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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2023№12
Endometrial cancer and pregnancy

Endometrial cancer and pregnancy

DOI
https://dx.doi.org/10.18565/aig.2023.178

Chernyakov A.A., Chernyshova A.L., Kolomiets L.A., Truschuk Yu.M., Dil O.S., Krasilnikov S.E., Antipov V.A., Shumeikina A.O., Chernyshova A.E.

1) Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia; 2) E.N. Meshalkin National Medical Research Center, Ministry of Health of Russia, Novosibirsk, Russia; 3) St. Petersburg State University, St. Petersburg, Russia

Objective: To summarize the current data on the combination of endometrial cancer and pregnancy, including risk factors, pathogenetic mechanisms and management options for patients.
Materials and methods: The databases and services, namely PubMed, Wiley, Scopus and Google scholar have been searched for the articles on the association of pregnancy and endometrial cancer over the past 12 years.
Results: The article presents the analysis of the modern literature on the incidence, possible mechanisms of pathogenesis and characteristics of the clinical course of endometrial cancer associated with pregnancy. The main risk factors typical for this pathology which were highlighted in various studies are presented. The studies of foreign scientists reviewing the molecular genetic and transcriptional profiles of endometrial malignancies during pregnancy are analyzed. The role of chorionic gonadotropin in the pathogenesis of endometrial cancer is also identified. Since this pathology affects the organ necessary for pregnancy and actually reduces a woman’s reproductive potential, it becomes obvious that cancer of the uterine body is not only an important medical problem, but it is also a social issue in the modern world. The combination of endometrial cancer and pregnancy is a rare case, its incidence is 1% and it is characterized by a favorable course and prognosis.
Conclusion: Endometrial cancer associated with pregnancy is rather a rare pathology and it is characterized by a favorable course and prognosis. There are no cases of cancer progression during pregnancy in the literature. However, the mechanisms of the protective effect of this physiological condition have not been studied enough, thus, it is necessary to continue research in this direction.

Authors’ contributions: Chernyakov A.A. – work with literature, writing an article; Chernyshova A.L. – developing the subject of the review, writing an article, working with literature; Kolomiets L.A. – work with literature, adding relevant comments; Truschuk Yu.M., Dil O.S., Krasilnikov S.E., Antipov V.A., Shumeikina A.O. – work with literature; Chernyshova A.E. – analysis and translation of the articles.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Chernyakov A.A., Chernyshova A.L., Kolomiets L.A., Truschuk Yu.M., Dil O.S., Krasilnikov S.E., Antipov V.A., Shumeikina A.O., Chernyshova A.E.Endometrial cancer and pregnancy. 
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (12): 40-46 (in Russian)
https://dx.doi.org/10.18565/aig.2023.178

Keywords

endometrial cancer
pregnancy
prognosis
survival
Full text (in Russian)

