Research led by University of Manchester and Salford Royal Hospital suggests weight loss leads to spontaneous reversal of endometrial neoplastic changes in obese women.
A study, published in the International Journal of Cancer, assessed the effect of obesity and subsequent bariatric surgery‐induced weight loss on endometrial morphology and molecular pathways implicated in endometrial carcinogenesis.
Blood and endometrial tissue were obtained from 72 women with class III‐IV obesity (BMI, ≥40 and ≥50 kg/m2, respectively) immediately prior to gastric bypass or sleeve gastrectomy, and after 2 and 12 months of follow-up.
The endometrium underwent pathological examination, and immunohistochemistry was used to quantify proliferation (Ki‐67), oncogenic signalling (PTEN, pAKT, pERK) and hormone receptor expression status.
Baseline endometrial biopsies revealed neoplastic change in 10 women (14%): 4 had endometrial cancer (EC), 6 had atypical hyperplasia (AH). Following bariatric surgery, most cases of AH resolved (5/6) without intervention (3/6) or with intrauterine progestin (2/6). Biomarkers of endometrial proliferation (Ki‐67), oncogenic signalling (pAKT) and hormone receptor status were significantly reduced, with restoration of glandular PTEN expression at 2 and 12 months.
The authors say the spontaneous reversal and accompanying downregulation of PI3K‐AKT‐mTOR signalling with weight loss may have implications for screening, prevention and treatment of endometrial cancer.
