The role of endocrine factors in the genesis of gynecological tumours

C. C. Cojocaru, A. C. Anton, M. Grigore, G. Costăchescu

Abstract: Diabetes mellitus is associated with increased incidence and poor outcome of variate gynecologic pathology. The authors performed a meta-analysis of published studies and try to point out the etiopathogeny of such significant association. Three mechanisms may operate in both diabetes mellitus and gynecological tumors: altered endogenous sex-hormone regulation, activation of the insulin-like growth factor (IGF), signalling pathway and activation of the insulin-signalling pathway. Obesity, the major risk factor for type 2 diabetes, is also associated with significantly increased risk of breast cancer incidence, presumably due to activation of these three mechanisms. Preclinical and clinical data suggest complex associations between the biological effects of diabetes on cancer risk and natural history, and the effects of diabetes on medical decision making about screening and management of various tumors. Clinically and pathologically, numerous stigmata of endocrine disease are evident on careful examination, which suggests that hormonal factors play an important part in the pathogenesis of endometrial carcinoma. Genetic predisposition is also likely to be involved. The association between diabetes and different gynecological tumors may be different in premenopausal and postmenopausal women, with different pathogenetic mechanisms, that requires specific therapeutic strategies.
Keywords: diabetes mellitus, receptors, hormons, carcinogenesis