References

  1. Каприн А.Д., Старинский В.В., Шахзадова А.О., ред. Состояние онкологической помощи населению России в 2021 году. МНИОИ им. П.А. Герцена − филиал ФГБУ «НМИЦ радиологии» Минздрава России. 2022; 239. [Kаprin А.D., Stаrinsky V.V., Shаkhzаdovа А.O., ed. The stаte of oncologicаl cаre to the populаtion of Russiа in 2021. Herzen Moscow Stаte Medicаl Reseаrch Institute − Brаnch of the Federаl Stаte Budgetаry Institution "NMIC of Rаdiology" of the Ministry of Heаlth of Russiа. 2022; 239 p. (in Russian)].
  2. Всемирнaя Оргaнизaция Здрaвоохрaнения (ВОЗ) [Электронный ресурс]: Электрон. журн. Режим доступa: http://www.who.int/topics/ru (дaтa обрaщения: 08.07.2023). [World Health Organization (WHO) [Electronic resource]: Electron. journal. Access mode: http://www.who.int/topics/ru (accessed: 08.07.2023) (in Russian)].
  3. Новикова О.В., Новикова Е.Г., Авасова Ч.А., Мокина В.Д. Рак эндометрия на фоне беременности. Тезисы I Национального конгресса «Онкология репродуктивных органов: от профилактики и раннего выявления к эффективному лечению» (19–21 мая 2016 года, Москва). М.: КВАЗАР; 2016. 194c. [Novikova O.V., Novikova E.G., Avasova Ch.A., Mokina V.D. Endometrial cancer during pregnancy. Theses of the I National Congress "Oncology of reproductive organs: from prevention and early detection to effective treatment" (May 19–21, 2016, Moscow). Moscow: KVAZAR; 2016. 194 p. (in Russian)].
  4. Gompel A. Progesterone and endometrial cancer. Best. Pract. Res. Clin. Obstet. Gynaecol. 2020; 69: 95-107. https://dx.doi.org/10.1016/j.bpobgyn.2020.05.003.
  5. Pu H., Wen X., Luo D., Guo Z. Regulation of progesterone receptor expression in endometriosis, endometrial cancer, and breast cancer by estrogen, polymorphisms, transcription factors, epigenetic alterations, and ubiquitin-proteasome system. J. Steroid. Biochem. Mol. Biol. 2023; 227: 106199.https://dx.doi.org/10.1016/j.jsbmb.2022.106199.
  6. Леонтьева Н.В. Особенности гормонального статуса во время беременности. Актуальные проблемы теоретической и клинической медицины. 2022; (1): 22-7. [Leontieva N.V. Features of hormonal status during pregnancy. Actual problems of theoretical and clinical medicine. 2022; (1): 22-7.(in Russian)]. https://dx.doi.org/10.24412/2790-1289-2022-1-2227].
  7. Jordan S.J., Na R., Weiderpass E., Adami H.O., Anderson K.E., van den Brandt P.A. at al. Pregnancy outcomes and risk of endometrial cancer: a pooled analysis of individual participant data in the epidemiology of endometrial cancer consortium. Int. J. Cancer. 2021; 148(9): 2068–78. https://dx.doi.org/10.1002/ijc.33360.
  8. Chen Q., Tong M., Guo F., Lau S., Zhao M. Parity correlates with the timing of developing endometrial cancer, but not subtype of endometrial cancer. J. Cancer. 2015; 6 (11): 1087-92. https://dx.doi.org/10.7150/jca.12736.
  9. Wan J., Gao Y., Zeng K., Yin Y, Zhao M, Wei J. et al. The levels of the sex hormones are not different between type 1 and type 2 endometrial cancer. Sci. Rep. 2016; 6: 39744. https://dx.doi.org/10.1038/srep39744.
  10. Trabert B., Troisi R., Grotmol T., Ekbom A., Engeland A., Gissler M. et al. Associations of pregnancy-related factors and birth characteristics with risk of endometrial cancer: a Nordic population-based case-control study. Int. J. Cancer. 2020; 146(6): 1523-31. https://dx.doi.org/10.1002/ijc.32494.
  11. Wan J., Hu Z., Zeng K., Yin Y., Zhao M., Chen M. et al. The reduction in circulating levels of estrogen and progesterone in women with preeclampsia. Pregnancy Hypertens. 2018; 11: 18-25. https://dx.doi.org/10.1016/j.preghy.2017.12.003.
  12. Shu C., Han S., Xu P., Wang Y., Cheng T., Hu C. Estrogen and preeclampsia: potential of estrogens as therapeutic agents in preeclampsia. Drug. Des. Devel Ther. 2021; 15: 2543-50. https://dx.doi.org/10.2147/DDDT.S304316.
  13. Lan K.C., Lai Y.J., Cheng H.H., Tsai N.C., Su Y.T., Tsai C.C., Hsu T.Y. Levels of sex steroid hormones and their receptors in women with preeclampsia. Reprod. Biol. Endocrinol. 2020; 18(1): 12. https://dx.doi.org/10.1186/s12958-020-0569-5.
