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Lee HJ, Lee B, Choi H, Lee M, Lee K, Lee TK, Hwang SO, Kim YB. Hormone Replacement Therapy and Risks of Various Cancers in Postmenopausal Women with De Novo or a History of Endometriosis. Cancers (Basel) 2024; 16:809. [PMID: 38398200 PMCID: PMC10886569 DOI: 10.3390/cancers16040809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
This study examined the impact of hormone replacement therapy (HRT) on the occurrence of various cancers in postmenopausal women with de novo or a history of endometriosis. In the datasets for ten cancers (cervical, uterine, ovarian, breast, colon, gastric, liver, lung, pancreatic, and thyroid), women who received HRT (the HRT group) and those who did not (the control group) were selected by a 1:1 matching with those who met the study criteria. In the dataset for each cancer, the incidence of each cancer was very low (0.2% to 1.5% in the HRT group and 0.2% to 1.3% in the control group). The duration of HRT was 1.3 ± 2.1 years. After adjusting for co-variables, HRT was a significant risk factor for uterine cancer (p < 0.05). However, the risk of liver cancer decreased significantly with duration of HRT (p < 0.05). Moreover, combined estrogen and progesterone decreased the risks of liver and thyroid cancers significantly (p < 0.05), and estrogen alone decreased the risks of breast and lung cancers significantly (p < 0.05). Tibolone was not associated with the risk of any of the cancers assessed. These results can help guide the use of HRT in women with de novo or a history of endometriosis.
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Affiliation(s)
- Hee Joong Lee
- Department of Obstetrics & Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 11765, Republic of Korea
| | - Banghyun Lee
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Hangseok Choi
- Medical Science Research Center, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Minkyung Lee
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Kyungjin Lee
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Tae Kyoung Lee
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Sung Ook Hwang
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea
| | - Yong Beom Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si 13620, Republic of Korea
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Chen B, Zhao L, Yang R, Xu T. New insights about endometriosis-associated ovarian cancer: pathogenesis, risk factors, prediction and diagnosis and treatment. Front Oncol 2024; 14:1329133. [PMID: 38384812 PMCID: PMC10879431 DOI: 10.3389/fonc.2024.1329133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Previous studies have shown that the risk of malignant transformation of endometriosis in premenopausal women is approximately 1%, significantly impacting the overall well-being and quality of life of affected women. Presently, the diagnostic gold standard for endometriosis-associated ovarian cancer (EAOC) continues to be invasive laparoscopy followed by histological examination. However, the application of this technique is limited due to its high cost, highlighting the importance of identifying a non-invasive diagnostic approach. Therefore, there is a critical need to explore non-invasive diagnostic methods to improve diagnostic precision and optimize clinical outcomes for patients. This review presents a comprehensive survey of the current progress in comprehending the pathogenesis of malignant transformation in endometriosis. Furthermore, it examines the most recent research discoveries concerning the diagnosis of EAOC and emphasizes potential targets for therapeutic intervention. The ultimate objective is to improve prevention, early detection, precise diagnosis, and treatment approaches, thereby optimizing the clinical outcomes for patients.
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Affiliation(s)
| | | | | | - Tianmin Xu
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, China
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Yin D, Jiang YJ. Case Series and a Literature Review: Two Ovarian Clear Cell Carcinoma Cases with Recurrent Endometriosis. Int J Womens Health 2023; 15:1611-1619. [PMID: 37901720 PMCID: PMC10612500 DOI: 10.2147/ijwh.s418135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Endometriosis-associated ovarian cancer (EAOC) is rare, occurring approximately in 1% of women with ovarian endometriosis. The main histological types are endometrioid adenocarcinoma and clear cell carcinoma (CCC), with the latter being the least common. Case Presentation In our hospital, we recently summarized two patients with ovarian clear cell carcinoma with similar characteristics. They all had endometriosis for a long time and had undergone ovarian cyst removal due to a chocolate cyst. Unfortunately, the cyst recurred after surgery, and the histological diagnosis was clear cell carcinoma. In case 1, the expression of P53 was found in the tumor by regular examination, and the stage was IIB. In Case 2, we found it in intraoperative freezing; the stage was IA. Case 1 has been treated with the TP regimen six times, and the survival period has reached one year. Case 2 had a survival period of 6 years after completing six TP regimen treatments. Clinicians should pay attention to patients with a long history of endometriosis and postoperative recurrence of ovarian cysts accompanied by serum CA-125 of more than 200U/mL. Imaging examination has a good prospect in diagnosing malignant transformation of endometriosis, especially PET-CT. Conclusion This case report highlights the risk factors related to the formation of ovarian clear cell carcinoma and suggests that the follow-up of patients with ovarian endometriosis is essential because of its recurrence characteristics. Radical surgery and postoperative platinum-containing chemotherapy are the primary treatment methods at present.
