer tissue specimens). The expression of eIF4E and MMP9 in the specimens was examined by immunohistochemistry and their corresponding levels were statistically analyzed. The positive expression rates of eIF4E and MMP9 in endometrial cancer specimens were 64.44% and 66.67% respectively, which were higher than those noted in hyperplastic endometrial tissue specimens and normal endometrial tissue specimens (p less than 0.05). The comparisons between the groups indicated that the expression levels of eIF4E and MMP9 in the endometrial cancer specimens were increased compared with those noted in the normal endometrial tissue specimens (p less than 0.0167). In endometrial cancer specimens, the positive expression rates of eIF4E and MMP9 were related to the endometrial cancer stages as determined by the International Federation of Gynecology and Obstetrics (FIGO), tumor cell differentiation degree and lymphatic metastasis (p less than 0.05) classifications. eIF4E expression was positively related to MMP9 expression in endometrial cancer specimens. High expression levels of eIF4E and MMP9 proteins were noted in endometrial cancer specimens, which were correlated with FIGO stages, histological grade and degree of lymphatic metastasis. Thus, endometrial cancer and malignant biological behavior may be connected to the high expression of eIF4E and MMP9. The positive correlation between eIF4E and MMP9 expression in endometrial cancer specimens suggests their potential up-regulation during carcinogenesis.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/genética
Hiperplasia Endometrial/genética
Neoplasias do Endométrio/genética
Fator de Iniciação 4E em Eucariotos/genética
Regulação Neoplásica da Expressão Gênica
Metaloproteinase 9 da Matriz/genética
[Mh] Termos MeSH secundário: Adulto
Biomarcadores Tumorais/metabolismo
Carcinogênese/genética
Carcinogênese/metabolismo
Carcinogênese/patologia
Estudos de Casos e Controles
Hiperplasia Endometrial/metabolismo
Hiperplasia Endometrial/patologia
Neoplasias do Endométrio/metabolismo
Neoplasias do Endométrio/patologia
Fator de Iniciação 4E em Eucariotos/metabolismo
Feminino
Perfilação da Expressão Gênica
Seres Humanos
Metástase Linfática
Metaloproteinase 9 da Matriz/metabolismo
Meia-Idade
Estadiamento de Neoplasias
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (Eukaryotic Initiation Factor-4E); EC 3.4.24.35 (MMP9 protein, human); EC 3.4.24.35 (Matrix Metalloproteinase 9)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:29215513
[Au] Autor:Pal N; Broaddus RR; Urbauer DL; Balakrishnan N; Milbourne A; Schmeler KM; Meyer LA; Soliman PT; Lu KH; Ramirez PT; Ramondetta L; Bodurka DC; Westin SN
[Ad] Endereço:Department of Gynecologic Oncology and Reproductive Medicine and the Division of Quantitative Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas.
[Ti] Título:Treatment of Low-Risk Endometrial Cancer and Complex Atypical Hyperplasia With the Levonorgestrel-Releasing Intrauterine Device.
[So] Source:Obstet Gynecol;131(1):109-116, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess efficacy of the levonorgestrel-releasing intrauterine device (LNG-IUD) for treatment of complex atypical hyperplasia or low-grade endometrial cancer. METHODS: This retrospective case series included all patients treated with the LNG-IUD for complex atypical hyperplasia or early-grade endometrial cancer from January 2003 to June 2013. Response rates were calculated and the association of response with clinicopathologic factors, including age, body mass index, and uterine size, was determined. RESULTS: Forty-six patients diagnosed with complex atypical hyperplasia or early-grade endometrial cancer were treated with the LNG-IUD. Of 32 evaluable patients at the 6-month time point, 15 had complex atypical hyperplasia (47%), nine had G1 endometrial cancer (28%), and eight had grade 2 endometrial cancer (25%). Overall response rate was 75% (95% CI 57-89) at 6 months; 80% (95% CI 52-96) in complex atypical hyperplasia, 67% (95% CI 30-93) in grade 1 endometrial cancer, and 75% (CI 35-97) in grade 2 endometrial cancer. Of the clinicopathologic features evaluated, there was a trend toward the association of lack of exogenous progesterone effect in the pathology specimen with nonresponse to the IUD (P=.05). Median uterine diameter was 1.3 cm larger in women who did not respond to the IUD (P=.04). CONCLUSION: Levonorgestrel-releasing IUD therapy for the conservative treatment of complex atypical hyperplasia or early-grade endometrial cancer resulted in return to normal histology in a majority of patients.
