Endometrial carcinoma is the most common gynecological malignancy in Western countries and is expected to increase in the following years because of the high index of obesity in the population. Recently, neural signaling has been recognized as part of the tumor microenvironment, playing an active role in tumor progression and invasion of different solid tumor types. The uterus stands out for the physiological plasticity of its peripheral nerves due to cyclic remodeling brought on by estrogen and progesterone hormones throughout the reproductive cycle. Therefore, a precise understanding of nerve-cancer crosstalk and the contribution of the organ-intrinsic neuroplasticity, mediated by estrogen and progesterone, of the uterine is urgently needed. The development of new and innovative medicines for patients with endometrial cancer would increase their quality of life and health. This review compiles information on the architecture and function of autonomous uterine neural innervations and the influence of hormone-dependent nerves in normal uterus and tumor progression. It also explores new therapeutic possibilities for endometrial cancer using these endocrine and neural advantages.
25 malignant cases (19.3%) (malignant group; MG), with a mean age of 58 ± 20. The mean age of the patients with benign cysts (benign group; BG) was 44.8 ± 16 and the difference was statistically significant (p < 0.001). Malignant cases were significantly more prevalent among post-menopausal women (68% versus 38%, P = 0.006). Comparison of US parameters between the groups revealed no significant difference between BG and MG groups regarding the size of the lesion (7.3 versus 8.4 cm; p = 0.331) and bilaterality (23% versus 17%; p = 0.782). Patients in the MG had more complex lesions (96% versus 61%; p < 0.001), free fluid in the pelvis (73% versus 22%; p ≤ 0.001) and higher CA125 levels (eta correlation coefficient 0.941). Presence of free fluid in the pelvis had the highest correlation with malignancy (phi = 0.416). Conclusions: Although expert opinion and Risk of Malignancy Indices are the state of the art in predicting ovarian malignancy, the combination of basic ultrasound findings and CA125 levels have significant benefit in the patient work-up and planning of the best intervention.
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