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Obstetrics, Gynecology and Reproduction

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Diagnostic significance of hormonal, biochemical and echographic methods in postmenopausal women with endometrial cancer

https://doi.org/10.17749/2313-7347.2019.13.3.189-196

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Abstract

Aim: to evaluate the significance of hormonal, biochemical, and echographic methods in the diagnosis of endometrial cancer.

Materials and methods. Fifty patients (aged 62.4 ± 1.0) with endometrial cancer of varying severity and 20 practically healthy postmenopausal women (aged 68.0 ± 0.7) were examined. All patients underwent hormonal, biochemical, and echographic examinations.

Results. At the period of this study, 68 % of patients had stage I cancer, 30 % had stage II, and 2 % – stage III endometrial cancer. In the medical history of examined patients, the incidence of abortion was 46.8 %, the rate of childbirth – 70.0 %, the infertility rate – 14.9 % (n = 7). A statistically significant decrease in the luteinizing/follicle-stimulating hormone ratio (0.69 ± 0.09), an increase in the levels of prolactin (467.3 ± 35.1 ng/ml), dehydroepiandrosterone-sulfate (92.9 ± 14.4 pg/ml), estrone (101.60 ± 6.29 ng/ml), progesterone (1.90 ± 0.52 ng/ml), as well as a decrease in estradiol (17.4 ± 3.4 pg/ml) and total testosterone (0.50 ± 0.02 ng/ml) in comparison with the practically healthy postmenopausal women (control group) were found. According to the echographic examination, a pathological increase in the endometrium thickness (24.9 ± 2.7 mm) was detected against the background of uterus and ovaries enlargement. The biochemical parameters in patients with endometrial cancer in the postmenopausal period were within the normal range.

Conclusion. The risk of endometrial cancer is high in elderly women with an increased body mass index. Evaluating of their hormone levels is of diagnostic and prognostic importance in endometrial cancer. Transvaginal sonography is an accurate diagnostic method for assessing the tumor invasion into the myometrium of patients with endometrial cancer.

About the Authors

M. A. Garashova
Azerbaijan Medical University
Azerbaijan

Mina A. Garashova – PhD, Associate Professor, Department of Obstetrics and Gynecology № 1

100 Bratyev Mardanovykh St., Baku AZ 1078



E. M. Alieva
Azerbaijan Medical University
Azerbaijan

Elmira M. Alieva – MD, PhD, Professor, Head of the Department of Obstetrics and Gynecology № 1

100 Bratyev Mardanovykh St., Baku AZ 1078



References

1. Chestnova G.P., Kulyushina E.A., Abashin V.G. et al. Peculiarities of diagnostics of hyperplastic processes in endometrium during long postmenopause. [Osobennosti diagnostiki giperplasticheskih processov v endometrii u zhenshchin v period dlitel'noj postmenopauzy]. Klinicheskaya medicina. 2013;91(9):46–7. (In Russ.).

2. Timmermans A., Opmeer B.C., Khan K.S. et al. Endometrial thickness measurement for detecting endometrial cancer in women with postmenopausal bleeding: a systematic review and meta-analysis. Am J Obstet Gynecol. 2010;116(1):160–7. DOI: 10.1097/AOG.0b013e3181e3e7e8.

3. Burger H.G., Hale G.E., Robertson D.M., Dennerstein L. A review of hormonal changes during the menopausal transition: focus on findings from the Melbourne Women’s Midlife Health Project. Hum Reprod Update. 2007;13(6):559–65. DOI: 10.1093/humupd/dmm020.

4. Siegel R.L., Miller K.D., Jemal A. Cancer statistics 2018. CA Cancer J Clin. 2018;68(1):7–30. DOI: 10.3322/caac.21442.

5. Kondrikova N.I., Silakova A.V. Endometrial hyperplastic changes and precancerous conditions: terminology and classification. [Giperplasticheskie izmeneniya i predrakovye sostoyaniya endometriya: voprosy terminologii i klassifikacii]. Arhiv patologii. 2010;72(1):60–2. (In Russ.).

6. Kuznetsov R.E., Sokolova L.M. The use of ambulatory hysteroscopy in elderly patients. [Primenenie ambulatornoj gisteroskopii u bol'nyh pozhilogo vozrasta]. Voenno-medicinskij zhurnal. 2009;330(7):69. (In Russ.).

7. Pushkarev V.A., Mustafina G.T., Khusnutdinov Sh.M. et al. Glandular hyperplasia of endometrium. Diagnotis, clinic, treatment. [Zhelezistaya giperplaziya endometriya. Diagnostika, klinika, lechenie]. Kreativnaya hirurgiya i onkologiya. 2013;(4):23–7. (In Russ.).

8. Goldstein S.R. The role of transvaginal ultrasound or endometrial biopsy in the evaluation of the menopausal endometrium. Am J Obstet Gynecol. 2009;201(1):5–11. DOI: 10.1016/j.ajog.2009.02.006.

9. Van Hanegem N., Breijer M.C., Khan K.S. et al. Diagnostic evaluation of the endometrium in postmenopausal bleeding: An evidence-based approach. Maturitas. 2011;68(2):155–64. DOI: 10.1016/j.maturitas.2010.11.010.

10. Santoro N., Taylor E.S. Reproductive hormones and the menopause transition. Obstet Gynecol Clin North Am. 2011;38(3):455–66. DOI: 10.1016/j.ogc.2011.05.004.

11. ACOG committee opinion № 734: the role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding. Am J Obstet Gynecol. 2018;131(5):945–6. DOI: 10.1097/AOG.0000000000002631.

12. Zucchetto A., Serraino D., Polesel J. et al. Hormone-related factors and gynecological conditions in relation to endometrial cancer risk. Eur J Cancer Prev. 2009;18(4:)316–21. PMID: 19554665.

13. Levina V.V., Nolen B., Su Y.Y. et al. Biological significance of prolactin in gynecologic cancer. Cancer Res. 2009;69(12):5226–33. DOI: 10.1158/0008-5472.

14. Breijer M.C., Timmermans A., van Doorn H.C. et al. Diagnostic strategies for postmenopausal bleeding. Obstet Gynecol Int. 2010;2010:850812. DOI: 10.1155/2010/850812.

15. Broeze K.A., Opmeer B.C., Bachmann L.M. et al. Individual patient data meta-analysis of diagnostic and prognostic studies in obstetrics, gynaecology and reproductive medicine. BMC Med Res Methodol. 2009;9:22. DOI: 10.1186/1471-2288-9-22.

16. Pennant M.E., Mehta R., Moody P., Hackett G., Prentice A. Premenopausal abnormal uterine bleeding and risk of endometrial cancer. BJOG. 2017;124(3):404–11. DOI: 10.1111/1471-0528.14385.


For citation:


Garashova M.A., Alieva E.M. Diagnostic significance of hormonal, biochemical and echographic methods in postmenopausal women with endometrial cancer. Obstetrics, Gynecology and Reproduction. 2019;13(3):189-196. (In Russ.) https://doi.org/10.17749/2313-7347.2019.13.3.189-196

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)