Rizikové faktory karcinomu endometria

Autoři: Aus Tariq Ali
Působiště autorů: Department of Chemical Pathology, Tygerberg Hospital and the University of Stellenbosch, Cape Town, South Africa
Vyšlo v časopise: Čes. Gynek.2013, 78, č. 5 s. 448-459
Kategorie: Původní práce


Endometrial cancer is the most common malignancy of women in developed countries, and its incidence is rising among pre- and postmenopausal women. In developed and numerous developing countries endometrial cancer, as well as other types of female cancers are an ever-increasing threat that may be explained, among other reasons, by increased life expectancy and changes in lifestyle factors. Endometrial cancer is more common in postmenopausal women than in premenopausal women. Through a review of the literature it was found that the risk of endometrial cancer is positively correlated with older age, early menarche & late menopause, obesity, family history of endometrial cancer (especially among close relatives), radiation exposure, and infertility particularly in the presence of Polycystic Ovarian Syndrome. Long-term use of unopposed oestrogens for hormone replacement therapy also increases the risk of endometrial cancer. Caucasians have a higher incidence of endometrial cancer than African or Asian women. Obese women were found to be at high risk for developing endometrial cancer, while diabetes, hypertension, and geographical and socioeconomic factors are still inconclusive. Finally, smoking is considered as a protective factor against endometrial cancer due to its anti- estrogenic effect. .

endometrial cancer – older age – race – early menarche – late menopause – obesity – null parity – tamoxifen


1. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide. IARC Cancer Base No. 5, version 2.0. Lyon: IARC Press, 2004.

2. Buchanan EM, Weinstein LC, Hillson C. Endometrial cancer. Am Fam Physician 2009; 80:1075–1080.

3. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58:71–96.

4. Persson I, Adami HO. Endometrial cancer. In: Adami HO, Hunter DJ, Trichopoulos D, eds. Textbook of Cancer Epidemiology. Oxford, United Kingdom: Oxford University Press; 2002. p. 359–377.

5. Duong LM, Wilson RJ, Ajani UA, Singh SD, Eheman CR. Trends in endometrial cancer incidence rates in the United States, 1999–2006. J Women’s Health 2011; 20,8: 1–7.

6. Lacey JV, Brinton LA, Lubin JH, Sherman ME, Schatzkin A, Schairer C. Endometrial Carcinoma Risks among Menopausal Estrogen plus Progestin and Unopposed Estrogen Users in a Cohort of Postmenopausal Women. Cancer Epidemiol Biomarkers Prev 2005; 14:1724–1731.

7. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB. Cancer incidence in five continents. vol VII. Lyon: IARC, Scientific Publication No. 155, 2002.

8. Viola AS, Gouveia D, Andrade L, Aldrighi JM, Viola CF, Bahamondes L. Prevalence of endometrial cancer and hyperplasia in non-symptomatic overweight and obese women. Aust Nz J Obstet Gynaecol 2008; 48:207–213.

9. Evans T, Sany O, Pearmain P, Ganesan R, Blann A, Sundar S. Differential trends in the rising incidence of endometrial cancer by type: data from a UK population-based registry from 1994 to 2006. Br J Cancer 2011; 104:1505–1510.

10. Sorosky JI. Endometrial cancer. Obstet Gynecol 2008; 111:436–447.

11. Alektiar KM, Venkatraman E, Abu-Rustum N, Barakat RR. Is endometrial carcinoma intrinsically more aggressive in elderly patiants? Cancer 2003; 98:2368–2377.

12. Manchana T, Khemapech N. Endometrial adenocarcinoma in young Thai women. Asian Pac J Cnacer Prev 2008; 9:283–286.

13. Fujita M, Tase T, Kakugawa Y, et al. Smoking, earlier menarche and low parity as independent risk factors for gynecologic cancers in Japanese : a case-control study. Tohoku J Exp Med 2008; 216:297–307.

14. Soliman PT, Oh JC, Schmeler KM, et al. Risk factors for young premenopausal women with endometrial cancer. Obstet Gynecol 2005; 105:575–580.

15. Who site; http://www.who.int/countries/en/ last accessed 19/12/2012.

16. Setiawan VW, Pike MC, Kolonel LN, Nomura AM, Goodman MT, Henderson BE. Racial/Ethnic differences in endometrial cancer risk: the multiethnic cohort study. Am J Epidemiol 2007; 165:262–270.

17. Allard JE, Maxwell GL. Race disparities between black and white women in the incidence, treatment, and prognosis of endometrial cancer. Cancer Control 2009; 16:53–56.

18. Farley J, Risinger JI, Rose GS, Maxwell GL. Racial disparities in blacks with gynecologic cancers. Cancer 2007; 110:234–243.

19. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin 2006; 56:106–130.

20. Linkov F, Taioli E. Factors influencing endometrial cancer mortality: the Western Pennsylvania Registry. Future Oncol 2008; 4:857–865.

