肿瘤相关物质在肿瘤诊断中的临床应用

目的探讨肿瘤相关物质(TSGF)在肿瘤诊断中的临床应用价值。方法用化学比色法测定对照组115例非肿瘤体检者,75例已明确诊断的肿瘤患者,21例肿瘤术后患者和29例随访肿瘤患者的TSGF的血清水平。结果TSGF的均值分别为(53.9±6.5)U/mL,(73.6±9.1)U/mL,(59.4±6.8)U/mL和(55.7±7.2)U/mL,患者与对照组比,差异均有统计学意义(P<0.05),TSGF的检出率分别为3.5%,79.4%,19.0%和10.3%,诊断效率为84.2%。结论TSGF测定对肿瘤的诊断有较高的灵敏度和特异性,在肿瘤的早期诊断、疗效观察和监测肿瘤复发和转移有较大的临床应用价值,可提高对肿瘤的早期诊断率。     

肿瘤相关物质群对肺癌诊断及转归判断的价值

目的探讨肿瘤相关物质群(TSGF)水平对肺癌诊断及转归评估的意义.方法用比色法检测169例肺癌患者(治疗前58例,治疗有效组51例,治疗无效组17例,复发转移组43例)和134例健康人血清TSGF水平.结果治疗前、治疗无效及复发转移组患者血清TSGF水平分别为(76.4±18.0)、(75.2±7.0)和(74.6±12.0)U/ml,均明显高于治疗显效组的(57.3±9.3)U/ml及健康对照的(54.5±5.2)U/ml(P＜0.01);与局部复发组的(67.6±9.1)U/ml;相比,远处转移组患者血清TSGF(78.8±11.4)U/ml水平显著升高(P＜0.01).以64U/ml为临界值时,TSGF对肺癌判断的灵敏度、特异度、阳性预测值和阴性预测值,分别为77.6%、97.0%、91.8%及90.9%.结论检测血清TSGF水平是肺癌诊断、疗效及预后判断的有效指标.     

肿瘤相关物质群水平对2性肿瘤复发转移的诊断

目的探讨肿瘤相关物质群(TSGF)对恶性肿瘤复发转移的诊断价值.方法采用比色法测定292例复发性恶性肿瘤患者及134例健康人的血清TSGF水平.结果各种复发性恶性肿瘤患者血清TSGF水平(x±s)显著高于健康对照组[(70.7±12.6)U/ml V.s(54.5±5.2)U/ml,P＜0.01];肿瘤转移患者血清TSGF水平高于局部复发组[(73.1±13.1)U/ml V.s(67.7±9.9)U/ml,P＜0.0L],尤其是肺、骨转移癌患者(P＜0.01);以64 U/ml为临界值时,TSGF检测复发转移瘤的敏感性为69.5%、特异性为97.0%.结论血清TSGF水平对恶性肿瘤的监测具有高度敏感性、高度特异性和广谱性,是监测其复发转移的重要指标.     

鼻咽癌患者血清VEGF、Endostatin和TSGF水平的相互关系

目的　探讨在鼻咽癌(NPC)患者血循环中血管内皮生长因子(VEGF)、内皮抑素(endostatin)和肿瘤相关物质群(TSGF)水平间的相互关系。方法　采用酶联免疫吸附试验(ELISA)检测14 0例NPC患者(治疗前组63例,完全缓解组41例,复发组3 6例)和40例健康人血清VEGF和Endostatin水平,采用光电比色法同步测定血清TSGF含量,并比较这些指标变化的相关性。结果　与健康对照组VEGF为(180 .9±14 7.7)ng/L ,Endostatin为(2 5 0 .9±2 5 4.4) μg/L ,TSGF为(5 3 .5±5 .2 )U /mL比较,NPC治疗前组、完全缓解组和复发组血清VEGF水平分别为[(2 96.5±183 .6)ng/L ,P <0 .0 1;(2 78.7±169.6)ng/L ,P <0 .0 5 ;(3 69.3±3 15 .6)ng/L ,P <0 .0 1] ;Endostatin水平分别为[(2 95 .6±5 0 .2 ) μg/L ,P <0 .0 1;(3 0 8.9±47.4) μg/L ,P <0 .0 1;(3 16.4±3 9.2 ) μg/L ,P <0 .0 1] ;TSGF水平分别为[(5 6.6±10 .3 )U /mL ,P >0 .0 5 ;(5 4.2±6.4)U /mL ,P >0 .0 5 ;(70 .6±15 .1)U /mL ,P <0 .0 1]。血清VEGF、Endostatin和TSGF水平均随着NPC临床病情进展而呈上升趋势,测定值间呈正相关关系(VEGF与Endostatin :γ=0 .0 5 4,P >0 .0 5 ;VEGF与TSGF :γ=0 .2 5 1,P <0 .0 1;Endostatin与TSGF :γ=0 .0 67,P >0 .0 5 )。结论NPC患     

