Department of Food Biotechnology, Medical University of Bialystok, Szpitalna 37 Street, 15-295, Bialystok, Poland.
Department of Gynecology and Obstetrics, Medical University of Bialystok, M. Sklodowskiej-Curie 24A Street, 15-089, Bialystok, Poland.
BMC Cancer. 2020 Sep 25;20(1):921. doi: 10.1186/s12885-020-07415-x.
It is a well-known fact show that the risk of developing endometrial cancer (type 1 EC) is strongly associated with obesity. In this study, selected markers, such as obesity, insulin resistance, angiogenesis and inflammation markers related to EC type 1 progression and patients' survival data were analyzed.
To measure levels of adiponectin, C-reactive protein (CRP), vascular endothelial growth factor-A (VEGF-A), angiopoietin-2 (Ang-2), insulin-like growth factor-1 (IGF-1), insulin and C-peptide in 176 preoperative serum samples, the immunoassay technique (EMIT) has been applied.
Angiopoietin-2 levels increase with age (P = 0.005), FIGO stage (p = 0.042), myometrial invasion (P = 0.009) and LVSI (P < 0.001). The CRP levels increase with age (P = 0.01), as well as the advancement of the FIGO stage (P < 0.001), higher tumor grade (P = 0.012), and myometrial invasion (P < 0.001). A positive correlation between serum Ang-2 and CRP levels was demonstrated (r = 0.44; p < 0.001). Kaplan-Meier survival analysis showed that patients with high CRP levels in serum and Ang-2 presented a worse outcome (P = 0.03 and P = 0.015, respectively). Cox regression analysis of individual predictors revealed that high serum levels of Ang-2, CRP, advanced clinical FIGO stage (P < 0.001, respectively), old age (P = 0.013) were all significant overall survival predictors. By means of multivariate analysis, their predictive significance was confirmed.
Our study provides evidence that serum levels of Ang-2 and CRP may serve as predictors for assessment of the clinical stage of type 1 EC and are significantly associated with poor prognosis. It is likely that angiogenesis and inflammation associated with obesity have a significant impact on EC type 1 progression and survival rate of patients.
众所周知，肥胖与子宫内膜癌（1 型 EC）的发病风险密切相关。本研究分析了与 1 型 EC 进展和患者生存数据相关的选择标志物，如肥胖、胰岛素抵抗、血管生成和炎症标志物。
应用免疫测定技术（EMIT）检测 176 例术前血清样本中脂联素、C 反应蛋白（CRP）、血管内皮生长因子-A（VEGF-A）、血管生成素-2（Ang-2）、胰岛素样生长因子-1（IGF-1）、胰岛素和 C 肽的水平。
Ang-2 水平随年龄（P=0.005）、FIGO 分期（p=0.042）、肌层浸润（P=0.009）和 LVSI（P<0.001）增加。CRP 水平随年龄（P=0.01）、FIGO 分期进展（P<0.001）、肿瘤分级升高（P=0.012）和肌层浸润（P<0.001）而升高。血清 Ang-2 和 CRP 水平呈正相关（r=0.44；P<0.001）。Kaplan-Meier 生存分析显示，血清 CRP 水平高和 Ang-2 高的患者预后较差（P=0.03 和 P=0.015）。个体预测因子的 Cox 回归分析显示，血清高水平的 Ang-2、CRP、FIGO 临床分期（P<0.001，分别）、高龄（P=0.013）均为总生存的显著预测因子。通过多变量分析，证实了它们的预测意义。
本研究表明，血清 Ang-2 和 CRP 水平可作为评估 1 型 EC 临床分期的预测因子，与不良预后显著相关。与肥胖相关的血管生成和炎症可能对 1 型 EC 的进展和患者的生存率有重大影响。
