Research On The Correlation Between Obesity And Endometrial Cancer

BACKGROUND:The proportion of overweight and obese people in our country is increasing.Obesity is associated with the development of a variety of malignancies.Endometrial cancer is one of the most commonly seen malignancies in the female reproductive system,and obese people have a higher risk of de-veloping endometrial cancer.Obesity brings changes of the le'vel of estrogen,adipokines and other cytokines,which may influence the development of endometrial cancer.Obesity can be defined and classified not only by BMI,but also by fat mass,since BMI classification has its limitation.The fat mass and fat distribution in the abdominal area are more intuitive variables that indicate obesity.Defining obesity according to imaging results may lead to different findings and ideas.PURPOSE:1.To establish the database of patients who was diagnosed endometrial cancer and received surgical treatment in Peking Union Medical College Hospital,analyze the clinical and pathological features.2.To compare the clinicopathological features and the expression patterns of adipokines in endometrial carcinoma of normal,overweight and obese patients.3.To analyze the correlation of abdominal fat mass/distribution and BMI,and compare the relationship between fat mass/distribution and the clinicopathological features of endometrial cancer.METHODS:1.We searched the clinical case database of Peking Union Medical College Hospital from March 2011 to February 2016 for patients who were diagnosed endometrial cancer and received surgical treatment in our hospital.We summed up their clinical and pathological characteristics and possible prognostic factors.2.We located the area of endometrial cancer on paraffin embedded tissues for each patient and made tissue microarrays.The immunohistochemical staining of several adipokines was performed on the tissue slice,and the staining intensity was determined by histochemical score.3.We measured the abdominal subcutaneous adipose thickness,abdominal subcutaneous adipose area,abdominal visceral adipose area and total area of abdominal adipose using CT and MRI image.The relationship between abdominal fat mass and fat distribution and the clinicopathological characteristics of endometrial cancer were analyzed.RESULTS:1.There was no significant correlation between BMI and histological type,FIGO stage and survival curves of endometrial cancer.2.There was a significant positive correlation between BMI and the expression of CRP in endometrial carcinoma,while BMI was not significantly correlated with the expression of leptin,chemokine,resistin,adiponectin and visfatin.There was no significant correlation between histological type and FIGO stage of endometrial cancer and the expression of the mentioned adipokines in endometrial carcinoma.3.The survival curves of preoperative CA125,FIGO stage,histological type,other tumors,expression of estrogen receptor and progesterone receptor were of significant differences.4.BMI and abdominal subcutaneous adipose thickness,abdominal visceral adipose area,abdominal subcutaneous adipose area,total area of abdominal adipose was positively correlated.5.There was a significant positive correlation between the thickness of abdominal wall and the expression of CRP in endometrial carcinoma.The abdominal subcutaneous adipose area was significantly correlated with the expression of visfatin,and the abdominal visceral adipose area was significantly correlated with adiponectin expression.6.There was no significant correlation between the abdominal subcutaneous adipose thickness,abdominal visceral adipose area,abdominal subcutaneous adipose area,total area of abdominal adipose,abdominal subcutaneous fat area ratio and endometrial cancer histological type and FIGO stage,and survival curves were of no significant differences.CONCLUSION:Whether obesity is defined with BMI or abdominal adipose mass and adipose distribution,obesity is not significantly associated with the clinical and biological characteristics of endometrial cancer.However,BMI,abdominal adipose mass and adipose distribution are associated with the expression of several adipokines in endometrial carcinoma,which may be a possible point to study the pathogenesis and development of endometrial cancer.