乳腺癌患者血清中肿瘤相关物质群的水平

 目的　探讨乳腺癌患者血清TSGF水平及其临床意义。方法　用光电比色法检测 2 0 0例乳腺癌患者及健康对照 6 6人的血清TSGF水平。结果　初治、治疗无效及复发转移患者的血清TSGF水平分别为 (6 7.5± 4 .9)U/ml、(6 7.5± 4 .7)U/ml及 (6 5 .5± 9.6 )U/ml,均明显高于治疗显效组的 (5 5 .9±5 .1)U/ml及对照组的 (5 5 .5± 5 .3)U/ml(P <0 .0 1) ;局部复发、转移者血清TSGF水平分别为 (6 5 .0±9.8)U/ml、(6 6 .2± 9.1)U/ml,其差异无统计学意义 (P >0 .0 5 ) ;以 6 4U/ml为阳性阈值 ,TSGF检测乳腺癌的灵敏度及特异度分别为 6 0 .3%、98.5 %。结论　检测血清TSGF水平对乳腺癌的疗效及预后判断有良好效果。     

肿瘤相关物质群联合检测对肺癌转移的临床诊断价值

目的　探讨肿瘤相关物质群 (TSGF)对肺癌转移和复发的诊断价值。方法　采用福建新大陆生物技术有限公司生产的TSGF快速检测诊断试剂盒对临床确诊的 75例肺癌患者 (其中局限组 39例 ,远转组 36例 )及 2 4例健康对照者血清TSGF含量进行检测 ,以TSGF≥ 6 4U/ml判断为阳性。结果　肺癌患者血清TSGF水平为 77.0 8± 15 .73U/ml( x±s) ,阳性率为 88% ,与正常对照组的 5 9.4± 4 .4 5U/ml( x±s)相比有显著差异 (P <0 .0 1)。远转组的肺癌患者的血清TSGF水平为 88.2 2± 15 .6 9U/ml,阳性率 97% ,与局限组肺癌的 6 7.5 6± 7.4 3U/ml相比亦有显著性差异 (P <0 .0 1)。结论　血清TSGF测定对肺癌的诊断有高度敏感性和特异性 ,尤其对肺癌转移的判断有临床意义     

血清高迁移率族蛋白B1在非霍奇金淋巴瘤中的表达和意义

目的探索非霍奇金淋巴瘤患者血清中高迁移率族蛋白B1(HMGB1)的表达水平,以及其与疗效和预后的关系。方法采用ELISA方法检测37例非霍奇金淋巴瘤患者初始治疗前、化疗后的HMGB1水平,并以35例健康体检者为对照。结果非霍奇金淋巴瘤患者初治前血清中HMGB1水平显著高于健康体检者,差异有统计学意义(P<0.05);化疗后缓解(部分缓解或完全缓解)的非霍奇金淋巴瘤患者血清HMGB1水平较初治前明显降低,差异有统计学意义(P<0.05)。HMGB1呈递减趋势的非霍奇淋巴瘤患者的生存时间较HMGB1呈递增趋势的非霍奇金淋巴瘤患者明显延长。结论血清HMGB1水平与非霍奇金淋巴瘤的发病和发展密切相关,检测血清HMGB1水平有助于了解患者的病情变化及转归。     

非霍奇金淋巴瘤患者血清乳酸脱氢酶的变化及临床意义

目的　研究血清乳酸脱氢酶与非霍奇金淋巴瘤分期、治疗及预后的关系。方法　检测 110例非霍奇金淋巴瘤患者血清乳酸脱氢酶水平。结果　治疗前Ⅰ期 +Ⅱ期患者血清乳酸脱氢酶异常增高为 42 9% (2 1/4 9) ,Ⅲ期 +Ⅳ期患者血清乳酸脱氢酶异常增高为 64 8% (4 6/71) ,以Ⅲ期 +Ⅳ期患者血清乳酸脱氢酶异常增高为普遍 (P <0 0 5 )。结论　血清乳酸脱氢酶水平与非霍奇金淋巴瘤分期及生存期有关 ,与治疗无关 ,可作为预测非霍奇金淋巴瘤分期及生存期的重要因素。     