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Affiliation(s)
- Dan Yin
- The Second Clinical College of Zhejiang Chinese Medical University, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yan-Jiao Jiang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University (Xinhua Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
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Lee HJ, Lee B, Choi H, Kim T, Kim Y, Kim YB. Impact of Hormone Replacement Therapy on Risk of Ovarian Cancer in Postmenopausal Women with De Novo Endometriosis or a History of Endometriosis. Cancers (Basel) 2023; 15:cancers15061708. [PMID: 36980597 PMCID: PMC10046182 DOI: 10.3390/cancers15061708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
The effect of hormone replacement therapy (HRT) on the malignant transformation of postmenopausal endometriosis remains unclear. This study aimed to investigate the impact of HRT on ovarian cancer occurrence in postmenopausal women with de novo endometriosis or a history of endometriosis. A total of 10,304 women that received HRT (the HRT group) and 10,304 that did not (the control group) were selected by 1:1 matching those that met the study criteria. Incidences of ovarian cancer (0.3% in the HRT group and 0.5% in the control group) and cumulative incidence rates of ovarian cancer were similar in the two groups. The overall mean duration of HRT was 1.4 ± 2.2 years, but the duration of HRT in women with ovarian cancer was 2.2 ± 2.9 years. After adjusting for co-variables, receipt of HRT, duration of HRT, combined use of estrogen and progesterone, and tibolone were not found to be risk factors for ovarian cancer. However, the use of estrogen alone was found to be a significant risk factor for ovarian cancer (HR 2.898; 95% CI 1.251–6.715; p = 0.013). With the exception of HRT using estrogen alone, HRT did not increase the risk of ovarian cancer in postmenopausal women with a history of endometriosis or de novo endometriosis.
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Affiliation(s)
- Hee Joong Lee
- Department of Obstetrics & Gynecology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si 11765, Gyeonggi-do, Republic of Korea
| | - Banghyun Lee
- Department of Obstetrics and Gynecology, Inha University Hospital, College of Medicine, Inha University, 27, Inhang-ro, Sinheung-dong, Jung-gu, Incheon 22332, Republic of Korea
- Correspondence: ; Tel.: +82-32-890-3429
| | - Hangseok Choi
- Medical Science Research Center, College of Medicine, Korea University, 73, Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Taehee Kim
- Department of Obstetrics and Gynecology, Inha University Hospital, College of Medicine, Inha University, 27, Inhang-ro, Sinheung-dong, Jung-gu, Incheon 22332, Republic of Korea
| | - Yejeong Kim
- Department of Obstetrics and Gynecology, Inha University Hospital, College of Medicine, Inha University, 27, Inhang-ro, Sinheung-dong, Jung-gu, Incheon 22332, Republic of Korea
| | - Yong Beom Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, Republic of Korea
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Chen Y, Ma Y, Zhai Y, Yang H, Zhang C, Lu Y, Wei W, Cai Q, Ding X, Lu S, Fang Z. Persistent dysregulation of genes in the development of endometriosis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1175. [PMID: 36467354 PMCID: PMC9708481 DOI: 10.21037/atm-22-4806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/07/2022] [Indexed: 09/29/2023]
Abstract
BACKGROUND Endometriosis is a chronic condition that affects women of child-bearing age. Since the etiology and pathogenesis of endometriosis have not been fully elucidated, it is important to investigate the mechanisms that lead to the deterioration of endometriosis. METHODS In this study, the transcriptome data of patients with normal, mild, and severe endometriosis were examined using the GSE51981 dataset obtained from the Gene Expression Omnibus database. Short Time Series Expression Miner (STEM) was used to screen the genes with continuous expression disorder in the development process, and the core genes were identified by constructing a protein-protein interaction network. The molecular mechanisms of endometriosis were examined using enrichment analysis. Finally, the