Hum. Reprod. Advance Access originally published online on December 16, 2005
Human Reproduction 2006 21(4):924-929; doi:10.1093/humrep/dei420
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The association between polycystic ovaries and endometrial cancer
1 University Department of Obstetrics and Gynaecology and 2 Histopathology, Royal Free and University College Medical School, University College London, 3 Department of Histopathology and 4 Gynaecological Oncology, University College London Hospitals, London, 5 Department of Obstetrics and Gynaecology, Queen’s Medical Centre NHS Trust, Nottingham and 6 Department of Histopathology, St Thomas Hospital, London, UK
7 To whom correspondence should be addressed at: Academic Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, The Royal Free Hospital, Pond Street, London NW3 2PF, UK. E-mail: p.hardiman{at}medsch.ucl.ac.uk
BACKGROUND: Women with polycystic ovary syndrome (PCOS) are assumed to be at increased risk of endometrial cancer (EC), albeit of a more differentiated type with better prognosis than in normal women. This study was designed to test these assumptions, as evidence for them is lacking. METHODS: The prevalence of polycystic ovaries (PCO), as a marker of PCOS, was investigated in ovarian sections from 128 women with EC and 83 with benign gynaecological conditions. The expression of the prognostic markers p53, Ki67, Bcl2 and cyclin D1 was also investigated by immunohistochemistry in endometrial tumours from 11 women with PCO and 16 with normal ovaries. RESULTS: Overall, PCO were similarly prevalent in women with EC (8.6%) and benign controls (8.4%); however, in women aged <50 years, PCO were more prevalent in women with EC (62.5 versus 27.3%, P = 0.033). Cyclin D1-expressing endometrial tumours tended to be more prevalent in women with PCO compared to normal ovaries (36.4 versus 6.25%, respectively, P = 0.071). Bcl2-, p53- and Ki67-expressing tumours were similarly prevalent. CONCLUSIONS: The association between PCOS and EC appears confined to premenopausal women. The tendency for cyclin D1-expressing endometrial tumours to be more prevalent in women with PCO challenges the assumption that EC prognosis is improved in women with PCOS.
Key words: cancer/endometrium/polycystic ovaries/prevalence/prognosis
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