A case-control study of uterine endometrial cancer of pre- and post-menopausal women

Endometrial cancers are generally divided into at least two different patho genetic types. One occurs from the proliferative endometrium, depending on continuous estrogen stimulation, while the other is not related to the stim ulation and occurs from the atrophic endometrium of older postmenopausal wo men. In order to assess the risk factors for endometrial carcinoma (EC), a case-control study with 136 Japanese women having EC and with 376 healthy c ontrols for ECs in Japan, together with an immunohistochemical analyses on p53, estrogen (ER) and progesterone receptors (PR) of EC patients was under taken. Nulliparity, increased BMI, hypertension, diabetes mellitus, later a ge at menopause and personal cancer history were all seen predominantly in the EC group. Frequency of irregular menses, polycystic ovary syndrome (PCO S) and obesity in the EC patients under 40-year old was significantly highe r than the control group. Immunohistochemical expressions of ER (P<0.05) an d PR (P<0.01) were more frequently recognized in the EC of the pre-menopaus al than in the post-menopausal patients. On the other hand, p53 overexpress ion was detected in 27.2% of the post-menopausal EC group, while only found in 7.1% of the pre-menopausal EC group. These findings indicate that possi ble factors related to endometrial carcinogenesis are different between the pre- and post-menopausal EC patients. Namely, untreated ovarian dysfunctio n such as PCOS with unopposed estrogenic action in the endometrium may be a ssociated with development and growth of EC in younger women, yet abnormali ty of p53 gene may be more concerned with the development of the post-menop ausal EC, independently of sex steroid influence.