Abstract:
Introduction. Endometrial cancer is the most common gynecological malignancy in industrialized
countries, the incidence is constantly increasing globally. Globally, endometrial cancer ranks third among
female genital malignancies, after the cervix and ovary, accounting for six percent of new cases of cancer
in women and accounting for three percent of all cancer deaths in women. About 69,950 new cases of
endometrial cancer were estimated in 2022, with 12,550 deaths from the disease, according to the American
Cancer Society. The most common histological type is endometrioid adenocarcinoma, accounting for 75-
80%.
Aim of study. The purpose of this study was to review data about characteristics of endocrine and metabolic
disorders involved in the pathogenesis of endometrial carcinoma.
Methods and materials. The source of information was represented by articles published in the online
databases: PubMed, HINARI, SCOPUS, EMBASE.
Results. Current evidence revealed the hypothesis that the complex of endocrine and metabolic disorders
that occur long before the development of endometrial carcinoma determines the biological characteristics
of the tumor, both its clinical evolution and the prognosis of the disease. Based on prospective studies in
patients with endometrial carcinoma, the authors postulate the existence of two different pathogenetic types
of endometrial carcinoma. The first pathogenetic type of the disease with a frequency of 65% occurs in
women with obesity, hyperlipidemia and signs of hyperestrogenism: anovulatory uterine bleeding,
infertility, late onset of menopause and hyperplasia of the ovarian and endometrial stroma, developing high
and moderate superficial invasion tumors. myometrium, high progestin sensitivity and favorable prognosis
(survival rate greater than 5 years) While the second pathogenetic type (35%) of the disease occurs in
women who have no signs mentioned above or these signs are not clearly defined and endocrine.
Conclusion. Endocrine and metabolic disorders are divided into two clinical / epidemiological entities:
type 1 cancers, which occur in young and obese patients, are associated with excess estrogen, a favorable
prognosis and endometrioid histology, and are often accompanied by and / or endometrial hyperplasia (
EH); compared to type 2 cancers, which are tumors that appear in older and non-obese patients, are
associated with an unfavorable prognosis and nonendometrioid histotypes and are usually serous histology
with no associated hyperplastic lesions.