transcription factors that regulate the core genes were predicted and the comprehensive mechanisms involved in the development of endometriosis were examined. RESULTS A total of 3,472 differentially expressed genes were identified from the normal, mild, and severe endometriosis samples. These were allocated into 12 modules and HRAS, HSP90AA1, TGFB1, TP53, and UBC were selected as the core genes. Enrichment analysis showed that the genes in modules 6, 7, and 9 were significantly related to oxygen levels, metallic processes, and hormone levels, respectively. Transcription factor prediction analysis showed that TP53 regulates HRAS to participate in immune related signaling pathways. Drug prediction analysis identified 792 drugs that interact with the targeted core genes. CONCLUSIONS This study explored the molecular mechanisms involved in the development of endometriosis and identified potential biomarkers of endometriosis. This data may provide novel targets and research directions for the diagnosis and treatment of endometriosis.
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Affiliation(s)
- Yanli Chen
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yanqun Ma
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yanzhi Zhai
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Haiyan Yang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Chunlan Zhang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Yingxin Lu
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Wei Wei
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Qing Cai
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Xuewen Ding
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Shan Lu
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Ziyu Fang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
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Wang D, Guo C, Li Y, Zhou M, Wang H, Liu J, Chen P. Oestrogen up-regulates DNMT1 and leads to the hypermethylation of RUNX3 in the malignant transformation of ovarian endometriosis. Reprod Biomed Online 2021; 44:27-37. [PMID: 34799276 DOI: 10.1016/j.rbmo.2021.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/05/2021] [Accepted: 06/17/2021] [Indexed: 01/01/2023]
Abstract
RESEARCH QUESTION What is the mechanism of hypermethylation of runt-related transcription factor 3 (RUNX3) in the eutopic endometrium of endometriosis as biomarker in the malignant transformation of endometriosis? DESIGN Methylation-specific polymerase chain reaction was used to analyse the methylation status of RUNX3 in endometriosis-associated ovarian cancer (EAOC). Primary eutopic endometrial stromal cells (ESC) were isolated from the uteri of patients with ovarian endometriosis. After RUNX3 knockdown by RNA interference technology or ESC treated with oestradiol, the proliferation and invasion ability were evaluated in ESC by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and transwell assays. RESULTS The frequency of methylation of RUNX3 in neoplastic tissue in the EAOC group was significantly higher than that in the ectopic endometrium of the endometriosis group (P < 0.001), and the frequency of methylation of RUNX3 in the eutopic endometrium of the EAOC group was significantly higher than that in the endometriosis group (P < 0.001). However, there was no significant difference in the eutopic endometrium when compared between the endometriosis group and the control endometrium group (P = 0.233). Silencing RUNX3 promoted the proliferation and invasion of ESC (P < 0.001 and P < 0.001). Following intervention with oestrogen, it was observed that the oestradiol group showed higher levels of RUNX3 methylation (P < 0.001) and DNA methyltransferase 1 (DNMT1) mRNA and protein expression (P < 0.001 and P < 0.001), and lower RUNX3 mRNA and protein expression when compared with the ESC group (P < 0.001 and P < 0.001). CONCLUSION This study demonstrated that hypermethylation of the RUNX3 was related to the malignant transformation of endometriosis and that this process was related to corresponding changes in the eutopic endometrium. Furthermore, the 'oestrogen-DNMT1' signalling pathway may induce the hypermethylation of RUNX3 to promote the malignant transformation of endometriosis.
