Circulating Serum Level of Visfatin in Patients with Endometrial Cancer.

Aneta Cymbaluk-Płoska,Bogusław Machaliński,Anita Chudecka-Głaz,Janusz Menkiszak,Ewa Pius-Sadowska,Agnieszka Sompolska-Rzechuła

doi:10.1155/2018/8576179

Abstract

Obesity is a well-known factor that leads to many diseases including endometrial cancer. The adipose tissue is a heterogeneous organ of internal secretion. Visfatin is a newly discovered protein produced by fat tissues. The purpose of this work was to evaluate serum level concentrations of visfatin in patients with endometrial cancer based on clinical progression and histopathological tumor differentiation. The diagnostic capabilities of visfatin protein in high differentiation (FIGO III and IV) from a lower (FIGO I and II) clinical stage and prognostic degree of cell differentiation (G1 versus G2, G2 versus G3) on the basis of the analysis of the area under the ROC curve are as follows: 0.87, 0.81, and 0.86. Significantly higher concentrations of visfatin have been observed in patients with invasion of the blood vessels (p = 0.02) and lymph node metastases (p = 0.01) in reference to the depth of infiltration of the endometrium (p = 0.004), as well as the size of the tumor (p = 0.003). Visfatin serum concentrations did not differ due to the invasion of the lymphatic vessels only. Visfatin seems to be a good marker of endometrial cancer progress. High visfatin serum level predicts poor prognosis in endometrial cancer patients.

Highlights

Lifestyle in developed countries has changed significantly in the last decades
We evaluated serum concentrations of visfatin in patients with endometrial cancer based on clinical progression and histopathological tumor differentiation and whether serum visfatin levels can be associated with poorer patient prognosis
The study has shown statistically significant differences in mean visfatin concentrations between patients with diabetes mellitus type 2 treated with metformin and patients with diabetes mellitus type 2 treated with insulin, respectively (21.3 ng/ml, 28.4 ng/ml)

Summary

Introduction

Lifestyle in developed countries has changed significantly in the last decades. The lack of physical activity and the easy access to high-calorie food contributed to the creation of an obese population [1]. Many changes are to be observed in it, including aromatization of androgen to estrogen, which affects, due to their hyperfunction, a high frequency of such estrogenicrelated tumors as breast cancer and endometrial cancer. The adipose tissue discharges a variety of active proteins such as leptin, adiponectin, tumor necrosis factor, visfatin, resistin, omentin-1, and vaspin [4]. In 2009, Ye presented a study stating that patients characterized by long-lasting oxygen deficiency in the adipose tissue, as a consequence of the expansion of adipocytes, are affected by a long-standing inflammatory state of decreasing adiponectin, leading to the dysfunction of paracrine adipocytes [5]. In 2011, He et al identified HIF-1 alpha and other mediators that cause hypoxia, conducing the release of free fatty acids from the adipose tissue. We would like to evaluate visfatin serum level in patients with different endometrial risk factors (obesity, diabetes mellitus type 2).

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