[Mh] Termos MeSH primário: Hiperplasia Endometrial/tratamento farmacológico
Hiperplasia Endometrial/patologia
Neoplasias do Endométrio/tratamento farmacológico
Neoplasias do Endométrio/patologia
Dispositivos Intrauterinos Medicados
Levanogestrel/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Biópsia por Agulha
Institutos de Câncer
Estudos de Coortes
Progressão da Doença
Feminino
Seres Humanos
Imuno-Histoquímica
Meia-Idade
Invasividade Neoplásica/patologia
Estadiamento de Neoplasias
Lesões Pré-Cancerosas/tratamento farmacológico
Lesões Pré-Cancerosas/patologia
Estudos Retrospectivos
Medição de Risco
Texas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
5W7SIA7YZW (Levonorgestrel)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002390


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[PMID]:28760367
[Au] Autor:Meireles CG; Pereira SA; Valadares LP; Rêgo DF; Simeoni LA; Guerra ENS; Lofrano-Porto A
[Ad] Endereço:Molecular Pharmacology Laboratory, Health Sciences Faculty, University of Brasilia, Brasilia, Brazil.
[Ti] Título:Effects of metformin on endometrial cancer: Systematic review and meta-analysis.
[So] Source:Gynecol Oncol;147(1):167-180, 2017 Oct.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Endometrial cancer is one of the most common gynecological cancers, which is frequently preceded by atypical endometrial hyperplasia, a premalignant lesion. Metformin, an antidiabetic drug, has emerged as a new adjunctive strategy for different cancer types, including endometrial cancer. This systematic review and meta-analysis aimed to evaluate the effects of metformin in atypical endometrial hyperplasia and endometrial cancer patients. METHODS: The search was conducted on January 2017 and the articles were collected in Cochrane, LILACS, PubMed, Scopus and Web of Science. A grey literature search was undertaken using Google SCHOLAR, ProQuest and Open Grey. Nineteen studies were included, which contained information about the following outcomes: reversal of atypical endometrial hyperplasia, cellular proliferation biomarkers expression and overall survival in metformin-users compared to non-users. RESULTS: Metformin was associated with reversion of atypical endometrial hyperplasia to a normal endometrial, and with decreased cell proliferation biomarkers staining, from 51.94% (CI=36.23% to 67.46%) to 34.47% (CI=18.55% to 52.43%). However, there is a high heterogeneity among studies. Metformin-users endometrial cancer patients had a higher overall survival compared to non-metformin users and non-diabetic patients (HR=0.82; CI: 0.70-0.95; p=0.09, I =40%). CONCLUSION: Regardless the high heterogeneity of the analyzed studies, the present review suggests that adjunct metformin treatment may assist in the reversal of atypical endometrial hyperplasia to normal endometrial histology, in the reduction of cell proliferation biomarkers implicated in tumor progression, and in the improvement of overall survival in endometrial cancer. Further work on prospective controlled trials designed to address the effects of adjunct metformin on clinical outcomes is necessary for definite conclusions.
