Prospective clinical study of the association between plasma level of free IGF-1 and myometrial invasion in patients with endometrial adenocarcinoma

Abstract

Abstract Introduction: Endometrial carcinoma is a common malignancy of the female genital tract. There is a strong correlation between myometrial invasion and clinical prognosis. Increasing myometrial penetration is associated with an increasing risk of pelvic and para-aortic lymph node metastasis, adnexal metastasis, positive peritoneal cytology, local vault recurrence, and hematogenous spread. The causal role for Insulin-like growth factor-1 and insulin in endometrial carcinogenesis is well supported and insulin and IGF system have mitogenic and antiapoptotic activity. Endometrial cancer cell lines express high-affinity insulin receptors, consistent with there being a direct biological effect of insulin and IGF system on the growth and myometrial invasion of endometrial cancer cells. Material and methods: Patients with endometrial carcinoma have been divided into three groups: tumor confined to the endometrium (stage IA, n:24), endometrial carcinoma with a minimal invasion (less than 50% of the myometrium; stage IB, n:32), and the control group (n:40). Demographic factors, estradiol and free IGF-1 plasma levels have been compared in all groups. Results: Lower Free IGF-1 plasma levels were found in patients with myometrial invasion when compared to the patients without myometrial invasion. Conclusions: In the following work we have presented the current understanding of endometrial carcinoma, association between free IGF-1 plasma levels and myometrial invasion in patients with endometrial adenocarcinoma in terms of management and survival.