losartan-potassium and Endometrial-Neoplasms

Preoperative treatment of anemia with intravenous iron is inconsistent despite known risks of anemia and allogeneic blood transfusions. Limited research exists on the effectiveness of preoperative intravenous iron for chronic kidney disease (CKD) patients. We discuss a patient with severe anemia from advanced CKD, endometrial cancer, and menometrorrhagia. Her hemoglobin increased more than 2 g/dL after erythropoietin and two 750-mg ferric carboxymaltose infusions 5 weeks before a total abdominal hysterectomy and avoided blood transfusions perioperatively. By raising hemoglobin, preoperative intravenous iron and erythropoietin reduce blood transfusions and consequent risk of future allograft rejection and alloimmunization in potential transplant recipients.

Topics: Administration, Intravenous; Anemia; Endometrial Neoplasms; Erythropoietin; Female; Ferric Compounds; Hemoglobins; Humans; Hysterectomy; Infusions, Intravenous; Iron; Kidney Diseases; Maltose; Middle Aged; Preoperative Care; Severity of Illness Index; Trace Elements; Treatment Outcome

HHUA, a rare endometrial cancer cell line expressing the estrogen receptor (ER), was adopted to investigate the expression of vascular endothelial growth factor (VEGF), erythropoietin (Epo), Bcl-2 and p53 under the administration of estradiol-17beta (E2). Based on quantitative real-time reverse transcription polymerase chain reaction assays, both VEGF and Bcl-2 mRNA levels decreased in a dose-dependent manner, although VEGF levels were increased in a time-dependent manner; no significant change was found for Epo and p53. An immunocytochemical study also showed the suppressed expression of VEGF and Bcl-2 under E2 induction. Both ERalpha and ERbeta mRNAs were detected in HHUA cells with ERbeta expression being predominantly higher than that of ERalpha, which is the converse of the pattern seen in normal endometria. The present study shows the E2-downregulated expression of VEGF and Bcl-2, and reveals a disrupted balance of ERalpha and ERbeta expression, which should be taken into consideration to understand the particularity of E2-regulated gene expression in HHUA cells.

Topics: Cell Line, Tumor; Endometrial Neoplasms; Endometrium; Erythropoietin; Estradiol; Estrogen Receptor alpha; Estrogen Receptor beta; Female; Gene Expression Regulation; Genes, p53; Humans; Proto-Oncogene Proteins c-bcl-2; RNA, Messenger; Vascular Endothelial Growth Factor A

Erythropoietin (Epo), which is induced by hypoxia, controls erythropoiesis and protects neurons from hypoxic damage. Hypoxia in malignant disease is associated with invasion, metastasis, and resistance to therapy. The authors recently demonstrated hypoxia-stimulated expression of Epo and Epo receptor (EpoR) in human breast and cervical carcinomas, suggesting a role for autocrine Epo signaling in the hypoxic adaptations of carcinomas.. The authors characterized the expression of Epo, EpoR, hypoxia-inducible factor (HIF)-1alpha, estrogen receptor (ER), and progesterone receptor (PR) by immunohistochemical methods using endometrial carcinoma samples from 107 women and benign endometrial samples from 59 women in various phases of the menstrual cycle. They then analyzed potential correlations of Epo and EpoR immunostaining and clinicopathologic tumor features with outcome.. In benign endometrial tissue samples, Epo and EpoR expression increased over the course of the cycle, with the highest levels observed in the late secretory phase. Epo expression in benign endometrial samples showed a negative correlation with ER and PR expression. The authors found Epo and EpoR expression in 95.3 % and 100% of endometrial carcinoma samples, respectively. Increased EpoR, but not Epo, expression in tumors was associated with advanced-stage disease, lymphovascular invasion, lymph node metastasis, and loss of ER expression. Increased Epo expression was observed in perinecrotic tumor regions in a pattern similar to the HIF-1alpha expression pattern. Increased Epo expression was significantly associated with adverse clinical outcome on both univariate and multivariate analysis.. Hypoxia-inducible autocrine Epo signaling in endometrial carcinoma may contribute to tumor progression and increased aggressiveness. Increased Epo expression in endometrial carcinomas may be an independent prognostic and/or predictive factor.

Topics: Adenocarcinoma, Clear Cell; Adult; Aged; Aged, 80 and over; Cell Hypoxia; Cystadenocarcinoma, Serous; Endometrial Neoplasms; Endometrium; Erythropoietin; Female; Gene Expression Regulation, Neoplastic; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Immunoenzyme Techniques; Lymphatic Metastasis; Menstrual Cycle; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Receptors, Erythropoietin; Receptors, Estrogen; Receptors, Progesterone; Survival Rate; Transcription Factors

Topics: Adenocarcinoma; Ascitic Fluid; CA-125 Antigen; Endometrial Neoplasms; Erythrocyte Count; Erythropoietin; Female; Humans; Middle Aged