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Plasma oestrogens in postmenopausal women with endometrial cancer
Author(s) -
Nyholm Henrik C. J.,
Nielsen Anette L.,
Lyndrup Jens,
Dreisler Anne,
Hagen Claus,
Haug Egil
Publication year - 1993
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1993.tb15176.x
Subject(s) - androstenedione , sex hormone binding globulin , medicine , endocrinology , menopause , endometrial cancer , testosterone (patch) , estrone , hormone , body mass index , estrogen , follicle stimulating hormone , androgen , cancer , luteinizing hormone
Objective To study plasma levels of oestrogens and androgens, sex hormone‐binding globulin (SHBG) and follicle stimulating hormone (FSH) in postmenopausal patients with endometrial cancer. Design Patients and controls were matched for age, body mass index, parity and years since menopause. Setting Department of Obstetrics and Gynaecology, Hvidovre Hospital, Denmark. Subjects Fifty postmenopausal patients with endometrial cancer and 54 matching controls. Measurements Plasma levels of SHBG, FSH, oestrone, oestradiol, oestrone‐sulphate, dehydro‐epiandrosterone sulphate, testosterone, and androstenedione were measured by radio‐immunoassays. Free fractions of oestradiol and testosterone were calculated according to levels of SHBG and albumin. Results The levels of oestradiol, free oestradiol, and oestrone were elevated ( P <0.001 ) in patients compared with controls (oestradiol: 51 (45–59) vs 37 (34–41) pmol/1; free oestradiol: 0.69 (0.59–0.80) vs 0.48 (0.42–0.54) pmol/1; oestrone: 180 (159–204) vs 119 (107–133) pmol/1 (mean values (95% CI) in patients vs controls)). Furthermore, an increased oestrone:androstenedione ratio (0.095 vs 0.072, P <0.01 ) was found in patients. SHBG correlated negatively ( P <0.001 ) with body mass, while the free fractions of oestradiol and testosterone correlated positively ( P <0.01 ) with body mass, in both patients and controls. Multiple regression analysis showed that the differences in oestrogen levels between the two groups persisted when controlling for the effect of body mass, age, years since menopause, parity, and levels of SHBG and FSH. Conclusion Patients with endometrial cancer exhibit increased plasma levels of oestradiol and oestrone. Speculatively, these oestrogens may result from an increased oestrone conversion from androstenedione, an increased ovarian and adrenal secretion of androstenedione, or alternative oestrogen production routes. The present findings support the hypothetical role for oestrogens in the aetiology of endometrial cancer.