ABSTRACT
The question hidden in the title of this manuscript (whether the topic develops or remains constant) is important for all areas of science. It is also a serious problem for endometrial cancer (EC) study. In recent times the incidence of EC gradually increases in parallel with obesity epidemics. The main point of this review was evaluation of changes in EC area in last few decades, which are not only seen in tumor incidence, but also in its biology, hormonal-metabolic characteristics of patients and in the ratio of risk and anti-risk factors. One can hope that data accumulated recently and summarized here under the notion of EC evolution will find its use for advancement of EC prevention and treatment.
Subject(s)
Endometrial Neoplasms/etiology , Endometrial Neoplasms/metabolism , Animals , Biological Evolution , Cell Transformation, Neoplastic/genetics , Cell Transformation, Neoplastic/metabolism , Comorbidity , Disease Susceptibility , Endometrial Neoplasms/diagnosis , Endometrial Neoplasms/epidemiology , Female , Hormones/metabolism , Humans , Mutation , Neoplasm Grading , Phenotype , Population Surveillance , Risk FactorsABSTRACT
BACKGROUND: As endometrial cancer (EC) prevalence increases with obesity, we aimed to determine whether EC characteristics depend upon obesity type: 'standard' (SO) or 'metabolically healthy obesity' (MHO). PATIENTS & METHODS: 258 EC patients were included. Data on anthropometry, blood hormones, lipids and glucose, and tumor features were collected. RESULTS: EC clinicopathologic characteristics and clinical stage correlate differently with BMI and obesity type. BMI is related inversely with tumor grade while SO patients are characterized by a more advanced clinical stage than those with MHO. Besides typical insulin resistance signs, EC patients with SO often display a higher serum leptin/adiponectin ratio compared with MHO patients. Historical data suggest a gradual increase in EC patient height and weight, and a decrease in MHO prevalence. CONCLUSION: It is currently unknown whether the latter observation reflects the evolution of EC, or obesity alongside the current epidemic. Regardless, the reduced MHO prevalence demonstrates the need for more intensive preventive measures aimed at obesity and obesity-associated conditions, including different EC subtypes.