鼻咽癌患者血清中肿瘤相关物质群水平变化的临床意义

目的　探讨血清中肿瘤相关物质群 (TSGF)水平与鼻咽癌 (NPC)临床病理因素的关系。方法　采用比色法测定 3 2 2例NPC患者 (治疗前 179例 ,复发 5 9例 ,治疗后 84例 )和 13 4例健康人血清TSGF水平。结果　治疗前、复发和健康对照组TSGF水平 ( x±s)分别为 ( 65 .2± 12 .1)、( 72 .9± 12 .4)和 ( 5 4.5± 5 .2 )U /ml,相互比较有非常显著性差异 (P <0 .0 1) ;TSGF水平随着NPC病情进展 (P <0 .0 1)而显著升高 ,远处转移者TSGF水平显著高于无远处转移者 (P <0 .0 1) ;以健康对照组的TSGF均值 ( 5 5U /ml)来判断NPC的灵敏度、特异度、阳性预测值和阴性预测值 ,分别为 81.0 %、5 6.7%、71.4%和 80 .5 % ;以无远处转移患者的TSGF均值 ( 62U /ml)作为临界值检测远处转移的灵敏度、特异度和阴性预测值分别为 93 .9%、48.4%和 96.1% ;放疗和化疗后NPC完全缓解或部分缓解组TSGF水平显著低于未缓解者 (P <0 .0 1)。结论　TSGF水平与NPC病情进展、疗效有关 ,尤其与远处转移与否有关。     

肿瘤相关物质群水平对鼻咽癌复发转移的诊断价值

目的:探讨肿瘤相关物质群(TSGF)对鼻咽癌复发转移的诊断价值。方法:采用比色法测定71例复发转移鼻咽癌患者及42例健康人的血清TSGF水平。结果:鼻咽癌患者血清TSGF水平(x-±s)显著高于健康对照组(68.7±14.1)U/ml vs(59.1±3.6)U/ml,P<0.01;肿瘤转移患者血清TSGF水平高于局部复发组(72.0±14.6)U/ml vs(64.7±12.6)U/ml,P<0.05,尤其是骨转移癌患者;以64U/ml为临界值时,TSGF检测复发转移癌的敏感性为70.4%(50/71)、特异性为95.2%(40/42)。结论:血清TSGF水平对鼻咽癌的监测具有高度敏感性、高度特异性,是监测其复发转移的重要指标。     

The medically important dematiaceous fungi and their identification

Dematiaceous fungi include a large group of organisms that are darkly pigmented (dark brown, olivaceous, or black). In most cases the pigment is melanin, and specifically, dihydroxynaphthalene melanin. The diseases produced include chromoblastomycosis, eumycotic mycetoma, and phaeohyphomycosis. Phaeohyphomycosis is a new classification for a diverse group of previously known entities grouped together on the basis of finding dematiaceous hyphal and/or yeast-like forms in tissue; tissue involvement may be superficial, cutaneous and corneal, subcutaneous, or systemic. Identification of these fungi is based mostly upon morphology. Important structures include annellides (Phaeoannellomyces, Exophiala), phialides (Phialophora, Wangiella), adelophialides (Phialemonium without collarettes, Lecythophora with collarettes), differentiation of conidiophores (Xylohypha versus Cladosporium) and conidial hilum, septation and germination (Bipolaris, Drechslera, Exserohilum). Useful laboratory tests include the 12% gelatin test (controversial), nitrate assimilation (W. dermatitidis is negative, most other species are positive), and determination of temperature maxima (especially 37 degrees C for E. jeanselmei, 40 degrees C for W. dermatitidis and B. spicifera, 42 degrees C for X. bantiana, and 45 degrees C for Dactylaria constricta var. gallopava and Scedosporium inflatum).     

