Search

Objective: Endometrial cancer (EC) is the most common gynecological malignancy in economically developed countries. Documented risk factors include diabetes mellitus and obesity. Metformin, a derivative of biguanide, applied in treatment of type 2 diabetes, also has anti-neoplastic effects. The analysis presented below represents an attempt to determine the effects of metformin on clinical-pathological variables of EC, linked to the morbidity and course of EC. Material and Methods: 1,305 patients with EC were included in this retrospective study, the control group consisted of 1,016 EC patients who were diabetes-free, 144 patients with EC and type 2 diabetes treated with metformin, and 145 patients with EC and type 2 diabetes treated with other antidiabetic agents. The analyzed variables included age upon diagnosis of EC, BMI, parity, clinical stage according to FIGO, histological type of cancer (type I or type II EC), grading, type of surgery, adjuvant treatment (radio- or chemotherapy), and comorbidities. Results: EC in females with type 2 diabetes treated with metformin or other antidiabetic agents were diagnosed at a more advanced age than those in the control group. Both groups of patients with type 2 diabetes manifested morbid obesity significantly more frequently than the control group. Advanced stages of cancer were detected less frequently among metformin users compared to the control group and among patients with diabetes treated with other antidiabetic agents. Moreover, in the metformin group, total abdominal hysterectomy and adnexectomy were less common than in the remaining groups. Adjuvant radiotherapy was applied more frequently in the metformin-treated group. Both groups of type 2 diabetes patients were also more likely to suffer from hypertension. Conclusion: Compared to the control group, women with EC and diabetes mellitus were diagnosed at a more advanced age. A lower percentage of women with EC using metformin were diagnosed at advanced stages of EC according to FIGO in contrast to the control group and the group with diabetes treated with other antidiabetic agents. Patients treated with metformin underwent TAHBSO less frequently, but radiotherapy was applied more often. The present results show that type 2 diabetes patients also suffer from hypertension more frequently regardless of the diabetes treatment applied. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to assess, among others, monocyte chemoattractant protein type-1 MCP-1 [also called chemokine ligand 2 (CCL2)], MCP-2 (CCL8), regulated on activation, normal T cell expressed and secreted (RANTES) (CCL5), Ki- 67, and transforming growth factor beta (TNF-β) levels in the serum of patients with benign and borderline ovarian lesions. Study Design: Patients who underwent laparoscopy and or laparotomy in the Gynecology and Obstetrics Clinical Hospital, Poznan Medical University, Poland, for adnexal changes in the form of endometrial cysts (n=11) and mature teratomas (n=11), mucinous cysts (n=16), borderline tumors of the ovary (n=17), simplex (serosa) cysts (n=19), or hemorrhagic cysts (n=5) were included in this study. Results: The differences in the medians of MCP-1, MCP-2, RANTES, Ki-67, and TNF-β were non-statistically significant. Spearman's correlation analysis performed on the group of women with endometriomas showed a statistically significant and positive dependence on the level of RANTES with Ki-67 (r = 0.6; p = 0.0467). Moreover, Spearman's correlation analysis performed on the group of women treated surgically for mature teratomas was statistically significant for the level of MCP-1 with TNF-β (r = 0.7; p = 0.0301). Conclusion: The study of serum levels of MCP-1 (CCL2), MCP-2, RANTES (CCL5), Ki-67, and TNF-β in patients with benign and borderline ovarian tumors revealed correlations between the level of RANTES and Ki-67 and of MCP-1 and TNF-β, which suggests that chemokines as the markers of benign and borderline ovarian tumors are questionable. [ABSTRACT FROM AUTHOR]

Objective: Ovarian tumours can be classified as benign, borderline or malignant lesions. The purpose of this study was to assess, inter alia, fibrinogen concentration, and the (C-reactive proteins) and high-sensitivity CRPs (hs-CRPs) levels in the blood serum of patients with ovarian lesions. Study Design: The study involved patients treated laparoscopically and laparotomy in the Gynaecology and Obstetrics Clinical Hospital of the Poznan due to adnexal changes in the form of endometrial cysts and mature teratomas, mucinous cysts, borderline tumors of the ovary, simplex (serosa) cysts or haemorrhagic cysts. Results: The groups differed considerably in fibrinogen (p = 0.022) and d-dimer levels (p = 0.002). Conclusion: Statistically significant differences were found in the fibrinogen and d-dimer profiles among patients with benign and borderline ovarian tumours. However, this requires further investigations in larger patient groups. [ABSTRACT FROM AUTHOR]