[Mh] Termos MeSH primário: Hiperplasia Endometrial/tratamento farmacológico
Neoplasias do Endométrio/tratamento farmacológico
Endométrio/patologia
Hipoglicemiantes/uso terapêutico
Metformina/uso terapêutico
[Mh] Termos MeSH secundário: Biomarcadores Tumorais/metabolismo
Quimioterapia Adjuvante
Neoplasias do Endométrio/metabolismo
Feminino
Seres Humanos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (Hypoglycemic Agents); 9100L32L2N (Metformin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE


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[PMID]:28712776
[Au] Autor:Russo M; Broach J; Sheldon K; Houser KR; Liu DJ; Kesterson J; Phaeton R; Hossler C; Hempel N; Baker M; Newell JM; Zaino R; Warrick JI
[Ad] Endereço:Department of Biochemistry, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA 17033; Institute for Personalized Medicine, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA 17033.
[Ti] Título:Clonal evolution in paired endometrial intraepithelial neoplasia/atypical hyperplasia and endometrioid adenocarcinoma.
[So] Source:Hum Pathol;67:69-77, 2017 Sep.
[Is] ISSN:1532-8392
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Endometrial intraepithelial neoplasia (EIN) and atypical endometrial hyperplasia (AH) are histomorphologically defined precursors to endometrioid adenocarcinoma, which are unified as EIN/AH by the World Health Organization. EIN/AH harbors a constellation of molecular alterations similar to those found in endometrioid adenocarcinoma. However, the process of clonal evolution from EIN/AH to carcinoma is poorly characterized. To investigate, we performed next-generation sequencing, copy number alteration (CNA) analysis, and immunohistochemistry for mismatch repair protein expression on EIN/AH and endometrioid adenocarcinoma samples from 6 hysterectomy cases with spatially distinct EIN/AH and carcinoma. In evaluating all samples, EIN/AH and carcinoma did not differ in mutational burden, CNA burden, or specific genes mutated (all P>.1). All paired EIN/AH and carcinoma samples shared at least one identical somatic mutation, frequently in PI(3)K pathway members. Large CNAs (>10 genes in length) were identified in 83% of cases; paired EIN/AH and carcinoma samples shared at least one identical CNA in these cases. Mismatch repair protein expression matched in all paired EIN/AH and carcinoma samples. All paired EIN/AH and carcinoma samples had identical The Cancer Genome Atlas subtype, with 3 classified as "copy number low endometrioid" and 3 classified as "microsatellite instability hypermutated." Although paired EIN/AH and carcinoma samples were clonal, private mutations (ie, present in only one sample) were identified in EIN/AH and carcinoma in all cases, frequently in established cancer-driving genes. These findings indicate that EIN/AH gives rise to endometrioid adenocarcinoma by a complex process of subclone evolution, not a linear accumulation of molecular events.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/genética
Carcinoma in Situ/genética
Carcinoma Endometrioide/genética
Evolução Clonal
Hiperplasia Endometrial/genética
Neoplasias do Endométrio/genética
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Biomarcadores Tumorais/análise
Biópsia
Carcinoma in Situ/enzimologia
Carcinoma in Situ/patologia
Carcinoma in Situ/cirurgia
Carcinoma Endometrioide/enzimologia
Carcinoma Endometrioide/patologia
Carcinoma Endometrioide/cirurgia
Proliferação Celular
Variações do Número de Cópias de DNA
Reparo de Erro de Pareamento de DNA
Enzimas Reparadoras do DNA/análise
Progressão da Doença
Hiperplasia Endometrial/enzimologia
Hiperplasia Endometrial/patologia
Hiperplasia Endometrial/cirurgia
Neoplasias do Endométrio/enzimologia
Neoplasias do Endométrio/patologia
Neoplasias do Endométrio/cirurgia
Feminino
Dosagem de Genes
Predisposição Genética para Doença
Sequenciamento de Nucleotídeos em Larga Escala
Seres Humanos
Histerectomia
Imuno-Histoquímica
Instabilidade de Microssatélites
Meia-Idade
Mutação
Fenótipo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); EC 6.5.1.- (DNA Repair Enzymes)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE


  5 / 3118 MEDLINE  
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[PMID]:28599864
[Au] Autor:Abdel-Latif RT; Zaitone SA; Abdel-Mottaleb Y; El-Maraghy NN
[Ad] Endereço:Department of Pharmacology, Toxicology & Biochemistry, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt.
