The relationship of estradiol level with clinical characteristics of postmenopausal women with endometrial malignancies and abnormal uterine bleeding

Document Type : Original Article

Authors

1 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22038/ijogi.2024.79972.6092

Abstract

Introduction: Considering the relatively high importance and complications of endometrial malignancies, especially during menopause, and considering that the role of endocrine hormones was not fully clarified, this study was performed with aim to determine the relationship between estradiol levels and the clinical characteristics of postmenopausal women with bleeding and endometrial malignancy.
Methods: This analytical cross-sectional study was conducted in 2023 on 54 patients with postmenopausal bleeding suffering from endometrial malignancy who referred to Imam Hossein (AS) hospital. Demographic and clinical (signs and symptoms) characteristics and serum estradiol levels of patients were collected. Data were analyzed by SPSS software (version 23) and Man-Whitney and Chi-square tests. P<0.05 was considered significant.
Results: Serum estradiol level was 26.80±15.77 pg/ml. In addition, 37 people (68.5%) had normal levels and 17 (31.5%) had abnormal levels of estradiol. In the normal estradiol group compared to abnormal estradiol, the prevalence of endometrial thickness ≥ 4 mm (0.73% vs. 100% and p=0.018) and family history of uterine malignancy (35.2% vs. 83.8% and p=0.026) was less. The most common type of pathology in both groups was grade 1 endometrioid adenocarcinoma, and this difference was not significant (p=0.780).
Conclusion: There is a correlation between estradiol level with high endometrial thickness and family history of uterine malignancy in women with endometrial malignancy.