  14. Schock H., Zeleniuch-Jacquotte A., Lundin E., Grankvist K., Lakso H.Å., Idahl A. et al. Hormone concentrations throughout uncomplicated pregnancies: a longitudinal study. BMC Pregnancy Childbirth. 2016; 16(1): 146.https://dx.doi.org/10.1186/s12884-016-0937-5.
  15. Menkhorst E., Winship A., Van Sinderen M., Dimitriadis E. Human extravillous trophoblast invasion: intrinsic and extrinsic regulation. Reprod. Fertil. Dev. 2016; 28(4): 406-15. https://doi.org/10.1071/RD14208.
  16. Sadovsky Y., Ouyang Y., Powell J.S., Li H, Mouillet J.F., Morelli A.E. et al. Placental small extracellular vesicles: current questions and investigative opportunities. Placenta. 2020; 102: 34-8. https://dx.doi.org/10.1016/j.placenta.2020.03.002
  17. Pillay P., Moodley K., Vatish M., Moodley J. Exosomal microRNAs in pregnancy provides insight into a possible cure for cancer. Int. J. Mol. Sci. 2020; 21(15): 5384. https://dx.doi.org/10.3390/ijms21155384.
  18. Main C., Chen X., Zhao M., Chamley L.W., Chen Q. Understanding how pregnancy protects against ovarian and endometrial cancer development: fetal antigens may be involved. Endocrinology. 202211; 163(11): bqac141.https://dx.doi.org/10.1210/endocr/bqac141.
  19. Liu Y., Cai Y., Chang Y. Dual inhibition of RNAi therapeutic miR-26a-5p targeting cMet and immunotherapy against EGFR in endometrial cancer treatment. Ann. Transl. Med. 2021; 9(1): 5. https://dx.doi.org/10.21037/atm-20-3166.
  20. Husby A., Wohlfahrt J., Melbye M. Pregnancy duration and endometrial cancer risk: nationwide cohort study. BMJ. 2019; 366: l4693.https://dx.doi.org/10.1136/bmj.l4693.
  21. Lundberg F.E., Iliadou A.N., Rodriguez-Wallberg K., Gemzell-Danielsson K., Johansson A.L.V. The risk of breast and gynecological cancer in women with a diagnosis of infertility: a nationwide population-based study. Eur. J. Epidemiol. 201934(5): 499-507. https://dx.doi.org/10.1007/s10654-018-0474-9.
  22. Cho H.W., Ouh Y.T., Lee K.M., Han S.W., Lee J.K., Cho G.J. at al. Long-term effect of pregnancy-related factors on the development of endometrial neoplasia: a nationwide retrospective cohort study. PLoS One. 2019 28; 14(3): e0214600. https://dx.doi.org/10.1371/journal.pone.0214600.
  23. Zhan B., Liu X., Li F., Zhang D. Breastfeeding and the incidence of endometrial cancer: a meta-analysis. Oncotarget. 2015; 6(35): 38398-409.https://dx.doi.org/10.18632/oncotarget.5049.
  24. Lima M.D.C.P., Melo A.S.O., Sena A.S.S., Barros V.O., Amorim M.M.R. Metabolic syndrome in pregnancy and postpartum: prevalence and associated factors. Rev. Assoc. Med. Bras. (1992). 2019; 65(12): 1489-95.https://doi.org/10.1590/1806-9282.65.12.1489.
  25. Belladelli F., Montorsi F., Martini A. Metabolic syndrome, obesity and cancer risk. Curr. Opin. Urol. 2022; 32(6): 594-97. https://dx.doi.org/10.1097/MOU.0000000000001041.
  26. Uzunlulu M., Telci Caklili O., Oguz A. Association between Metabolic Syndrome and Cancer. Ann Nutr. Metab. 2016; 68(3): 173-9.https://dx.doi.org/10.1159/000443743.
  27. Esposito K., Chiodini P., Colao A., Lenzi A., Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012; 35(11): 2402-11. https://dx.doi.org/10.2337/dc12-0336.
  28. Mili N., Paschou S.A., Goulis D.G., Dimopoulos M.A., Lambrinoudaki I., Psaltopoulou T. Obesity, metabolic syndrome, and cancer: pathophysiological and therapeutic associations. Endocrine. 2021; 74(3): 478-97.https://dx.doi.org/10.1007/s12020-021-02884-x.
  29. Чернышова А.Л., Коломиец Л.А., Бочкарева Н.В, Асадчикова О.Н. Метаболический синдром, взаимосвязь с процессами канцерогенеза эндометрия. Сибирский онкологический журнал. 2008; 5(29): 68-74. [Chernyshova A.L., Kolomiets L.A., Bochkareva N.V., Asadchikova O.N. Metabolic syndrome, interraction with endometrial carcinogenesis. Siberian Oncological Journal. 2008; 5(29): 68-74. (in Russian)].
  30. Jenkins H.N., Rivera-Gonzalez O., Gibert Y., Speed J.S. Endothelin-1 in the pathophysiology of obesity and insulin resistance. Obes. Rev. 2020; 21(12): e13086. https://dx.doi.org/10.1111/obr.13086.