[Ti] Título:The anorectic agent, lorcaserin, disturbs estrous cyclicity and produces endometrial hyperplasia without affecting ovarian population in female rats.
[So] Source:Life Sci;183:69-77, 2017 Aug 15.
[Is] ISSN:1879-0631
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIMS: The present study aims to investigate the effect of the new anorectic agent, lorcaserin, on estrous cyclicity, reproductive hormones and folliculogenesis in female mature rats. MATERIALS AND METHODS: Rats were divided into four groups; Group i: control group. Group ii-iv: rats treated with lorcaserin (5, 10 or 30mg/kg/day, p.o.), respectively. The treatment continued for 28days. KEY FINDINGS: Lorcaserin (5 or 10mg/kg) caused estrous cycle disturbance in 40% of treated rats while the high dose (30mg/kg) produced disturbances in 100% of the treated rats. Lorcaserin (5-30mg/kg) altered some of female hormones where it enhanced estradiol but reduced luteinizing hormone. Minimal edema with congested vessels was observed in the medulla of ovarian sections. Further, epithelial and uterine sections showed hyperplasia. SIGNIFICANCE: Taken together, the present results demonstrated that lorcaserin affected some reproductive hormones, disturbed estrous cyclicity and induced histopathological changes in the ovaries and uteri without affecting the ovarian populations. Therefore, lorcaserin should be used with caution in women of child bearing potential until adequate clinical safety data are available.
[Mh] Termos MeSH primário: Depressores do Apetite/farmacologia
Benzazepinas/farmacologia
Hiperplasia Endometrial/induzido quimicamente
Ciclo Estral/efeitos dos fármacos
Ovário/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Depressores do Apetite/administração & dosagem
Benzazepinas/administração & dosagem
Relação Dose-Resposta a Droga
Estradiol/metabolismo
Feminino
Hormônio Luteinizante/metabolismo
Folículo Ovariano/efeitos dos fármacos
Ovário/patologia
Ratos
Ratos Wistar
Útero/efeitos dos fármacos
Útero/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Appetite Depressants); 0 (Benzazepines); 4TI98Z838E (Estradiol); 637E494O0Z (lorcaserin); 9002-67-9 (Luteinizing Hormone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170611
[St] Status:MEDLINE


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[PMID]:28476823
[Au] Autor:Sletten ET; Arnes M; Lysa LM; Moe BT; Straume B; Orbo A
[Ad] Endereço:Department of Gynecologic Oncology, Clinic for Surgery, Cancer and Women's Diseases, University Hospital of North Norway, Tromso, Norway.
[Ti] Título:Prediction of Relapse After Therapy Withdrawal in Women with Endometrial Hyperplasia: A Long-term Follow-up Study.
[So] Source:Anticancer Res;37(5):2529-2536, 2017 05.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate whether risk of relapse of endometrial hyperplasia persists many years after successful primary therapy and whether clinical or biological markers observed at primary diagnosis may predict relapse. MATERIALS AND METHODS: A series of 57 women with endometrial hyperplasia received levonorgestrel-impregnated intrauterine system or oral progestin for three months during 1998-2000. Index biopsies were classified according to WHO1994 and D-score systems, and immunohistochemical staining for estrogen receptor α (ERα), estrogen receptor ß (ERß), progesterone receptor A (PRA), progesterone receptor B (PRB), B-cell lymphoma 2/apoptosis regulator (BCL2), BCL2-associated X protein/apoptosis regulator (BAX), paired box 2 (PAX2), and phosphatase and tensin homolog (PTEN) reported as H-scores. RESULTS: Over a follow-up of 157.8 months, 23% (10/43) of patients experienced relapse. No correlation with age, body mass index, parity, WHO94 classification, or D-score was found. Only PRA (p=0.004) and PRB (p=0.038) showed certain correlation with relapse. CONCLUSION: Endometrial hyperplasia recurs many years after successful progestin therapy. Increased expression of PRB and reduced expression of PRA significantly correlated with relapse. Our results support the importance of continuous endometrial protection and the need for new clinical surveillance guidelines.
