COMPARATIVE FEATURES OF CARBOHYDRATE METABOLISM STATE, BODY WEIGHT AND ASSOCIATED HORMONAL FACTORS IN VARIOUS MOLECULAR-BIOLOGICAL TYPES OF ENDOMETRIAL CANCER

Abstract

Aims: The tradition of dividing endometrial cancer (EC) into two types - which existed for many decades - has undergone significant changes over the past few years. The aim of this work was to collect data on important aspect of hormonal-metabolic status in patients having one of the four EC types which compose a modern molecular-biological classification of this tumor. Materials and methods: The division of EC into types (234 tumors from patients predominantly of postmenopausal age) was based on the classification of this carcinoma, which includes cases with mutations in tumor tissue of DNA polymerase epsilon (POLE), signs of mismatch repair deficiency - microsatellite instability (MMR-D), expression of the multifunctional protein p53 and, finally, with the absence of these three features. In the studies of hormone-metabolic status, depending on the methodology, materials from a varying number of patients were involved. Results and conclusions: It has been established that EC patients, carriers of the POLE mutations, are characterized by a lower body mass index (BMI), a decreased incidence of overt diabetes and a lower ratio of leptin/adiponectin in the serum. For patients with EC having signs of MMR-D, an increase in BMI and the most pronounced tendency to disturbances in carbohydrate metabolism were found, while for patients with increased expression of oncoprotein p53 were characteristic frequent detection of patients with low body weight (BMI <25.0) and a trend towards a decrease in the insulin resistance index. In conditionally “triply negative” type (not having three listed markers: POLE mutations, MMR-D signs and p53 hyperexpression), uterine body cancer patients revealed highest average BMI value and positive correlation of BMI with the level of leptinemia. The data obtained indicate the need for a selective approach to the prevention of different types of EC and for the study on the association of revealed type-specific features with the further course of the disease.