Plasma oestrogens in postmenopausal women with endometrial cancer

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Abstract
Objective To study plasma levels of oestrogens and androgens, sex hormone‐binding globulin (SHBG) and follicle stimulating hormone (FSH) in postmenopausal patients with endometrial cancer. Design Patients and controls were matched for age, body mass index, parity and years since menopause. Setting Department of Obstetrics and Gynaecology, Hvidovre Hospital, Denmark. Subjects Fifty postmenopausal patients with endometrial cancer and 54 matching controls. Measurements Plasma levels of SHBG, FSH, oestrone, oestradiol, oestrone‐sulphate, dehydro‐epiandrosterone sulphate, testosterone, and androstenedione were measured by radio‐immunoassays. Free fractions of oestradiol and testosterone were calculated according to levels of SHBG and albumin. Results The levels of oestradiol, free oestradiol, and oestrone were elevated (Pvs 37 (34–41) pmol/1; free oestradiol: 0.69 (0.59–0.80) vs 0.48 (0.42–0.54) pmol/1; oestrone: 180 (159–204) vs 119 (107–133) pmol/1 (mean values (95% CI) in patients vs controls)). Furthermore, an increased oestrone:androstenedione ratio (0.095 vs 0.072, PPP<0.01) with body mass, in both patients and controls. Multiple regression analysis showed that the differences in oestrogen levels between the two groups persisted when controlling for the effect of body mass, age, years since menopause, parity, and levels of SHBG and FSH. Conclusion Patients with endometrial cancer exhibit increased plasma levels of oestradiol and oestrone. Speculatively, these oestrogens may result from an increased oestrone conversion from androstenedione, an increased ovarian and adrenal secretion of androstenedione, or alternative oestrogen production routes. The present findings support the hypothetical role for oestrogens in the aetiology of endometrial cancer.