[Mh] Termos MeSH primário: Hiperplasia Endometrial/tratamento farmacológico
Levanogestrel/uso terapêutico
Medroxiprogesterona/uso terapêutico
Progestinas/uso terapêutico
[Mh] Termos MeSH secundário: Administração Oral
Adulto
Idoso
Anticoncepcionais Femininos/administração & dosagem
Anticoncepcionais Femininos/uso terapêutico
Hiperplasia Endometrial/metabolismo
Feminino
Seguimentos
Seres Humanos
Dispositivos Intrauterinos Medicados
Levanogestrel/administração & dosagem
Medroxiprogesterona/administração & dosagem
Meia-Idade
Progestinas/administração & dosagem
Receptores de Progesterona/metabolismo
Recidiva
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Contraceptive Agents, Female); 0 (Progestins); 0 (Receptors, Progesterone); 0 (progesterone receptor A); 0 (progesterone receptor B); 5W7SIA7YZW (Levonorgestrel); HSU1C9YRES (Medroxyprogesterone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170507
[St] Status:MEDLINE


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[PMID]:28441840
[Au] Autor:Bai TJ; Bao DM; Li Y; Wang Y; Cui H; Zhu HL
[Ad] Endereço:Department of Obstetrics and Gynecology, Peking Univeristy People's Hospital, Beijing 100044, China.
[Ti] Título:[Atypical polypoid adenomyoma of the uterus: a clinicopathological review of 27 cases].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(4):244-248, 2017 Apr 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) for improvement of the diagnosis, different diagnosis and treatment of the disease. The clinical data, pathological characteristics, and the follow-up information were retrospectively analyzed in 27 cases of APA admitted in Peking Univeristy People s Hospital from 2007 to 2016. The median age was 42.6 years old (range 25-60 years old). Fifteen patients were nullipara, 2 patients were postmenopausal. The most common presenting symptom was abnormal uterine bleeding (81%, 22/27) . Leisions were obtained by using hysteroscopy in 23 cases, hysterectomy 3 cases and dilatation and curettage 1 case. Fertility preserving treatments were performed in 10 patients who had strong desire for fertility, among which 1 case progressed into endometrial carcinoma. Among 15 patients underwent hysterectomy and (or) bilateral salpingo-oophorectomy, 9 cases of them had endometrial atypical hyperplasia. Endometrial carcinoma along with APA were found in three patients, 2 cases of them underwent hysterectomy and bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the other one received medication for fertility preservation. Follow up information were available in 24 cases (89%, 24/27) with a median follow up of 46 months (range 4-108 months), 1 case recurred and 1 case progressed into endometrial carcinoma. One case died of other malignancy, while the other patients were alive. APA is a rare uterine neoplasm mixed with epithelial and mesenchymal component. It occurs mostly in childbearing-age women and its diagnosis is dependent on pathology. Although it s clinical course is benign, there is risk of co-existance of endometrial carcinoma and endometrial atypical hyperplasia. For those who has desire of fertility, the treatment strategy is completely removed the lesion and closely followed up. For those who do not desire to preserve fertility, hysterectomy may be an option.
[Mh] Termos MeSH primário: Adenomioma/patologia
Preservação da Fertilidade
Histerectomia
Histeroscopia
Pólipos/patologia
Neoplasias Uterinas/patologia
[Mh] Termos MeSH secundário: Adenomioma/cirurgia
Adulto
Diagnóstico Diferencial
Dilatação e Curetagem
Hiperplasia Endometrial
Neoplasias do Endométrio
Feminino
Fertilidade
Seres Humanos
Meia-Idade
Recidiva Local de Neoplasia
Ovariectomia
Pólipos/cirurgia
Gravidez
Estudos Retrospectivos
Resultado do Tratamento
Neoplasias Uterinas/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567X.2017.04.006


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[PMID]:28427775
[Au] Autor:Baker WD; Pierce SR; Mills AM; Gehrig PA; Duska LR
[Ad] Endereço:Department of Obstetrics & Gynecology, University of Virginia, Charlottesville, VA, United States. Electronic address: wdbaker@novanthealth.org.