  31. Da Silva A.A., do Carmo J.M., Li X., Wang Z., Mouton A.J., Hall J.E. Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited. Can. J. Cardiol. 2020; 36(5): 671-82. https://dx.doi.org/10.1016/j.cjca.2020.02.066.
  32. Gobato A.O., Vasques A.C., Zambon M.P., Barros Filho Ade A., Hessel G. Metabolic syndrome and insulin resistance in obese adolescents. Rev. Paul. Pediatr. 2014; 32(1): 55-62. https://dx.doi.org/10.1590/s0103-05822014000100010.
  33. Yang X., Li X., Dong Y., Fan Y., Cheng Y., Zhai L., Zhang S., Zhou J., Wang J. Effects of metabolic syndrome and its components on the prognosis of endometrial cancer. Front. Endocrinol (Lausanne). 2021; 12: 780769.https://dx.doi.org/10.3389/fendo.2021.780769.
  34. Коломиец Л.А., Бочкарева Н.В., Чернышова А.Л. Рак эндометрия и метаболический синдром. Томск: Типография «Иван Федоров»; 2010. 228 с.[Kolomiets L.A., Bochkareva N.V., Chernysheva A.L. Endometrial cancer and metabolic syndrome. Tomsk: Ivan Fedorov Printing House; 2010. 228 p.(in Russian)].
  35. Jankowska A.G., Andrusiewicz M., Fischer N., Warchol P.J. Expression of hCG and GnRHs and their receptors in endometrial carcinoma and hyperplasia. Int. J. Gynecol. Cancer. 2010; 20(1): 92-101. https://dx.doi.org/10.1111/IGC.0b013e3181bbe933.
  36. Cole L.A., Butler S. Hyperglycosylated h.C.G, hCGβ and Hyperglycosylated hCGβ: interchangeable cancer promoters. Mol. Cell. Endocrinol. 2012; 349(2): 232-8. https://dx.doi.org/10.1016/j.mce.2011.10.029.
  37. Kölbl A.C., Schlenk K., Behrendt N., Andergassen U. The importance of hCG in human endometrial adenocarcinoma and breast cancer. Int. J. Biol. Markers. 2018; 33(1): 33-9. https://dx.doi.org/10.5301/ijbm.5000290.
  38. Chen L., Xie Y., Fan J., Sui L., Xu Y., Zhang N. et al. HCG induces β1,4-GalT I expression and promotes embryo implantation. Int. J. Clin. Exp. Pathol. 2015; 8(5): 4673-83.
  39. Arcangeli A., Noci I., Fortunato A., Scarselli G.F. The LH/hCG axis in endometrial cancer: a new target in the treatment of recurrent or metastatic disease. Obstet. Gynecol. Int. 2010; 2010: 486164. https://dx.doi.org/10.1155/2010/486164.
  40. Cole L.A., Butler S. Hyperglycosylated hCG, hCGβ and hyperglycosylated hCGβ: interchangeable cancer promoters. Mol. Cell. Endocrinol. 2012; 349(2): 232-38. https://dx.doi.org/10.1016/j.mce.2011.10.029.
  41. Daggez M., Dolanbay M., Akgun H., Gülseren V., Keklikcioglu S.A., Ozcelik B., Serin I.S. Human chorionic gonadotropin expression in endometrial hyperplasia and endometrial carcinoma: could it be a new marker? Int. J. Gynecol. Cancer. 2023; 33(5): 707-12. https://dx.doi.org/10.1136/ijgc-2023-004279.
  42. Shiomi M., Matsuzaki S., Kobayashi E., Hara T., Nakagawa S., Takiuchi T. et al. Endometrial carcinoma in a gravid uterus: a case report and literature review. BMC Pregnancy Childbirth. 2019; 19(1): 425. https://dx.doi.org/10.1186/s12884-019-2489-y.
  43. Korenaga T.K., Tewari K.S. Gynecologic cancer in pregnancy. Gynecol. Oncol. 2020; 157(3): 799-809. https://dx.doi.org/10.1016/j.ygyno.2020.03.015.
  44. Eriksson A.G., Fallaas Dahl G., Nesbakken A.J., Lund K.V., Amant F. Endometrial cancer during pregnancy: management strategies. Int. J. Gynecol. Cancer. 2019; 29(7): 1221-24. https://dx.doi.org/10.1136/ijgc-2019-000756.
  45. Trabert B., Troisi R., Grotmol T., Ekbom A., Engeland A., Gissler M. at al. Associations of pregnancy-related factors and birth characteristics with risk of endometrial cancer: a nordic population-based case-control study. Int. J. Cancer. 2020; 146(6): 1523-31. https://dx.doi.org/10.1002/ijc.32494.
  46. Troisi R., Bjørge T., Gissler M., Grotmol T., Kitahara C.M., MyrtveitSaether S.M. et al. The role of pregnancy, perinatal factors and hormones in maternal cancer risk: a review of the evidence. J. Intern. Med. 2018; 283(5): 430-45. https://dx.doi.org/10.1111/joim.12747.
  47. Wu Q.J., Li Y.Y., Tu C., Zhu J., Qian K.Q., Feng T.B. at al. Parity and endometrial cancer risk: a meta-analysis of epidemiological studies. Sci. Rep. 2015; 5: 14243. https://dx.doi.org/10.1038/srep14243.

