Serum tumour necrosis factor alpha levels in benign and malignant lesions of the endometrium in postmenopausal women. A preliminary study.

Tumour necrosis factor alpha (TNF alpha) concentration was determined by a solid phase immunoradiometric assay in sera of 20 healthy postmenopausal women (reference group), 10 women suffering from postmenopausal bleeding with histologically confirmed cystic glandular hyperplasia, and 10 postmenopausal bleeding patients with histologically confirmed endometrial adenocarcinoma. In cases of endometrial adenocarcinoma serum TNF alpha (157.6 +/- 28 pg/ml) was found to be significantly higher than in controls (80.6 +/- 4.1 pg/ml). The rate of abnormally high values of serum TNF alpha increased with advancing stage of the disease. On the other hand, serum TNF alpha level in cases of endometrial hyperplasia (38 +/- 6 pg/ml) was significantly lower than in healthy individuals. It seems that the rise of serum TNF alpha in cases of endometrial carcinoma represents a possible mechanism of immune surveillance. The results suggest clinical usefulness of serum TNF alpha estimations for the differential diagnosis of benign and malignant lesions of the endometrium in women with postmenopausal bleeding.