[Ti] Título:Nonoperative management of atypical endometrial hyperplasia and grade 1 endometrial cancer with the levonorgestrel intrauterine device in medically ill post-menopausal women.
[So] Source:Gynecol Oncol;146(1):34-38, 2017 Jul.
[Is] ISSN:1095-6859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the endometrial response rates to treatment with the levonorgestrel intrauterine device in post-menopausal women with atypical hyperplasia/endometrial intraepithelial neoplasia and grade 1 endometrioid (AH/EC) endometrial carcinoma who are not surgical candidates. METHODS: Chart review was undertaken of patients with AH/EC who underwent levonorgestrel intrauterine device insertion by a gynecologic oncologist within two academic health systems between 2002 and 2013. When available, tissue blocks were evaluated with immunohistochemical staining for progesterone receptor expression. RESULTS: A total of 41 patients received treatment for AH/EC with the levonorgestrel intrauterine device. Follow up sufficient to assess response occurred in 36 women (88%). Complete response was documented in 18 of 36 women (50%), no response in 8 patients (22%), partial response in 3 women (8%) and progression of disease in 7 patients (19%). Four of 18 patients with complete response (22%) later experienced relapse of hyperplasia or cancer. Four patients (10%) died during the study period: none had evidence of metastatic disease and 1 of the 4 woman died of perioperative complications following hysterectomy for stage I disease. Patients responding to treatment had significantly lower progesterone receptor expression on post-treatment biopsies. CONCLUSIONS: Intrauterine levonorgestrel is a viable treatment option for post-menopausal women with AH/EC who are poor candidates for standard surgical management. The response rate in this series is similar to published reports in premenopausal patients and includes cases of disease recurrence following conversion to benign endometrium.
[Mh] Termos MeSH primário: Hiperplasia Endometrial/tratamento farmacológico
Neoplasias do Endométrio/tratamento farmacológico
Dispositivos Intrauterinos
Levanogestrel/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Hiperplasia Endometrial/metabolismo
Neoplasias do Endométrio/metabolismo
Neoplasias do Endométrio/patologia
Feminino
Seres Humanos
Imuno-Histoquímica
Levanogestrel/efeitos adversos
Meia-Idade
Gradação de Tumores
Pós-Menopausa
Receptores de Progesterona/biossíntese
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptors, Progesterone); 5W7SIA7YZW (Levonorgestrel)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE


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[PMID]:28368791
[Au] Autor:Gonthier C; Trefoux-Bourdet A; Luton D; Koskas M
[Ad] Endereço:Service de gynécologie-obstétrique, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France. Electronic address: clementinegonthier@hotmail.com.
[Ti] Título:[Fertility-sparing management of endometrial cancer and atypical hyperplasia].
[Ti] Título:Traitement conservateur des hyperplasies atypiques et cancers de l'endomètre et préservation de la fertilité..
[So] Source:Gynecol Obstet Fertil Senol;45(2):112-118, 2017 Feb.
