title: Non-sex cord-stromal ovarian tumors frequently produce and secrete estrogen in postmenopausal women: impact on bone metabolism and abnormal endometrial histology.
abstract: OBJECTIVE
  We investigated whether the estrogen released from non-sex cord-stromal ovarian tumors has biological effects on bone and endometrial tissue in postmenopausal women.
  
  
  METHODS
  A total of 132 patients with malignant (n = 112) or benign (n = 20) gynecological disease with normal postmenopausal ovaries were recruited as a control group (group C). The 75 patients with ovarian tumors were divided into 2 groups: group L (serum estradiol [E2] level of < 20 pg/ml; n = 42) and group H (serum E2 level of > 20 pg/ml; n = 33). The subjects' serum E2 levels, bone mineral density, urinary levels of the N-telopeptide of type I collagen, and serum levels of bone-specific alkaline phosphatase were measured before and after surgery. Histological examinations of the endometrium were carried out in the 75 patients with non-sex cord-stromal ovarian tumors.
  
  
  RESULTS
  High serum E2 levels were detected in 33 (44%) of 75 patients with ovarian tumors. The serum E2 levels of group H were significantly decreased after surgery. In the other subjects, there were no significant differences between the serum E2 levels observed before and after surgery. The mean preoperative N-telopeptide of type I collagen and bone-specific alkaline phosphatase levels of group H were significantly lower than those of group C. The bone mineral density values of groups L and H were significantly decreased after surgery. Five (6.7%) of 75 patients with non-sex cord-stromal ovarian tumors displayed abnormal endometrial histology, including 4 patients with grade 1 endometrioid cancer.
  
  
  CONCLUSIONS
  The E2 released from ovarian tumors might have biological effects on bone metabolism and the incidence of abnormal endometrial histology.
authors.affiliation: Department of Obstetrics and Gynecology, Yamagata University, Faculty of Medicine, Yamagata 990-9585, Japan.
authors.forename: Sohei
authors.initials: S
authors.lastname: Matsumura
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohta
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kurachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015519:Bone Density; D001842:Bone and Bones / Q000201:enzymology / Q000378:metabolism; D018269:Carcinoma, Endometrioid / Q000453:epidemiology / Q000473:pathology; D003094:Collagen / Q000652:urine; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D004967:Estrogens / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D060787:Neoplasm Grading; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000473:pathology*; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology*; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D010053:Ovary / Q000378:metabolism* / Q000601:surgery
chemical_list: D015415:Biomarkers; D004967:Estrogens; C461299:urinary N-telopeptide of type I collagen, human; D004958:Estradiol; D003094:Collagen; C548267:ALPL protein, human; D000469:Alkaline Phosphatase