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Yasin HK, Taylor AH, Ayakannu T. A Narrative Review of the Role of Diet and Lifestyle Factors in the Development and Prevention of Endometrial Cancer. Cancers (Basel) 2021; 13:cancers13092149. [PMID: 33946913 PMCID: PMC8125712 DOI: 10.3390/cancers13092149] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/19/2022] Open
Abstract
Simple Summary The incidence and prevalence of endometrial cancer is increasing globally. The main factors involved in this increase have been the way women live today and what they eat and drink. In fact, the obesity pandemic that is sweeping across the planet is considered to be the main contributory feature. This review aims to introduce to a new audience, those that are not experts in the field, what is known about the different types of endometrial cancer and the mechanisms for their induction and protection. We also seek to summarise the existing knowledge on dietary and lifestyle factors that prevent endometrial development in susceptible populations and identify the main problem in this arena; the paucity of research studies and clinical trials that investigate the interaction(s) between diet, lifestyle and endometrial cancer risk whilst highlighting those areas of promise that should be further investigated. Abstract Endometrial cancer is the most common cancer affecting the reproductive organs of women living in higher-income countries. Apart from hormonal influences and genetic predisposition, obesity and metabolic syndrome are increasingly recognised as major factors in endometrial cancer risk, due to changes in lifestyle and diet, whereby high glycaemic index and lipid deposition are prevalent. This is especially true in countries where micronutrients, such as vitamins and minerals are exchanged for high calorific diets and a sedentary lifestyle. In this review, we will survey the currently known lifestyle factors, dietary requirements and hormonal changes that increase an individual’s risk for endometrial cancer and discuss their relevance for clinical management. We also examine the evidence that everyday factors and clinical interventions have on reducing that risk, such that informed healthy choices can be made. In this narrative review, we thus summarise the dietary and lifestyle factors that promote and prevent the incidence of endometrial cancer.
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Affiliation(s)
- Hajar Ku Yasin
- Department of Obstetrics & Gynaecology, Cumberland Infirmary, Carlisle CA2 7HY, UK;
| | - Anthony H. Taylor
- Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, UK;
| | - Thangesweran Ayakannu
- Gynaecology Oncology Cancer Centre, Liverpool Women’s NHS Foundation Trust, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
- Correspondence: ; Tel.: +44-(0)-151-708-9988 (ext. 4531)
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Xiao W, Dong X, Zhao H, Han S, Nie R, Zhang X, An R. Expression of MIF and c-erbB-2 in endometrial cancer. Mol Med Rep 2016; 13:3828-34. [PMID: 26985869 PMCID: PMC4838132 DOI: 10.3892/mmr.2016.4992] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 12/08/2015] [Indexed: 12/03/2022] Open
Abstract
The aim of the present study was to investigate the expression of c-erbB-2 and macrophage migration inhibitory factor (MIF) in endometrial cancer and to elucidate the significance of the early diagnosis and prognosis of endometrial cancer. The gene copy number of c-erbB-2 and MIF was characterized by reverse transcription quantitative polymerase chain reaction and the reactivity was assessed by immunohistochemistry in 70 patients using a polyclonal antibody, and evaluated semiquantitatively according to the percentage of cells demonstrating membranous or diffuse cytoplasmic staining. A correlation between age, tumor stage, grade, myometrial invasion and lymph node metastasis was observed. The mRNA expression of c-erbB-2 and MIF was high in endometrial carcinoma. The positive expression rate of MIF protein in normal endometrium, atypical hyperplasia and endometrial carcinoma significantly increased along with the degree of aggravation of the disease by 20 (3/15), 45 (9/20) and 70% (35/50), respectively. The positive expression of MIF and c-erbB-2 was highest in endometrial cancer and a significantly higher level of protein was observed in tumors at stage I, stage G1, with a depth of myometrial invasion <0.4 cm and no lymph node metastasis. The protein expression of c-erbB-2 in endometrial cancer was higher in tumors at the G2-3 phase, clinical stage III–IV, lymph node metastasis, and had no association with the depth of myometrial invasion and age. MIF and c-erbB-2 were correlated with the occurrence and the development of endometrial cancer, and thus can be used for the early diagnosis and prognosis of endometrial cancer. The present study laid the foundation for identifying new treatments for endometrial cancer.