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Affiliation(s)
- Danbo Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang Liaoning Province 110042, People's Republic of China.
| | - Cuishan Guo
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, Shenyang Liaoning Province 110004, People's Republic of China
| | - Yan Li
- Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, Shenyang Liaoning Province 110004, People's Republic of China.
| | - Mingyi Zhou
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang Liaoning Province 110042, People's Republic of China
| | - Huimin Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang Liaoning Province 110042, People's Republic of China
| | - Jing Liu
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang Liaoning Province 110042, People's Republic of China
| | - Peng Chen
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang Liaoning Province 110042, People's Republic of China
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Mikhaleva LM, Solomatina AA, Milovanov AP, Beeraka NM, Khovanskaya TN, Chabieva LB, Mikhalev SA, Gracheva NA, Chigray LV, Beylerli O, Patsap OI, Aliev G. Histomorphological and Functional Features of the Eutopic Endometrium in Patients with Ovarian Endometriosis After Surgery-a Clinical Study. Reprod Sci 2021; 28:2350-2358. [PMID: 33650096 DOI: 10.1007/s43032-021-00508-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/21/2021] [Indexed: 12/15/2022]
Abstract
Endometriosis causes infertility and the alterations in endometrial receptivity. Pinopodia in eutopic endometrial epithelium may have significant implications in the endometriosis-associated infertility. The aim of this study is to ascertain whether the surgical interventions to remove endometrioid ovarian cysts (EOCs) can improve endometrial receptivity. The study included 172 patients of reproductive age with EOC, who underwent laparoscopic cystectomy. Aspiration endometrial biopsy was performed at 6 and 12 months after the surgery during the proliferation and secretion phases. Histopathology analysis included H&E staining and IHC. Morphometric studies were performed on endometrial biopsies collected during the proliferation phase of 28 patients, and the secretion phase of 12 patients. The expression of IHC markers for estrogen receptors (ER) and progesterone receptors (PR) and the percentage of cells containing pinopodia were determined. A significant increase in the ER and PR expression was observed in the epithelium during the "middle stage, proliferation phase" and in the stroma and glands during "middle stage, secretion phase". A delay in endometrial secretory transformation and statistically significant decrease in the number of pinopodia was observed on the apical surface of the cells. These structural and functional alterations were observed both at 6 and 12 months after cystectomy. The endometriosis-associated infertility after surgical intervention of EOC could be due to the extensive expression of ER and PR during the proliferation and secretion phases, as well as the delayed secretory transformation and impaired formation of pinopodia in the eutopic endometrium in the patients at 6 and 12 months after surgery.
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Affiliation(s)
- Liudmila M Mikhaleva
- Research Institute of Human Morphology, 3, Tsyurupy Street, Moscow, 117418, Russia.
- Department of Public Health, City Clinical Hospital, No-31, Moscow, Russia.
| | - Antonina A Solomatina
- Department of Obstetrics and Gynecology, Russian National Research Medical University Named After N.I. Pirogov, Moscow, Russia
| | - Andrey P Milovanov
- Research Institute of Human Morphology, 3, Tsyurupy Street, Moscow, 117418, Russia
| | - Narasimha M Beeraka
- Department of Biochemistry, Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), JSS Academy of Higher Education & Research (JSS AHER), Mysore, India
| | | | - Leyla B Chabieva
- Department of Public Health, City Clinical Hospital, No-31, Moscow, Russia
- Department of Obstetrics and Gynecology, Russian National Research Medical University Named After N.I. Pirogov, Moscow, Russia
| | | | - Natalya A Gracheva
- Department of Public Health, City Clinical Hospital, No-31, Moscow, Russia
| | - Lyudmila V Chigray
- Department of Public Health, City Clinical Hospital, No-31, Moscow, Russia
| | - Ozal Beylerli