Laboratory Techniques Alternative to In Vivo Experiments for Studying the Liberation, Penetration and Fungicidal Action of Topical Antimycotic Agents in the Skin, Including Ciclopiroxolamine

Summary: Short-term experiments on excised skin (human, pig) gave the following results: 1. In the tissue activity test with direct inoculation (D-TAT) commercial preparations of the non-azole antimycotics ciclopiroxolamine, tolnaftate and naftifine, produced higher inhibitory activity against Trichophyton mentagrophytes (standard strain) in various levels of the horny layer than were produced by the azole antimycotics econazole, miconazole, clotrimazole, oxiconazole and bifonazole. Fast drying solutions of antimycotics invariably gave higher inhibitory activities than creams. In the ultrafiltration tissue activity test (UFT- TAT) against Candida albicans (2 strains), antimycotic agents ranked in order of effectiveness as follows: ciclopiroxolamine – most of the azole antimycotics – bifonazole and naftifine. 2. In tests of fungicidal activity against T. mentagrophytes (2 strains) and Microsporum gypseum (1 strain) the first step was to inoculate the skin surface. After the horny layer had been penetrated by fungal mycelia, antimycotic agents of documented fungicidal potency, chiefly in the form of creams, were applied to the skin surface and left to act for up to 18 hours. The horny layer and epidermis were then scraped off and the concentration of viable fungi was determined. Ciclopiroxolamine cream and lotion produced by far the greatest diminution in viable fungi; creams containing oxiconazole and naftifine were moderately effective and those containing tioconazole and bifonazole produced a relatively small decrease in viable fungi. To avoid erroneous results it is important to homogenize and dilute the skin scrapings; if this is not done certain antimycotics will give misleadingly high fungal killing rates. At this early stage the scatter of results is still wide and minor differences in efficacy cannot as yet be detected with certainty. 3. From the results of various comparative tests it is evident that pig skin can be used as a substitute for human skin in the tests listed under 1. and 2. above. This discovery may make a valuable contribution towards limiting the need for experiments on living animals and trials on human beings. Zusammenfassung: In Kurzzeitversuchen an exzidierter Haut (Mensch, Schwein) wurde gefunden: 1. Im Gewebeaktivitätstest mit direkter Inokulation (D-GAT) wurde mit Handelspräparaten der Nichtazol-Antimykotika Ciclopiroxolamin, Tolnaftat und Naftifin in verschiedenen Hornschichtniveaus eine höhere Hemmaktivität gegenüber Trichophyton mentagrophytes (Standard-Stamm) erzielt als mit solchen der Azol-Antimykotika Econazol, Miconazol, Clotrimazol, Oxiconazol und Bifonazol. Rasch trocknende Lösungen von Antimykotika ergaben durchweg höhere Hemmaktivitäten als Cremes. Im Ultrafiltrations-Gewebeaktivitätstest (UFT-GAT) gegenüber Candida albicans (2 Stämme) ergab sich nach erzielter Wirksamkeit die Rangfolge Ciclopiroxolamine – Mehrzahl der Azolantimykotika – Bifonazol und Naftifin. 2. In Fungizidie-Testen gegenüber T. mentagrophytes (2 Stämme) und Microsporum gypseum (1 Stamm) wurde zunächst die Hautoberfläche inokuliert. Nach Durchdringung der Hornschicht mit Pilzmyzelien wirkten auf die Hautoberfläche bis zu 18 Stunden lang überwiegend Cremes von als fungizid publizierten Antimykotika ein. Während sich in abgeschabter Hornschicht und Epidermis der so bearbeiteten Hautoberflächen mit Ciclopiroxolamin-Creme und -Lotion die weitaus höchste Verminderung lebensfähiger Keime ergab, bewirkten Cremes mit Oxiconazol und Naftifin eine mittlere und solche mit Tioconazol und Bifonazol eine relativ niedrige Keimeliminierung. Zur Vermeidung von fehlerhaften Ergebuissen mußten Homogenisierung und Verdünnung der Hautschabsel erfolgen, anderenfalls bei mehreren Antimykotika eine zu hohe Keimabtötung vorgetäuscht worden wäre. Wegen der vorerst noch hohen Streuung der Ergebnisse können kleinere Wirksamkeitsunterschiede noch nicht sicher erfaßt werden. 3. Nach dem Ergebnis verschiedener Vergleichstests kann in den Testen zu 1. und 2. Schweinehaut als Ersatz für Haut vom Menschen dienen und dürfte damit wesentlich zur Einschränkung von Versuchen am lebenden Tier und von Prüfungen am Menschen beitragen.     

