The aim of this work was to optimize the prognosis of early recurrences of uterine cancer by searching for informative laboratory biomarkers. The study included 343 patients with I-IV stages FIGO endometrial adenocarcinoma the ages of 53 and 76 years. In patients before surgery, as well as 3 and 6 months after the end of primary treatment, the concentration of oncological markers CA-125, HE4, DJ-1, DKK-1 was determined in blood serum by ELISA and electrochemiluminescence immunoassay. We analyzed the predictive informativeness of monitoring markers to assess the risk of early recurrences of cancer within two years after surgery. In patients with uterine cancer with the stage of the disease and the degree of tumor differentiation in the blood serum, the concentration of DJ-1 is changed. With myometrial invasion of more than 50%, increased serum levels of three markers - CA-125, HE4, and DJ-1. Depending on the risk of disease recurrence, the assessment of which was determined by intraoperative and histological characteristics, a difference was revealed in the content of HE4 and DJ-1 markers in the blood. It was found that the risk of early recurrence of uterine cancer increased (p<0,05) when the concentration of CA-125 exceeded the level of 29,3 U/ml, HE4 was above 79,3 pmol/l, DJ-1 was above 90,0 ng/ml and DKK-1 above 47,3 pg/ml 6 months after the end of primary treatment. The highest predictive information value was found for monitoring DJ-1 and HE4 in blood serum, which indicates that they are promising for use in continuous monitoring of the course of cancer.
Background
To date, knowledge about the effects of testosterone (T) on the cardiovascular system of men remains controversial and requires additional research. Especially the putative impact of T replacement therapy (TRT) on lipid metabolism and endothelial dysfunction as a starting mechanism for the development of cardiovascular pathology in men with type 2 diabetes mellitus (T2DM) presenting with T deficiency has to be elucidated.
The aim of this work was to evaluate the effect of T replacement therapy on lipid metabolism and function of endothelium in men with T2DM and hypogonadism.
Methods
The study included 95 men (mean age 55,3±2,4 years) with T2DM and late onset hypogonadism, established according to EAU 2015 criteria. Parameters of carbohydrate and lipid metabolism, as well as ultrasound assessment of flow-mediated dilatation of the brachial artery (FMD-BA) and intima-media thickness (IMT) of brachial arteries were performed at baseline and after 9 months. Patients were randomized into 2 groups: 1 - 45 men receiving TRT, using 1% transdermal T-gel and 2 (control group) - 50 men, who were not assigned to TRT. Statistical analysis was carried out using the Wilcoxon - test for repeated measurements (STATISTICA 10 software package).
Results
During the treatment period no serious adverse events were registered. The study revealed a significant decrease in HbA1c (p<0.001), total cholesterol (p=0.009), triglycerides (p=0.004) and LDL (p=0.01) levels as well as an increase in HDL level (p=0.001) in the 1st group vs baseline and compared to the 2nd one. There was a decrease in IMT (from 1.0 [0.8; 1.1] to 0.7 [0.6; 0.9] mm, p=0.002) in the 1st group compared to the 2nd (p<0.001). The endothelium-dependent FMD-BA increased 1.5 - fold in men applying T-Gel vs baseline as well as compared to the control group at the time point of follow- up (p<0.001). At the same time TRT leaded to acceleration of the time until maximal vasodilation – it became twice faster (from 120 [90; 120] to 60 [60; 90] sec, p<0.001) compared to baseline and the 2nd group (p<0.001). Linear blood flow velocity increased markedly in the 1st group compared to the 2nd at the time point of follow-up (p=0.03).
Conclusion
TRT in men with T2DM and T deficiency leads to an improvement in carbohydrate and lipid metabolism together with a significant decrease in IMT and enhancement of endothelium vasomotor function, seems to facilitate a reduction in cardiovascular risk.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Russian Science Foundation
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