- Bashkir State Medical University, Ufa, Republic of Bashkortostan, 450008, Russia
| | - Olga I Patsap
- Department of Pathology, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency, 1-10, Ostrovityanova Street, Moscow, 117997, Russia
| | - Gjumrakch Aliev
- Research Institute of Human Morphology, 3, Tsyurupy Street, Moscow, 117418, Russia
- GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX, 78229, USA
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SPOCK2 Affects the Biological Behavior of Endometrial Cancer Cells by Regulation of MT1-MMP and MMP2. Reprod Sci 2020; 27:1391-1399. [PMID: 32430715 DOI: 10.1007/s43032-020-00197-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Abnormal expression of SPARC (osteonectin), cwcv and kazal-like domains proteoglycan 2 (SPOCK2) plays a significant role in the development and progression of various human cancers, yet a relationship between SPOCK2 and endometrial cancer (EC) has not been reported. Here, we assessed the potential role and mechanism by which SPOCK2 acts in the pathogenesis and progression of EC. First, protein expression of SPOCK2 in EC tissue from patients was detected by immunohistochemistry and associated clinical data were analyzed. Then, HEC-1A and Ishikawa cells were transfected with an adenoviral vector containing an SPOCK2 recombinant fragment and the biological behavior of transfected cells was observed. Finally, the expression of membrane type 1 matrix metalloproteinase (MT1-MMP) and MMP2 in the transfected cells was detected by Western blot and zymography gel assay to analyze the effect of SPOCK2 on the regulation of the MT1-MMP/MMP2 pathway. We found that there was significantly less SPOCK2 protein expression in the EC tissue than in the normal endometrium tissue, and lack of SPOCK2 protein expression in EC tissue was associated with distant metastasis and myometrial invasion. Upregulation of SPOCK2 in HEC-1A and Ishikawa cells inhibited cell proliferation, invasion, adhesion, and apoptosis. Upregulation of SPOCK2 inhibited the expression of MT1-MMP and MMP2 and activation of MMP2 in HEC-1A and Ishikawa cells. Collectively, our data indicated that SPOCK2 contributed to the progression of EC by regulating the biological behavior of cancer cells, which is achieved partly through regulating protein expression of MT1-MMP and MMP2 and activation of MMP2.
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Li J, Huang Y, Zhao S, Guo Q, Zhou J, Han W, Xu Y. Based on network pharmacology to explore the molecular mechanisms of astragalus membranaceus for treating T2 diabetes mellitus. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:633. [PMID: 31930034 DOI: 10.21037/atm.2019.10.118] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Astragalus membranaceus refers to a type of traditional Chinese medicine (TCM) used to treat type 2 diabetes mellitus (T2DM), whereas its molecular mechanism remains unclear. In the presented study, network pharmacology was performed to analyze the molecular mechanism of astragalus membranaceus against T2DM. Methods First, we found common targets of astragalus membranaceus and disease, protein-protein interaction (PPI) network was built by String, and then key targets were screened from these common targets by topological analysis. Subsequently, common targets were introduced into DAVID to achieve the results of gene ontology (GO) and KEGG enrichment analysis. The therapeutic effect of astragalus was observed, and several key targets were verified by an animal experiment. Results First, 13 key targets (EGFR, KDR, SRC, ERBB2, FYN, ESR1, AR, HSP90AA1, PTGS2, ABCG2, AB1, MMP2, and CYP1) were found by topological analysis. Then, the results of GO and KEGG suggested that the anti-diabetes effect of astragalus membranaceus was strongly associated with the activation of receptor protein tyrosine kinase (RPTK). The results of animal experiments revealed that astragalus could enhance the morphology of rat pancreas and up-regulate the expression of tyrosine receptor. Conclusions In brief, 13 key targets were found in this study, and astragalus membranaceus was found up-regulating insulin signaling pathways by improving the activity of casein kinase, regulating lipid metabolism, and enhancing insulin resistance to treat T2DM. The present study lays a basis for subsequent experimental research and broadens the clinical application of astragalus membranaceus.
