Endometrial cancer (mechanism of disease) скачать в хорошем качестве

Endometrial cancer (mechanism of disease)

ERRATA: Type 1 is more associated with PTEN; Type 2 with p53. Thanks, @jl9774. This is a mechanism of disease flowchart for endometrial cancer, covering the etiology, pathophysiology, and manifestations. ADDITIONAL TAGS: Pharmacology / toxicity Infectious / microbial Biochem / molecular bio Mutation Signs / symptoms Labs / tests / imaging results Endometrial cancer Core concepts Social determinants of health / risk factors Hormone changes Genetics / hereditary Mass effect Pathophysiology Etiology Manifestations Mutation, such as: -Loss of function or null mutation in tumor suppressor gene (p53 [Type I] or PTEN [Type II]) -Increase in activity of oncogene (Her2/neu) Long term exposure to ↑ estrogen levels Genetic predisposition Nulliparity Early menarche Late menopause ↑ fat cells contain aromatase ↑ insulin Production of extraovarian estrogen Metabolic syndrome (obesity, DM2) ↑ IGF-2 → proliferation of endometrial cells Unopposed estrogen replacement therapy, such as for menopause symptoms, without added progestin Tamoxifen treatment History of breast cancer Hereditary nonpolyposis colorectal cancer (Lynch syndrome) Older Post-menopausal African American Type I, estrogen-dependant Type II estrogen-independent, endometrial atrophy ↑ progesterone Multiparity Combined OCPs Lifelong soy diet Regular exercise ↑ androgen x x Protective factors Smoking x Abnormal uterine bleeding -Postmenopausal: anything -Pre-/perimenopausal: heavy, irregular, intermenstrual +/- enlarged uterus Contiguous spread, regional extension Metastatic spread Pelvic pain Vaginal mass Weight loss Lethargy Pleural effusion Cough Anemia TVUS: endometrial thickness 4 mm Biopsy: Endometrial hyperplasia with atypia +/- concomitant adenocarcinoma Abdominal distension Abnormal cervix