Abstract
Endometrial cancer is one of the most frequently diagnosed gynecological neoplasms in developed countries and its incidence is rising. Usually, it is diagnosed in the early stages of the disease and has a good prognosis; however, in later stages, the rate of recurrence reaches up to 60%. The discrepancy in relapse rates is due to the heterogeneity of the group related to the presence of prognostic factors affecting survival parameters. Increased body weight, diabetes, metabolic disturbances and estrogen imbalance are important factors for the pathogenesis of endometrial cancer. Even though prognostic factors such as histopathological grade, clinical stage, histological type and the presence of estrogen and progesterone receptors are well known in endometrial cancer, the search for novel prognostic biomarkers continues. Adipose tissue is an endocrine organ involved in metabolism, immune response and the production of biologically active substances participating in cell growth and differentiation, angiogenesis, apoptosis and carcinogenesis. In this manuscript, we review the impact of factors secreted by the adipose tissue involved in the regulation of glucose and lipid metabolism (leptin, adiponectin, omentin, vaspin, galectins) and factors responsible for homeostasis maintenance, inflammatory processes, angiogenesis and oxidative stress (IL-1β, 6, 8, TNFα, Vascular endothelial growth factor (VEGF), Fibroblast growth factors (FGFs)) in the diagnosis and prognosis of endometrial cancer.
Highlights
We evaluated the information provided in articles published in English using a combination of keywords relevant to the proper adipokines, angiogenic growth factors (VEGF, Fibroblast growth factors (FGFs) and Insulin Growth Factor-1 (IGF-1)), inflammatory cytokines (TNFα, IL-6, IL-1β and IL-8) and endometrial cancer
Adipokines have been linked to cancer pathogenesis and progression as they impact on insulin resistance, inflammation and angiogenesis
Named nicotinamide phosphoribosyltransferase (NAMPT) due to its role in nicotinamide adenine dinucleotide (NAD) biosynthesis, is an adipokine secreted by the adipose tissue, there is some evidence that it is mainly released by the visceral white adipose tissue macrophages in response to inflammation [21]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Adipose tissue acts as one of the major endocrine glands that synthesizes and secretes multiple hormones and cytokines that are involved in the regulation of glucose and lipid metabolism (omentin-1, vaspin, galectins, leptins, adiponectin), vascular homeostasis, immune regulation, apoptosis, angiogenesis and cell growth and differentiation (IL-1β, 6, 8, TNFα, Vascular endothelial growth factor (VEGF) and Fibroblast growth factor (FGFs)). Obesity is associated with a chronic low-level inflammatory environment, which, together with potential paracrine factors secreted by the adipose tissue, could contribute to the process of carcinogenesis [3,4,5]. We evaluated the information provided in articles published in English using a combination of keywords relevant to the proper adipokines, angiogenic growth factors (VEGF, FGF and IGF-1), inflammatory cytokines (TNFα, IL-6, IL-1β and IL-8) and endometrial cancer. We focus on the factors secreted by the adipose tissue that seem to have the highest potential use in the diagnosis and prognosis of endometrial cancer
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