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Affiliation(s)
- Jie Li
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yanqin Huang
- Department of Endocrine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China
| | - Sen Zhao
- Department of Chinese Medicine, The General Hospital of the People's Liberation Army, Beijing 100853, China
| | - Qiuyue Guo
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Jie Zhou
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Wenjing Han
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yunsheng Xu
- Department of Endocrine, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250001, China
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Wu H, Luo Y, Yin N, Gui W, Cao Y. Vaginal endometrial stromal sarcoma: A literature review. Eur J Obstet Gynecol Reprod Biol X 2019; 4:100094. [PMID: 31528854 PMCID: PMC6742903 DOI: 10.1016/j.eurox.2019.100094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/23/2019] [Accepted: 08/25/2019] [Indexed: 11/19/2022] Open
Abstract
Vaginal endometrial stromal sarcoma (VESS) is a rare disease. To the best of our knowledge, there have only been a few reported cases in the literature. Therefore, we conducted a literature review to obtain specific knowledge of this disease. Thirteen cases of VESS were found by searching the Medline and EMBASE databases in the English language. The mechanism of VESS may be associated with endometriosis, and its diagnosis largely depends on pathological examination because it has no typical symptoms. Treatment of VESS incorporates surgery, chemotherapy, radiotherapy, and hormonal therapy. Some novel drugs targeting its mechanism may become alternative therapies. Its prognostic factors may include tumor stage and the expression of hormonal receptors.
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Affiliation(s)
- Hongwen Wu
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Luo
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing China
| | - Nanlin Yin
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenwu Gui
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Cao
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing China
- Corresponding author at: Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Zhou WJ, Yang HL, Shao J, Mei J, Chang KK, Zhu R, Li MQ. Anti-inflammatory cytokines in endometriosis. Cell Mol Life Sci 2019; 76:2111-2132. [PMID: 30826860 PMCID: PMC11105498 DOI: 10.1007/s00018-019-03056-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/29/2019] [Accepted: 02/25/2019] [Indexed: 02/07/2023]
Abstract
Although the pathogenesis of endometriosis is not fully understood, it is often considered to be an inflammatory disease. An increasing number of studies suggest that differential expression of anti-inflammatory cytokines (e.g., interleukin-4 and -10, and transforming growth factor-β1) occurs in women with endometriosis, including in serum, peritoneal fluid and ectopic lesions. These anti-inflammatory cytokines also have indispensable roles in the progression of endometriosis, including by promoting survival, growth, invasion, differentiation, angiogenesis, and immune escape of the endometriotic lesions. In this review, we provide an overview of the expression, origin, function and regulation of anti-inflammatory cytokines in endometriosis, with brief discussion and perspectives on their future clinical implications in the diagnosis and therapy of the disease.
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Affiliation(s)
- Wen-Jie Zhou
- Laboratory for Reproductive Immunology, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200090, People's Republic of China
- Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Hui-Li Yang
- Laboratory for Reproductive Immunology, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200090, People's Republic of China
| | - Jun Shao
- Laboratory for Reproductive Immunology, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200090, People's Republic of China
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, People's Republic of China
| | - Jie Mei
- Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Reproductive Medicine Center, The Affiliated Hospital of Nanjing University Medicine School, Nanjing, 210000, People's Republic of China
| | - Kai-Kai Chang
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, People's Republic of China
| | - Rui Zhu
- Center for Human Reproduction and Genetics, Suzhou Municipal Hospital, Suzhou, 215008, People's Republic of China
| | - Ming-Qing Li
- Laboratory for Reproductive Immunology, NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200090, People's Republic of China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, People's Republic of China.