Diabetes and tumour diseases are serious health problems in the elderly population. Several studies have suggested that patients with diabetes are at significantly higher risk of cancer. On the other hand, epidemiologic evidence suggests that some drugs used to treat hyperglycemia are associated with reduced risk of cancer. Metformin, the drug applied in type 2 diabetes, has been shown to reduce incidence and mortality due to malignant tumours in various localities. A hypothesis is presented which seeks to explain the anticancer effects of metformin. Empirical data from the scientific literature is used to support the hypothesis that metformin restricts the growth of human cancer stem cells (CSCs). The LKB1/AMPK (liver kinase B1/AMP activated protein kinase) mechanism of the antineoplastic action is pleiotropic, involving the activation of the LKB1/AMP pathway, which inhibits mTOR signalling, inhibits STAT-3 phosphorylation, arrests cell cycle at the G1 phase, inhibits cyclin D1 activity, reduces insulin levels, as well as IGF-1, TNFα, and IL-6 levels which reduce proliferation leading to apoptosis of neoplastic cells. In various tumours, including gynaecological cancers, metformin eliminates cancer stem cells (CSCs). Repositioning metformin as a possible antineoplastic option seems promising. The present authors suggest here that metformin could be a valuable tool for clinicians to help reduce cancer risk in elderly adults with diabetes. [ABSTRACT FROM AUTHOR]

Gonadoblastomas are benign tumors composed of germ cells and sex cords derivatives resembling immature granulosa and Sertoli cells. They occur almost entirely in patients with gonadal dysgenesis and in those carrying the Y chromosome. The authors present a case of a 17-year-old patient admitted because of primary amenorrhea and delayed puberty diagnosed, and operated because of bilateral gonadoblastoma. [ABSTRACT FROM AUTHOR]

There are some pelvic masses which are difficult to correctly classify as malignant or benign. The decision concerning method and choice of surgical intervention is not simple in this situation. Some tumors are extremely rare and need to be presented in the literature. The authors report a rare case of fibrous tumor of the omentum simulating a malignant ovarian tumor, which ultimately resulted to be a primary solitary fibrous tumor of the omentum. Ultrasound findings are mostly precise prognostic tools according ovarian masses. However, from time to time, Doppler blood flow examination may present false positive results. [ABSTRACT FROM AUTHOR]

Despite the introduction of "the golden standard" in chemotherapy for ovarian cancer (taxanes/platinum), a relapse of the disease is noted in 80% of women treated in this manner. Studies on ovarian cancer stem cells (CSCs) and attempts at treatment using salinomycin, isolated from Streptomyces albus and endotoxin of Clostridium perfringens, are promising, in particular because CSC markers have been identified. Resistance of ovarian cancer cells to paclitaxel and cisplatin is associated with a reduced expression of miR-30c, miR-130, and miR335, which results in activation of M-CSF, the known factor of resistance to cytostatic drugs. In clear cell ovarian cancer, a reduced expression of miR-449 was detected, which may lead to overexpression of MET phenotype, typical for chemoresistant ovarian cancer. MicroRNAs remain in investigations, but their involvement in the control of genes linked to the development of the cancer and its progression seems to offer the promise of a targeted therapy. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 26-year-old woman who was admitted to the Gynecology Department with abdominal pain. The patient was found to have a tumor on the left ovary, and a left salpingo-oophorectomy was performed. The final result of the histopathological analysis revealed that the patient has a malignant neoplasm and a squamous cell ovarian carcinoma. The patient undergoes periodic control examination after an operation and no further treatment for her condition is required.

The article presents a study of an assessment of the endothelin-1 (ET-1) level and its correlation with differential diagnosis in ovarian tumors. It mentions that 53 women with ovarian tumors were treated and their ET-1 serum levels were compared with CA125 and Doppler guidelines. It says that a significant difference in ET-1 levels occurred between the ovarian cancer and benign tumor groups. It concludes that it is not satisfying for ET-1 as a new biomarker for predicting ovarian cancer.

The authors present a case of a 56-year-old patient diagnosed with ovarian cancer and endometrial cancer who reported a breast cancer in her medical history. [ABSTRACT FROM AUTHOR]

The article presents a case study of the difficulty in diagnosing and treating a patient with phyllodes tumour of the breast. It notes the importance of detectable examination, imaging diagnostics and histopathological examination in the process of giving a diagnosis. It highlights the use of surgical removal of the tumour in the treatment process which helps reduce the risk of local recurrence.