Received 25.07.2023

Accepted 04.12.2023

About the Authors

Alexander A. Chernyakov, resident physician, Research Institute of Oncology, Tomsk National Research Medical Centre of the Russian Academy of Sciences,
а.cherniаckow@yаndex.ru, Author ID (Scopus): 1172939, SPIN Code: 6269-5998. https://orcid.org/0000-0003-0829-0340, 634009, Russia, Tomsk, Kooperativny per. 5.
Alena L. Chernyshova, Dr. Med. Sci., Professor of the RAS, Chief Researcher, Department of Gynecology, Research Institute of Oncology, Tomsk National Research Medical Centre of the Russian Academy of Sciences, аlасhеr@list.ru, Author ID (Scopus): 55220758100, Reseacher ID (WOS): C-8608-2012, SPIN code: 2522-7513,
https://orcid.org/0000-0002-8194-2811, 634009, Russia, Tomsk, per. Kooperativny, 5.
Larisa A. Kolomiets, Dr. Med. Sci., Professor, Head of the Department of Gynecology, Research Institute of Oncology, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Author ID (Scopus): 7004921120. Reseacher ID (WOS): C-8573-2012, https://orcid.org/0000-0002-6854-8940, 634009, Russia, Tomsk,
per. Kooperativny, 5.
Yulia M. Trushuk, doctor, Oncology Department No. 4, Research Institute of Oncology, Tomsk National Research Medical Centre, Russian Academy of Sciences,
julija-bilina@mail.ru, Author ID (Scopus): 1142135, SPIN code: 9852-3387, https://orcid.org/0000-0001-5926-2601, 634009, Russia, Tomsk, per. Kooperativny, 5.
Olga S. Dil, resident physician, Research Institute of Oncology, Tomsk National Research Medical Centre of the Russian Academy of Sciences, lyаbishevа.os@mаil.ru,
Аuthor ID (Scopus): 1142135, SPIN code: 7265-4352, https://orcid.org/0000-0001-6562-7574, 634009, Russia, Tomsk, per. Kooperativny, 5.
Sergey E. Krasilnikov, Dr. Med. Sci., Professor, Director, Academician E.N. Meshalkin National Medical Research Centre, Ministry of Health of the Russian Federation, professorkrasilnikov@rambler.ru, https://orcid.org/0000-0003-0687-0894, 630055, Russia, Novosibirsk, Rechkunovskaya str., 15.
Vitaly A. Antipov, Dr. Med. Sci., Academician E.N. Meshalkin National Medical Research Centre, Ministry of Health of the Russian Federation, Author ID (Scopus): 7005104470; https://orcid.org/0000-0003-3522, 630055, Russia, Novosibirsk, Rechkunovskaya str., 15.
Anastasia O. Shumeikina, oncologist, Academician E.N. Meshalkin National Medical Research Centre, Ministry of Health of the Russian Federation, +7(999)464-01-63, nashum99@mail.ru, 630055, Russia, Novosibirsk, Rechkunovskaya str., 15.
Arina E. Chernyshova, student, Faculty of Medicine, St. Petersburg State University, 199034, Russia, St. Petersburg, Universitetskaya naberezhnaya, 7/9.
Corresponding author: Alena L. Chernyshova, alacher@list.ru

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