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12
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Ren F, Wang D, Wang Y, Chen P, Guo C. SPOCK2 Affects the Biological Behavior of Endometrial Cancer Cells by Regulation of MT1-MMP and MMP2. Reprod Sci 2019:1933719119834341. [PMID: 30832559 DOI: 10.1177/1933719119834341] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abnormal expression of SPARC (osteonectin), cwcv and kazal-like domains proteoglycan 2 (SPOCK2) plays a significant role in the development and progression of various human cancers, yet a relationship between SPOCK2 and endometrial cancer (EC) has not been reported. Here, we assessed the potential role and mechanism by which SPOCK2 acts in the pathogenesis and progression of EC. First, protein expression of SPOCK2 in EC tissue from patients was detected by immunohistochemistry and associated clinical data were analyzed. Then, HEC-1A and Ishikawa cells were transfected with an adenoviral vector containing an SPOCK2 recombinant fragment and the biological behavior of transfected cells was observed. Finally, the expression of membrane type 1 matrix metalloproteinase (MT1-MMP) and MMP2 in the transfected cells was detected by Western blot and zymography gel assay to analyze the effect of SPOCK2 on the regulation of the MT1-MMP/MMP2 pathway. We found that there was significantly less SPOCK2 protein expression in the EC tissue than in the normal endometrium tissue, and lack of SPOCK2 protein expression in EC tissue was associated with distant metastasis and myometrial invasion. Upregulation of SPOCK2 in HEC-1A and Ishikawa cells inhibited cell proliferation, invasion, adhesion, and apoptosis. Upregulation of SPOCK2 inhibited the expression of MT1-MMP and MMP2 and activation of MMP2 in HEC-1A and Ishikawa cells. Collectively, our data indicated that SPOCK2 contributed to the progression of EC by regulating the biological behavior of cancer cells, which is achieved partly through regulating protein expression of MT1-MMP and MMP2 and activation of MMP2.
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Affiliation(s)
- Fang Ren
- 1 Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Danni Wang
- 1 Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yizi Wang
- 1 Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Peng Chen
- 1 Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Cuishan Guo
- 1 Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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13
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Ozyurek ES, Yoldemir T, Kalkan U. Surgical challenges in the treatment of perimenopausal and postmenopausal endometriosis. Climacteric 2018; 21:385-390. [DOI: 10.1080/13697137.2018.1439913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- E. S. Ozyurek
- Department of Obstetrics and Gynecology, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - T. Yoldemir
- Department of Obstetrics and Gynecology, Marmara University Hospital, Istanbul, Turkey
| | - U. Kalkan
- Department of Obstetrics and Gynecology, Egemed Hospital, Aydin, Turkey
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14
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Gemmell LC, Webster KE, Kirtley S, Vincent K, Zondervan KT, Becker CM. The management of menopause in women with a history of endometriosis: a systematic review. Hum Reprod Update 2017; 23:481-500. [PMID: 28498913 PMCID: PMC5850813 DOI: 10.1093/humupd/dmx011] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 05/04/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Endometriosis is typically regarded as a premenopausal disease, resolving after natural or iatrogenic menopause due to declining oestrogen levels. Nonetheless, case reports over the years have highlighted the incidence of recurrent postmenopausal endometriosis. It is now clear that both recurrence and malignant transformation of endometriotic foci can occur in the postmenopausal period. Postmenopausal women are commonly treated with hormone replacement therapy (HRT) to treat climacteric symptoms and prevent bone loss; however, HRT may reactivate endometriosis and stimulate malignant transformation in women with a history of endometriosis. Given the uncertain risks of initiating HRT, it is difficult to determine the best menopausal management for this group of women. OBJECTIVE AND RATIONAL The aim of this study was to systematically review the existing literature on management of menopausal symptoms in women with a history of endometriosis. We also aimed to evaluate the published literature on the risks associated with HRT in these women, and details regarding optimal formulations and timing (i.e. initiation and duration) of HRT. SEARCH METHODS Four electronic databases (MEDLINE via OVID, Embase via OVID, PsycINFO via OVID and CINAHL via EbscoHost) were searched from database inception until June 2016, using a combination of relevant controlled vocabulary terms and free-text terms related to 'menopause' and 'endometriosis'. Inclusion criteria were: menopausal women with a history of endometriosis and menopausal treatment including HRT or other preparations. Case reports/series, observational studies and clinical trials were included. Narrative review articles, organizational guidelines and conference abstracts were excluded, as were studies that did not report on any form of menopausal management. Articles were assessed for risk of bias and quality using GRADE criteria. OUTCOMES We present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing treatment for menopausal symptoms. We highlight common presenting symptoms, potential risk factors and outcomes amongst the studies. Sparse high-quality evidence was identified, with few observational studies and only two randomized controlled trials. Given this paucity of data, no definitive conclusions can be drawn concerning risk. WIDER IMPLICATIONS Due to the lack of high-quality studies, it remains unclear how to advise women with a history of endometriosis regarding the management of menopausal symptoms. The absolute risk of disease recurrence and malignant transformation cannot be quantified, and the impact of HRT use on these outcomes is not known. Multicentre randomized trials or large observational studies are urgently needed to inform clinicians and patients alike.