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Main Subjects


  1. Afrooz N, Nasiri S, Aminimoghaddam S. Comparison of PFS-OS between two treatment methods (surgery and then chemotherapy compared with neoadjuvant and then surgery) in patients with endometrial cancer: a retrospective study. Iranian Journal of Obstetrics, Gynecology and Infertility 2022; 25(11):26-33.
  2. Felix AS, Yang HP, Bell DW, Sherman ME. Epidemiology of endometrial carcinoma: etiologic importance of hormonal and metabolic influences. Molecular Genetics of Endometrial Carcinoma 2017: 3-46.
  3. Suidan RS, He W, Sun CC, Zhao H, Fleming ND, Ramirez PT, et al. Impact of body mass index and operative approach on surgical morbidity and costs in women with endometrial carcinoma and hyperplasia. Gynecologic oncology 2017; 145(1):55-60.
  4. Rezaianzadeh A, Dehghani SL, Mousavi M, Rezaeianzadeh R. The incidence of uterus cancer in Iran: a systematic review. Women’s Health Bulletin 2017; 4(1):1-4.
  5. Kadkhodayan S, Maleki A, Hasanzadeh M, Yousefi Z. Prevalence of endometrial cancer in young patients. Tehran University of Medical Sciences Journal 2018; 76(5):331-7.
  6. Savelli L, Testa AC, Mabrouk M, Zannoni L, Ludovisi M, Seracchioli R, et al. A prospective blinded comparison of the accuracy of transvaginal sonography and frozen section in the assessment of myometrial invasion in endometrial cancer. Gynecologic Oncology 2012; 124(3):549-52.
  7. Seilanian TF, Hasanzade S, Hasanzadeh MM, Khoroushi F, Aminzade B, Fathabadi A. Diagnostic Value of Dynamic Magnetic Resonance Imaging with Diffusion Weighted Imaging in the Staging of Endometrial Carcinoma. Iranian Journal of Obstetrics, Gynecology and Infertility 2022; 25(5):18-25.
  8. Yeganeh Z, Sheikhan Z, Hajian P, Esteki T, Nasiri M, Khodakarami N. Relationship between duration of breast feeding and endometrial cancer: a case-control study. The Iranian Journal of Obstetrics, Gynecology and Infertility 2020; 23(8):58-65.
  9. Hoseini SS, Yousefi Z, Emadzadeh M, Homaee Shandiz F, Hokmabadi P, Salehi M, et al. Changes in prevalence and epidemiology of female genital cancers in northeastern Iran in a 35-year study. The Iranian Journal of Obstetrics, Gynecology and Infertility 2020; 22(12):11-8.
  10. Yeganeh Z, Sheikhan Z, Kariman N, Hajian P, Nasiri M. Relationship between gestational diabetes and endometrial cancer. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 22(3):49-58.
  11. Hamidi Layen A, Yousefi Z, Davachi B, Jafarian AH, Morovatdar N, Azimi H, et al. Epidemiological findings and risk factors for endometrial cancer patients. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 22(1):20-5.
  12. Rashidi Fakari F, Saei Ghare Naz M, Ghasemi V, Riazi H, Afrakhteh M, Keshavarz Z. Relationship between serum lipids and endometrial cancer: A systematic review and meta-analysis. The Iranian Journal of Obstetrics, Gynecology and Infertility 2018; 21(5):87-96.
  13. Mirzaeian S, Dehghani M, Pourhoseini SA, Jafari Joshaghan A, Dadgar Moghadam M, Emadzadeh M. Relationship between the findings of vaginal sonography and pathology of endometrial curettage in women with abnormal uterine bleeding at perimenopause. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 22(8):1-9.
  14. Moodley M, Roberts C. Clinical pathway for the evaluation of postmenopausal bleeding with an emphasis on endometrial cancer detection. Journal of Obstetrics and Gynaecology 2004; 24(7):736-41.
  15. Brinton LA, Trabert B, Anderson GL, Falk RT, Felix AS, Fuhrman BJ, et al. Serum estrogens and estrogen metabolites and endometrial cancer risk among postmenopausal women. Cancer Epidemiology, Biomarkers & Prevention 2016; 25(7):1081-9.
  16. Kaaks R, Lukanova A, Kurzer MS. Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiology Biomarkers & Prevention 2002; 11(12):1531-43.
  17. Ziegler RG, Fuhrman BJ, Moore SC, Matthews CE. Epidemiologic studies of estrogen metabolism and breast cancer. Steroids 2015; 99:67-75.
  18. Brown SB, Hankinson SE. Endogenous estrogens and the risk of breast, endometrial, and ovarian cancers. Steroids 2015; 99:8-10.
  19. Brinton LA, Trabert B, Anderson GL, Falk RT, Felix AS, Fuhrman BJ, et al. Serum estrogens and estrogen metabolites and endometrial cancer risk among postmenopausal women. Cancer Epidemiology, Biomarkers & Prevention 2016; 25(7):1081-9.
  20. Dallal CM, Lacey JV, Pfeiffer RM, Bauer DC, Falk RT, Buist DS, et al. Estrogen metabolism and risk of postmenopausal endometrial and ovarian cancer: the B∼ FIT cohort. Hormones and Cancer 2016; 7:49-64.
  21. Tofiloska V, Krstevska M, Daneva-Markova A, Jovanovska V. The connection of the level of estradiol in serum and obesity with the endometrial bleeding in postmenopausal women. Open Access Macedonian Journal of Medical Sciences 2019; 7(1):88.
  22. Khalaf MS, Zaki MS, Elshourbgy MS, Abdelmageed AM. Relationship between estradiol level, transvaginal ultrasound endometrial thickness, body mass index and endometrial pathology in women with postmenopausal bleeding. The Egyptian Journal of Hospital Medicine 2019; 74(2):284-93.
  23. Mohammed SA. Assessment of Endometrial Thickness in Postmenopausal Women Using Ultrasonography. Doctoral dissertation, Sudan University of Science & Technology; 2018.
  24. Elkholi DG, Nagy HM. Unexplained postmenopausal uterine bleeding from atrophic endometrium: Histopathological and hormonal studies. Middle East Fertility Society Journal 2015; 20(4):262-70.