[Is] ISSN:2468-7189
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:The fertility sparing management of endometrial cancer and atypical hyperplasia concern women in childbearing age with stage 1, grade 1, endometrioid adenocarcinoma confined to endometrium or atypical hyperplasia (simple or complex). These pathologies affecting more frequently postmenopausal women, the number of people involved is relatively low. The main risk factor is hyperestrogenism and these patients often present a history of infertility with a desire for pregnancy. The recommendations for this conservative management are scarce and unclear. The national observatory in the gynecology and obstetrics department of Bichat hospital gives expert advice to help doctors and patients concerned. We present a type of conservative management based on the expertise of the national observatory. Rigorous pre-therapeutic assessment must first be made to avoid missing a more advanced lesion. Hormone therapy is then started to obtain complete remission. In case of remission, fast achieving pregnancy is advised, and the use of assisted reproductive therapy is possible if necessary. Monitoring by hysteroscopy and histological examination is essential during the treatment. Hysterectomy is the last time the conservative management. It is motivated by the risk of recurrence and progression. The probability of remission after conservative treatment is estimated at 78.0 % at 12 months, the probability of recurrence at 29.2 % at 24 months, and the risk of progression at 15 % (stage 1A with myometrial invasion or more on the hysterectomy specimen). In terms of fertility, 32 % of women get at least one pregnancy.
[Mh] Termos MeSH primário: Carcinoma Endometrioide/terapia
Hiperplasia Endometrial/terapia
Neoplasias do Endométrio/terapia
Preservação da Fertilidade/métodos
[Mh] Termos MeSH secundário: Antineoplásicos Hormonais/uso terapêutico
Carcinoma Endometrioide/patologia
Hiperplasia Endometrial/patologia
Neoplasias do Endométrio/patologia
Feminino
Seres Humanos
Histerectomia
Invasividade Neoplásica/patologia
Recidiva Local de Neoplasia/prevenção & controle
Gravidez
Indução de Remissão/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE


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[PMID]:28353144
[Au] Autor:Moradan S; Nikkhah N; Mirmohammadkhanai M
[Ad] Endereço:Gynecologist, Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.
[Ti] Título:Comparing the Administration of Letrozole and Megestrol Acetate in the Treatment of Women with Simple Endometrial Hyperplasia without Atypia: A Randomized Clinical Trial.
[So] Source:Adv Ther;34(5):1211-1220, 2017 May.
[Is] ISSN:1865-8652
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The present study was conducted as a pilot to compare the therapeutic effects and the potential side effects of oral Megestrol acetate and Letrozole in the treatment of simple hyperplasia in perimenopausal women. METHODS: The participants of this randomized clinical trial consisted of two groups of 25 women aged 44-50 presenting with abnormal uterine bleeding diagnosed with simple endometrial hyperplasia without cytologic atypia confirmed by transvaginal ultrasonography and biopsy. The first group received 40-mg doses of Megestrol acetate for 2 weeks per month for a total period of 2 months. The second group received 2.5-mg daily doses of Letrozole for a total period of 2 months. The differences in terms of quantitative measurements were analyzed using the independent two-sample t test and the paired t test. To compare the two groups in terms of the distribution of the categorical variables, Pearson's Chi square and Fisher's Exact tests were used at the significance level of 0.05 by Stata-9.2. RESULTS: Although the intervention led to significant improvements in both groups (P < .001), there was no difference between the groups in terms of accomplishing resolution (P = .74) [seven (28%) patients in the Letrozole group and five (20%) in the Megestrol group], while two patients in the Letrozole group and nine in the Megestrol group suffered from side effects, suggesting significantly lower side effects in the Letrozole group (P = .02). CONCLUSION: Letrozole and Megestrol acetate seem to have similar effects on the treatment of simple endometrial hyperplasia, the only difference being that Letrozole presents fewer side effects than Megestrol acetate in patients with this condition. FUNDING: Abnormal Uterine Bleeding Research Center of Semnan University of Medical Sciences, Semnan, Iran. TRIAL REGISTRATION: IRCT2015031011504N5.
[Mh] Termos MeSH primário: Hiperplasia Endometrial/tratamento farmacológico
Acetato de Megestrol/uso terapêutico
Nitrilos/uso terapêutico
Triazóis/uso terapêutico
[Mh] Termos MeSH secundário: Administração Oral
Adulto
Feminino
Seres Humanos
Meia-Idade
Projetos Piloto
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Nitriles); 0 (Triazoles); 7LKK855W8I (letrozole); TJ2M0FR8ES (Megestrol Acetate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.1007/s12325-017-0509-8



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