Peculiarities of molecular-biological and hormonal tumor status in patients with endometrial cancer

Abstract

Endometrial cancer (EC) ranks second in the structure of oncogynecological diseases both in Ukraine and worldwide. More than 80 % of recurrences occur in the first two years after surgical treatment. Molecular biological markers are extensively studied in different oncological diseases, because they allow to understand the etiology and pathogenesis of malignant growth more deeply. Aim. To study molecular biological markers and tumor hormonal status in patients with EC and determine their practical significance. Materials and methods. Molecular biologic markers of the tumor were studied in 89 stage I–IV EC patients. To study the hormonal status of the tumor in EC patients, 119 examinations were carried out. Results. Significant correlations were found between the level of molecular biological marker (MBM) expression, hormonal status of the tumor, the presence of disease recurrence, and the age of EC patients. The novelty of the study lay in the substantiation of treatment individualization for EC patients based on the determination of the tumor molecular biological characteristics and their prognostic value. It has been proven that the expression level of the studied MBM, ER and PR receptors in EC patients differed depending on age, presence, localization and severity of disease recurrence. A group of patients with a high risk of the disease recurrence has been revealed among EC patients. For the first time, a technology has been developed for the combined treatment of patients with I–II (T1-2N0M0) stages of EC with a negative receptor status (EP–, PR–) and a high risk of the disease recurrence to assess MBM levels (VEGF, Bcl-2, Ki-67), degree of differentiation, myometrial invasion depth and tumor localization in the uterine cavity allowing to individualize the choice of adjuvant therapy regimen, thus improving the effectiveness of treatment and preventing the occurrence of locoregional relapses and distant metastases. Conclusions. For the first time, the expression levels of the studied molecular biological markers and ER and PR receptors have been shown to differ depending on age, localization, and relapse severity, which could be used to determine the risk of relapse in EC patients.