Efficiency of crude and purified fungal antigens in serodiagnosis to discriminate mycotic from other respiratory diseases

Mycotic immunodiagnosis was performed in 186 hospitalized patients with different respiratory diseases, mostly considered as tuberculosis and others with a doubtful diagnosis. Crude histoplasmin, coccidioidin, paracoccidioidin, blastomycin, candidin, aspergillin, and sporotrichin, as well as purified polysaccharide-protein complexes (PPC) of Histoplasma capsulatum, Coccidioides immitis, and Paracoccidioides brasiliensis were used as antigens. Immune tests used included skin test (ST), gel immunodiffusion (ID), counterimmunoelectrophoresis (CIE), complement fixation (CF), and ELISA. A possible association with candidosis was observed in 17% of patients with tuberculosis and diabetes; one presumptive paracoccidioidomycosis, one confirmed aspergillosis, and six cases of active histoplasmosis were determined. Candidin ST showed 29% of positive reactions with an increased frequency in patients between 31 and 55 years of age. CF test showed the highest positivity percentages with crude antigens, specially for Candida antigen (26.3%) and histoplasmin (18.2%). Cross reactions were evident with crude antigens but decreased when PPC's were used in ELISA.     

Isoconazole nitrate in the treatment of tropical dermatomycoses

Summary. A total of 54 patients with culturally proven tropical dermatomycoses, comprising 23 with various types of dermatophytoses, one with foot infection due to Trichosporon beigelii and one with foot infection due to Geotrichum candidum , two with candidoses of the groin and 27 with pityriasis versicolor, were included in a clinical trial of efficacy of 1% isoconazole cream (Travogen^R, Schering, Berlin, Germany). Five patients were not evaluable. A clinical and mycological cure was achieved in 29 cases in 3–4 weeks. In 15 (31%) of the remaining patients treatment was required for 5–6 weeks, while another three patients required treatment for 8 weeks. In two patients the disease proved to be resistant to treatment with the drug.
Zusammenfassung. Insgesamt 54 Patienten mit kulturell gesicherter Dermatomykose, (23 unterschiedliche Dermatophytosen, eine Trichosporon beigelii - und eine Geotrichum candidum -Fußinfektion, 2 Candidosen der Leistengegend und 27 Pityriasis versicolor) wurden in einer klinischen Wirksamkeits-studie mit 1% iger Isoconazol-Creme (Travogen^R, Schering, Berlin, Deutschland) behandelt. Fünf Patienten waren nicht auswertbar. Eine klinische und mykologische Heilung wurde bei 47 von 49 Patienten (96%) erreicht. Bei 29 patienten (59%) wurde die Heilung bereits nach 3–4 Wochen Behandlung erreicht. Weitere 15 Patienten (31%) benötigten 5–6 Wochen und drei Patienten 8 Wochen Behandlungsdauer. Zwei Mykosesituationen erwiesen sich als therapieresistent.     

