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The association between polycystic ovary syndrome and endometrial cancer.

Chedumbarum Pillay, O.D.; (2010) The association between polycystic ovary syndrome and endometrial cancer. Doctoral thesis, UCL (University College London). Green open access

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Abstract

HYPOTHESIS: Women suffering from polycystic ovary syndrome have an increased risk of developing endometrial carcinoma. AIM: To determine whether people with polycystic ovary syndrome have an increased risk of developing endometrial carcinoma. BACKGROUND: Endometrial cancer is one of the commonest cancers to occur in women in the Western World and unopposed oestrogen stimulation of the uterus is amongst one of the aetiologies postulated for this condition. It is generally assumed that women with polycystic ovary syndrome are more likely to develop endometrial hyperplasia and carcinoma for the reason mentioned above. The validity of this association has however never been tested. This relationship is investigated within this thesis. METHODS: 1. A case- control study comparing the ovarian morphology of women diagnosed with endometrial carcinoma and those with benign gynaecological conditions. 2. An immunohistochemical study to assess expression of cell cycle and apoptotic proteins (surrogate markers of prognosis) in cases of endometrial carcinoma from women with PCO or from women with normal ovaries. 3. A microarray study of gene expression in the endometrium of cycling and non-cycling women with polycystic ovary syndrome. RESULTS: We found no significant difference in the prevalence of PCO (using this as a marker of PCOS in the absence of information on biochemistry) in the ovaries of patients diagnosed with endometrial cancer compared to women with benign gynaecology disease. Cyclin D1 expression was significantly increased in the endometrial cancers associated with PCO whilst the expression of ki67, Bcl2 and p53 was not significantly different. A total of 101 genes were differentially expressed in the endometrium of women with PCOS with regular cycles, long cycles and simple endometrial hyperplasia. CONCLUSION: Although our numbers were small, these results challenge the assumption that PCOS is a risk factor for endometrial cancer. The raised expression of Cyclin D1 in endometrial cancers associated with PCO suggests that the prognosis for women with PCO is not necessarily better than those without PCO. There were alterations in the expression of genes which affect endometrial function in women with PCOS including those with regular menstrual cycle women. This suggests that the altered hormonal environment has an effect on gene expression at a very early stage which may have an implication on endometrial carcinogenesis.

Type:Thesis (Doctoral)
Title:The association between polycystic ovary syndrome and endometrial cancer.
Open access status:An open access version is available from UCL Discovery
Language:English
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Women's Health

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