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Affiliation(s)
- Wei Xiao
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaanxi 710061, P.R. China
| | - Xiujuan Dong
- Department of Gynaecology and Obstetrics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, P.R. China
| | - Honghui Zhao
- Department of Gynaecology and Obstetrics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, P.R. China
| | - Shiyu Han
- Department of Gynaecology and Obstetrics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, P.R. China
| | - Ruixue Nie
- Department of Gynaecology and Obstetrics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, P.R. China
| | - Xiahua Zhang
- Department of Gynaecology and Obstetrics, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, P.R. China
| | - Ruifang An
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaanxi 710061, P.R. China
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Banno K, Yanokura M, Iida M, Masuda K, Aoki D. Carcinogenic mechanisms of endometrial cancer: Involvement of genetics and epigenetics. J Obstet Gynaecol Res 2014; 40:1957-67. [DOI: 10.1111/jog.12442] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 03/03/2014] [Indexed: 01/05/2023]
Affiliation(s)
- Kouji Banno
- Department of Obstetrics and Gynecology; School of Medicine, Keio University; Tokyo Japan
| | - Megumi Yanokura
- Department of Obstetrics and Gynecology; School of Medicine, Keio University; Tokyo Japan
| | - Miho Iida
- Department of Obstetrics and Gynecology; School of Medicine, Keio University; Tokyo Japan
| | - Kenta Masuda
- Department of Obstetrics and Gynecology; School of Medicine, Keio University; Tokyo Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology; School of Medicine, Keio University; Tokyo Japan
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HER2/neu: an increasingly important therapeutic target. Part 2: Distribution of HER2/neu overexpression and gene amplification by organ, tumor site and histology. ACTA ACUST UNITED AC 2014. [DOI: 10.4155/cli.14.62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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O'Hara AJ, Bell DW. The genomics and genetics of endometrial cancer. ADVANCES IN GENOMICS AND GENETICS 2012; 2012:33-47. [PMID: 22888282 PMCID: PMC3415201 DOI: 10.2147/agg.s28953] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Most sporadic endometrial cancers (ECs) can be histologically classified as endometrioid, serous, or clear cell. Each histotype has a distinct natural history, clinical behavior, and genetic etiology. Endometrioid ECs have an overall favorable prognosis. They are typified by high frequency genomic alterations affecting PIK3CA, PIK3R1, PTEN, KRAS, FGFR2, ARID1A (BAF250a), and CTNNB1 (β-catenin), as well as epigenetic silencing of MLH1 resulting in microsatellite instability. Serous and clear cell ECs are clinically aggressive tumors that are rare at presentation but account for a disproportionate fraction of all endometrial cancer deaths. Serous ECs tend to be aneuploid and are typified by frequent genomic alterations affecting TP53 (p53), PPP2R1A, HER-2/ERBB2, PIK3CA, and PTEN; additionally, they display dysregulation of E-cadherin, p16, cyclin E, and BAF250a. The genetic etiology of clear cell ECs resembles that of serous ECs, but it remains relatively poorly defined. A detailed discussion of the characteristic patterns of genomic alterations that distinguish the three major histotypes of endometrial cancer is reviewed herein.
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Affiliation(s)
- Andrea J O'Hara
- National Human Genome Research Institute, Cancer Genetics Branch, National Institutes of Health, Bethesda, MD, USA
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Lambropoulou M, Stefanou D, Alexiadis G, Tamiolakis D, Tripsianis G, Chatzaki E, Vandoros GP, Kiziridou A, Papadopoulou E, Papadopoulos N. Cytoplasmic expression of c-erb-B2 in endometrial carcinomas. Oncol Res Treat 2007; 30:495-500. [PMID: 17890888 DOI: 10.1159/000107734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to investigate the expression of c-erb-B2 in endometrial cancer with attention to both membranous and cytoplasmic staining, and to elucidate the significance of cytoplasmic signaling. MATERIALS AND METHODS c-erb-B2 reactivity was assessed by immunohistochemistry in 110 patients using a polyclonal antibody, and evaluated semiquantitatively according to the percentage of cells demonstrating membranous or diffuse cytoplasmic staining. Correlation was made with tumor stage, grade, myometrial invasion, histologic type, and disease outcome. RESULTS c-erb-B2 overexpression, indicated by membranous and cytoplasmic staining of at least 10% of the tumor cells, was found in 47 (42.7%) cases. Cytoplasmic expression of c-erb-B2 was observed more frequently than membranous (69.1 vs. 5.5%). Synchronous cytoplasmic and membranous signaling was noticed in 7.9% of cases. Interestingly, patients with cytoplasmic c-erb-B2-positive tumors had a significantly shorter survival (p = 0.047). CONCLUSIONS These results indicate that c-erb-B2 is a specific marker of endometrial cancer. It is also an independent prognostic indicator of poor outcome. Cytoplasmic staining is as important as membranous staining, and is also a specific finding.