Orale Langzeitbehandlung von Onychomykosen mit Ketoconazol

Zusammenfassung: An der Studie zur Wirksamkeit und Anwendungssicherheit von Ketoconazol nahmen 27 Männer im Alter von 20 bis 80 (Median: 57) Jahre, davon 18 mit Onychomykosen und 9 als KontroUen bei den Laborwertbestimmungen, teil. Während des ersten Behandlungsmonats erhielten je 9 Patienten 200 mg und 400 mg Ketoconazol täglich. Danach wurden beide Gruppen 6 Monate mit 200 mg/d weiterbehandelt. Die klinische Beurteilung sowie hämatologische, biochemische und Plasmaspiegeluntersu-chungen erfolgten mindestens monafich, mykologische Untersuchungen wurden vor Aufnahme und bei Beendigung der Therapie vorgenommen. Erne letzte klinische Unter-suchung erfolgte 1 Jahr nach Beginn der Studie. Nach 7 Monaten Behandlung wurden 23 von 30 Nägeln mit “gebessert” bis “stark gebessert” beurteilt, nach dem behandlungsfreien Intervall galt dies für 28 von 30 Nägeln. Die Plasmaspiegel waren mit 200 mg/d ausreichend und uber den Behandlungszeit-raum konstant. Dies spricht für gute orale Resorption und Abwesenheit von Enzyminduktion. Die Laborwerte zeigten im Vergleich zu den Kontrollen und den Werten vor Behandlung keine signifikanten Abweichungen, so daß myelo-, nephro- und hepatotoxische Wirkungen von 400 bzw. 200 mg/d ausgeschlossen werden können. Der Lipidhaushalt wurde nicht beeinfluat und es trat unter Therapie als Folge der Ketoconazolwirkung lediglich Lanosterin im Serum auf. Nach Beendigung der Therapie ging der Lanosteringehalt schnell zurück. Damit erweist sich Ketoconazol in den angewandten Dosen als ein gut verträgliches und zur Langzeitbehandlung von Onychomykosen geeignetes Antimykotikum. Summary: Twenty-seven males with a median age of 57 (range: 20 to 80) years took part in this study on the efficacy and safety of ketoconazole. Eighteen men suffered from onychomycosis; nine served as controls in the safety evaluation. During the first month of treatment, nine patients received 200 mg and the nine other 400 mg ketoconazole daily. Then the treatment was uniformly continued with 200 mg/d for 6 months. Clinical evaluation and haematological, biochemical and plasma level investigations were carried out at least at monthly intervals; mycological controls were performed at the start and end of therapy. A final clinical evaluation was carried out one year after the start of the study. After 7 months of treatment, moderate or definite clinical improvement was obtained in 23 out of 30 nails. After 5 more months without antimycotic treatment this was the case in 28 of 30 nails. Plasma levels obtained with 200 mg ketoconazole daily were adequate and constant during the entire treatment period. This indicates a good oral resorption as well as the absence of induction of hepatic enzymes. The laboratory values did not show significant deviations as compared with the controls or with the pretreatment values. This excludes myelo-, nephro- and hepatotoxic effects of 400 and 200 mg ketoconazole daily. The lipid metabolism was not influenced, the only difference was the occurrence of lanosterol in the serum, which is a result of the mechanism of action of ketoconazole. After the medication period the lanosterol levels subsided rapidly. In the applied doses ketoconazole is a well-tolerated and effective drug for the systemic long-term treatment of onychomycosis.     

Large-scale molecular characterization and analysis of gastric cancer

The recent effort by The Cancer Genome Atlas （TCGA） Network has revealed that gastric cancer, which is a leading cause of cancerrelated deaths worldwide with a 5-year survival rate less than 25%, is a much more heterogeneous disease than previously thought. And yet, conventional treatment approaches and clinical trials have assumed it is a single disease. Although it is well known that under the microscope, gastric cancer cells appear quite different, the current classification scheme recognizes two main categories of gastric cancer： diffuse and intestinal.     

A conceptually new treatment approach for relapsed glioblastoma: Coordinated undermining of survival paths with nine repurposed drugs (CUSP9) by the International Initiative for Accelerated Improvement of Glioblastoma Care

To improve prognosis in recurrent glioblastoma we developed a treatment protocol based on a combination of drugs not traditionally thought of as cytotoxic chemotherapy agents but that have a robust history of being well-tolerated and are already marketed and used for other non-cancer indications. Focus was on adding drugs which met these criteria: a) were pharmacologically well characterized, b) had low likelihood of adding to patient side effect burden, c) had evidence for interfering with a recognized, well-characterized growth promoting element of glioblastoma, and d) were coordinated, as an ensemble had reasonable likelihood of concerted activity against key biological features of glioblastoma growth. We found nine drugs meeting these criteria and propose adding them to continuous low dose temozolomide, a currently accepted treatment for relapsed glioblastoma, in patients with recurrent disease after primary treatment with the Stupp Protocol. The nine adjuvant drug regimen, Coordinated Undermining of Survival Paths, CUSP9, then are aprepitant, artesunate, auranofin, captopril, copper gluconate, disulfiram, ketoconazole, nelfinavir, sertraline, to be added to continuous low dose temozolomide. We discuss each drug in turn and the specific rationale for use- how each drug is expected to retard glioblastoma growth and undermine glioblastoma''s compensatory mechanisms engaged during temozolomide treatment. The risks of pharmacological interactions and why we believe this drug mix will increase both quality of life and overall survival are reviewed.     

Endometrial cancers and predisposition

As nearly 5% of all endometrial cancers occur because of a predisposition, this possibility has systematically to be explored. The hallmarks of predisposition, a young age at diagnosis, a personal or a familial history of cancer, have to be searched systematically. The identification of a predisposition in a family has a major impact on the management of the proband or his relatives. The endometrial cancer main predisposition is Lynch's syndrome. In this review, we will focus on this condition and describe its clinical manifestations, the underlying molecular mechanisms, the cancer risks and the management guidelines. We will also get onto some far less frequent other predispositions.