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Affiliation(s)
- L C Gemmell
- Case Western Reserve School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - K E Webster
- Endometriosis CaRe Centre, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Women's Centre, Oxford OX3 9DU, UK
| | - S Kirtley
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK
| | - K Vincent
- Endometriosis CaRe Centre, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Women's Centre, Oxford OX3 9DU, UK
| | - K T Zondervan
- Endometriosis CaRe Centre, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Women's Centre, Oxford OX3 9DU, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - C M Becker
- Endometriosis CaRe Centre, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Women's Centre, Oxford OX3 9DU, UK
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15
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Malignant Transformation of Endometriosis: An Unusual Diverticular Mass. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2016. [DOI: 10.5301/je.5000239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Malignant transformation of endometriosis may occur years following hysterectomy and oophorectomy. It may present with a pelvic mass, pain or vaginal bleeding. Risk factors have been poorly defined, but may include exogenous or endogenous unopposed estrogens. Case This report presents a case of malignant transformation of endometriosis resulting in endometrioid adenocarcinoma of a colonic diverticulum in a patient on unopposed estrogen. Conclusions Patients with a history of endometriosis who present with a pelvic mass should be evaluated for the possibility of a tumor arising from the endometriosis, even long after definitive surgical treatment. Sampson's criteria for malignant transformation of endometriosis remain relevant. The continued practice of prescribing unopposed estrogen after hysterectomy to patients with a history of endometriosis may contribute to the frequency of this otherwise uncommon disease.
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16
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Elgamal DA, Othman EER, Ahmed SF. Ultrastructural Features of Eutopic Endometrium in a Rat Model of Endometriosis. J Microsc Ultrastruct 2015; 4:20-27. [PMID: 30023206 PMCID: PMC6014242 DOI: 10.1016/j.jmau.2015.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 10/09/2015] [Accepted: 10/11/2015] [Indexed: 11/30/2022] Open
Abstract
Endometriosis is a chronic recurrent disease that is relatively common. Diagnosis is difficult and often delayed. Current treatments are inadequate with unacceptable side effects and multiple surgeries may be needed. Abnormal eutopic endometrium may play important role in endometriosis-associated infertility. This study aimed to examine the ultrastructural changes in eutopic endometrium in a rat model of surgically induced endometriosis. Endometrial tissue was removed from rats in surgical endometriosis induction group (n = 10), sham operated (n = 10) and non-operated control (n = 10) groups in the diestrus phase of the estrus cycle. They were studied with light, transmission and scanning electron microscope as well as morphometric analysis. Eutopic endometrium in surgically induced endometriosis showed pseudostratified epithelium, vacuolated columnar cells alternated with dark cells. The stroma was edematous exhibiting dilated, congested blood vessels. The mean endometrial mucosal depth and surface epithelial height significantly increased. Ultrastructurally, most luminal epithelial cells showed vacuolation. Mucous secretory granules were surrounded by dilated rough endoplasmic reticulum cisternae. Mitochondria, glycogen deposits and vesicles with electron dense cores were observed. The nuclei were highly euchromatic. Well defined microvilli were noticed with evident apical tight junctions. Scanning electron microscope revealed flattened and structurless surface epithelium with apparent decrease in the number of pinopodes. A different response to sex hormones in different parts of eutopic endometrium was observed. Ultrastructural features of estrogen dominance or progesterone resistance in the eutopic endometrium might account for inappropriate cyclic changes occurring in the disease.
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Affiliation(s)
| | - Essam-Eldin Rashad Othman
- OB-GYN department, Assiut University, Assiut, Egypt.,Center of Excellence of Stem Cells and Regenerative Medicine CESCRM, Zewail City of Science and Technology- Assiut University, Egypt
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