[Characteristics of endometrial carcinoma in obese women].

INTRODUCTION: In most developed countries, endometrial cancer appears as most frequent invasive neoplasm of genital tract. Obesity is one of most important risk factors. Aim of study was to establish characteristics endometrial cancer in obese women. MATERIAL AND METHODS: The study included 50 surgically treated women with endometrial cancer. According body mass index they were divided into two groups--group A (30 obese women), group B (20 non-obese women). RESULTS AND DISCUSSION: Non-obese women with endometrial cancer are statistically significantly older than obese. Menopausal status, parity are not statistically significant. The obese group most frequently includes endometrioid type of tumor, while non-obese group most frequently includes non-endometrioid types of endometrial cancer. Over 50% thick myometrial invasion is statistically more frequent in non-obese group than in obese group. In obese group, less than 50% thick myometrial invasion, is statistically significant in comparison to nonobese group. High-differentiated endometrial cancer (G1) is statistically significantly more present in obese women than non-obese. Low-differentiated endometrial cancer is statistically more frequent in non-obese women than in obese. Most frequent in both groups is NG2. According to FIGO stage I, disease is statistically significantly more frequent in obese group than in non-obese. In non-obese group, total number of diseased in higher stages (II and III) is statistically significantly higher than in stage I. CONCLUSION: Endometrial cancer present in obese women is mostly endometroid type I, with slow myometrial invasion, with histological grade I, nuclear grade II in FIGO stage I of disease. In non-obese women, non-endometrioid cancer-- type II is more frequent, with faster myometrial invasion, histological grade II and III, nuclear grade II, in FIGO stage II of disease.

Insulin resistance and C-reactive protein in preeclampsia.

Preeclampsia is referred to as the "disease of the theories" because of the multiple hypotheses proposed to explain is occurrence. Despite considerable research, the causes of preeclampsia remain unclear. Preeclampsia is likely to be multifactorial in origin, and recent research has focused on endothelial dysfunction as a central abnormality in preeclampsia. Insulin resistance and inflammation may contribute to the onset of preeclampsia. They could also be correlated. The aim of the study was to evaluate the presence and relationship between insulin resistance and its markers and C-reactive protein as a marker of inflammation. During their third trimester, 17 preeclamptic women and 20 normotensive controls underwent oral glucose tolerance test, basic biochemical analyses and SHBG. Preeclamptic women were more insulin resistant (p=0,004), and they had higher triglycerides levels (p=0,006), uric acid (p=0,002). However, the study groups did not differ in C-reactive protein (CRP), sex hormone-binding globulin (SHBG), high and low-density lipoproteins (HDL-cholesterol and LDL-cholesterol). In multiple regression analysis only SHBG (p=0,014) and triglycerides (p=0,003) were associated with insulin sensitivity independently of the body mass index (BMI), weight gain, HDL and LDL, and CRP. Preeclampsia is a state of increased insulin resistance, and CRP as the marker of inflammation was not increased in our research, and not associated with established preeclampsia.

[Color Doppler imaging and measurements of intraovarian and intrauterine vascularization on basal ultrasound examination in spontaneous ovulatory and anovulatory cycles].

BACKGROUND/AIM: Any organs functioning directly depends on vascularization. It applies also to the uterus and ovary which go through changes of vascularization during a menstruation cycle. The aim of this investigation was to determine differences in intrauterine and ovarian stromal arterioral blood flow on basal ultrasound examination (day 2-4) between spontaneous ovulatory and anovulatory cycles. METHODS: This prospective clinical investigation included 205 patients divided into two groups: with ovulatory and with anovulatory cycles. RESULTS: Resistance to ovarian arterioral stromal blood flow was significantly lower in the patients with ovulatory cycles (pulsatile index--PI 0.97 +/- 0.4 vs 1.93 +/- 1.37; p = 0.001737; and (resistance index - RI 0.55 +/- 0.12 vs 0.68 +/- 0.14; p = 0.040033). There. were no statistically significant differences in arcuate arterioral blood flow in the pateints with ovulatory and anovulatory cycles (PI 1.21 +/- 0.34 vs 61 +/- 0,61 p = 0.136161 and RI 0.64 +/- 0.11 vs 0.74 +/- 0.07; p = 0.136649). The patients with ovulatory cycles had lower uterine radial arterioral blood flow than the patients with anovulatory cycles (PI 1.001 +/- 0.22 vs 1.61 +/- 0.23 p = 0.007501 and RI 0.55 +/- 0.08 vs 0.71 +/- 0.12; p = 0,0460113). The patients with ovulatory cycles had lower subendometrial arterioral blood flow resistance (PI 0.69 0.19 vs 1.385 +/- 0.09; p = 0.00622 and RI 0.44 +/- 0.09 vs 0.65 +/- 0.02; p = 0.027458). CONCLUSION: Color Doppler ultrasuond imaging and measurements of intrauterine and ovarian stromal arterioral blood flow on basal ultrasound examination (day 2-4), showed lower resistance to blood flow in ovulatory than in anovulatory cycles.