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Affiliation(s)
- Maria Lambropoulou
- Department of Histology/Embryology, Democritus University of Thrace, Alexandroupolis, Greece
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Yeon CH, Pegram MD. Anti-erbB-2 antibody trastuzumab in the treatment of HER2-amplified breast cancer. Invest New Drugs 2006; 23:391-409. [PMID: 16133791 DOI: 10.1007/s10637-005-2899-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Human epidermal growth factor receptor-2 (HER2/erbB-2) is a member of a family of four transmembrane receptor tyrosine kinases that regulate cell growth, survival and differentiation via multiple signal transduction pathways. Amplification of the HER2 gene occurs in 20-25% of human breast cancers. This amplification event is an independent adverse prognostic factor as well as a predictive factor for increased response to doxorubicin-based combination chemotherapy, response to trastuzumab and decreased response to hormonal therapy. Methods for detecting protein overexpression or gene amplification in clinical tumor specimens include immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) techniques, with the latter considered by some to be more accurate. Trastuzumab (Herceptin) is a recombinant humanized monoclonal antibody which targets an epitope in the extracellular domain of the HER2 protein. Preclinical models demonstrated that this antibody has significant anti-tumor activity as a single agent and has synergy with certain chemotherapeutic drugs. Phase II and III clinical trials performed in women with metastatic breast cancer that overexpress HER2 have shown that trastuzumab has clinical activity when used as first-, second- or third-line monotherapy, and improves survival when used as first-line therapy in combination with chemotherapy. Newer combinations with numerous chemotherapeutic drugs have also shown significant clinical activity in phase II studies. In all of these trials, trastuzumab was generally well-tolerated, but cardiac toxicity (particularly when the antibody was combined with anthracyclines) was an unexpected adverse effect. Although trastuzumab is currently usually administered on a weekly intravenous schedule, evidence suggests that a triple dose of the drug given once every three weeks has a pharmacokinetic profile expected to be equally efficacious. Neither the optimal schedule nor the optimal duration of trastuzumab therapy has yet been clearly defined in controlled clinical trials. Current clinical investigations of trastuzumab include its use in both the adjuvant and neoadjuvant settings as well as in combination with other chemotherapy drugs or new biologic targeted agents.
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Affiliation(s)
- Christina H Yeon
- Division of Hematology-Oncology and the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.
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Ling KS, Chen GD, Tsai HJ, Lee MS, Wang PH, Liu FS. Genetic Changes in Ovarian Cancer. Taiwan J Obstet Gynecol 2005. [DOI: 10.1016/s1028-4559(09)60144-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Konopka B, Janiec-Jankowska A, Paszko Z, Goluda M. The coexistence of ERBB2, INT2, and CMYC oncogene amplifications and PTEN gene mutations in endometrial carcinoma. J Cancer Res Clin Oncol 2003; 130:114-21. [PMID: 14663583 DOI: 10.1007/s00432-003-0518-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Accepted: 10/10/2003] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the frequency of ERBB2, INT2 and CMYC oncogene amplifications and their coexistence with PTEN gene mutations in endometrial carcinomas. METHODS In 54 endometrial carcinomas amplification of ERBB2, INT2 and CMYC was determined using differential polymerase chain reaction (dPCR), and mutations in all exons of PTEN were investigated by PCR-SSCP and direct sequencing methods. Results were correlated with clinicopathological features of tumors. RESULTS In 31 out of 54 endometrial carcinomas (57.4%) genetic defects were found within the examined genes. Of all identified defects, mutations in PTEN and the amplification of CMYC were most frequent (26/54-48.1% and 10/54-18.5%, respectively). INT2 was amplified in 5.6% (3/54) of cases. In no case did we find ERBB2 amplification. In 77.4% (24/31) of cases only one gene was damaged. Of these, 20 cases showed only PTEN mutations, three cases only CMYC, and one case only INT2 amplification. In another seven out of 31 tumors (22.5%) defects in two or three genes coexisted simultaneously: PTEN and CMYC in five cases, CMYC and INT2 in one case, and PTEN, CMYC, and INT2 in one case. We found a number of interesting relations between the location of mutations within the PTEN sequence and the presence (+) or lack (-) of CMYC amplification. In the PTEN+CMYC- tumors the PTEN mutations were most frequent in exons 1-5, and less frequent in exons 7-8 (66.7% and 33.3%, respectively). In contrast, in the PTEN+CMYC+ carcinomas the PTEN mutations were found mainly in exons 7-8 (85.7%). PTEN mutations were equally frequent in both early and more advanced endometrial carcinomas. The CMYC amplification, however, was more frequent in advanced as compared to early tumors, although this difference did not reach statistical significance. CONCLUSIONS Our data suggest that differences in the presence of genetic defects may reflect the different molecular pathways of endometrial carcinogenesis. These data also suggest that location of intragenic PTEN mutations and their coexistence with the CMYC amplification may play a crucial part in the development of various subtypes of endometrial carcinoma, but this preliminary suggestion requires further research.
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Affiliation(s)
- Bozena Konopka
- Endocrinology Department, Maria Sklodowska-Curie Memorial Cancer Center, 5 WK Roentgen Street, 02-781, Warsaw, Poland.
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