21. Rice LW. Hormone prevention strategies for breast, endometrial and ovarian cancers. Gynecol Oncol 2010; 118:202–207.

22. Reis N, Beji NK. Risk factors for endometrial cancer in Turkish women: results from a hospital-based case control study. Eur J Oncol Nurs 2009; 13:122–127.

23. Brinton LA, Berman ML, Mortel R, et al. Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case-control study. Am J Obstet Gynecol 1992; 167:1317–1325.

24. Wernli KJ, Ray RM, Gao DL, De Roos AJ, Checkoway H, Thomas DB. Menstrual and reproductive factors in relation to risk of endometrial cancer in Chinese women. Cancer Causes Control 2006; 17:949–955.

25. Zucchetto A, Serraino D, Polesel J, et al. Hormone-related factors and gynecological conditions in relation to endometrial cancer risk. Eur J Cancer Prev 2009; 18:316–321.

26. Dossus L, Allen N, Kaaks R, et al. Reproductive risk factors and endometrial cancer: the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2010; 127:442–451.

27. Parazzini F, La Vecchia C, Moroni S. Family history and the risk of endometrial cancer. Int J of Cancer 1994; 59:460–462.

28. Lucenteforte E, Talamini R, Montella M, et al. Family history of cancer and the risk of endometrial cancer. Eur J Cancer Prev 2009; 18:95–99.

29. Gruber SB, Thompson WD. A population-based study of endometrial cancer and familial risk in younger women. Cancer and Steroid Hormone Study Group. Cancer Epidemiol Biomarkers Prev 1996; 5: 411–417.

30. Lu KH, Schorge JO, Rodabaugh KJ, et al. Prospective determination of prevalence of lynch syndrome in young women with endometrial cancer. J Clin Oncol 2007; 25:5158–5164.

31. Lu KH, Dinh M, Kohlmann W, et al. Gynecologic cancer as a „sentinel cancer“ for women with hereditary nonpolyposis colorectal cancer syndrome. Obstet Gynecol 2005; 105:569–574.

32. Hampel H, Stephens JA, Pukkala E, et al. Cancer risk in hereditary nonpolyposis colorectal cancer syndrome: later age of onset. Gastroenterology 2005; 129:415–421.

33. Lalloo F and Evans G. Molecular genetics and endometrial cancer. Best Pract Res Clin Obstet Gynaecol 2001; 15: 355–363.

34. Inoue M, Okayama A, Fujita M, Enomoto T, Tanizawa O, Ueshima H. A case-control study on risk factors for uterine endometrial cancer in Japan. Jpn J Cancer Res 1994; 85:346–350.

35. McGrath M, Lee IM, Buring J, Hunter DJ, De Vivo I. Novel breast cancer risk alleles and endometrial cancer risk. Int J Cancer 2008; 123:2961–2964.

36. Beiner ME, Finch A, Rosen B, et al. The risk of endometrial cancer in women with BRCA1 and BRCA2 mutations, a prospective study. Gynecol Oncol 2007; 104:7–10.

37. Thompson D, Easton DF, Breast Cancer Linkage Consortium. Cancer incidence in BRCA1 mutation carriers. J Natl Cancer Inst 2002; 94:1358–1365.

38. The Breast Cancer Linkage Consortium. Cancer risks in BRCA2 mutation carriers. J Natl Cancer Inst 1999; 91:1310–1316.

39. Brinton LA, Westhoff CL, Scoccia B, et al. Causes of infertility as predictors of subsequent cancer risk. Epidemiology 2005; 16:500–507.

40. Uharcek P, Mlyncek M, Ravinger J, Matejka M. Prognostic factors in women 45 years of age or younger with endometrial cancer. Int J Gynecol Cancer 2008; 18:324–328.

41. Evans-Metcalf ER, Brooks SE, Reale FR, Baker SP. Profile of women 45 years of age and younger with endometrial cancer. Obstet Gynecol 1998; 91:349–354.

42. Elliott JL, Hosford SL, Demopoulos RI, Perloe M, Sills ES. Endometrial adenocarcinoma and polycystic ovary syndrome: risk factors, management, and prognosis. South Med J 2001; 94:529–531.

43. Pillay OC, Te Fong LF, Crow JC, et al. The association between polycystic ovaries and endometrial cancer. Hum Reprod 2006; 21:924–929.

44. Kulie T, Slattengren A, Redmer J, Counts H, Eglash A, Schrager S. Obesity and Women‘s Health: An Evidence-Based Review. J Am Board Fam Med 2011; 24:75–85.

45. Navaratnarajah R, Pillay OC, Hardiman P. Polycystic ovary syndrome and endometrial cancer. Semin Reprod Med 2008; 26:62–71.

46. Hardiman P, Pillay OC, Atiomo W. Polycystic ovary syndrome and endometrial carcinoma. Lancet 2003; 361:1810–1812.

47. Althuis MD, Moghissi KS, Westhoff CL, et al. Uterine cancer after use of Clomiphene Citrate to induce ovulation. Am J Epidemiol 2005; 161:607–615.

48. Pfeiffer RM, Mitani A, Landgren O, et al. Timing of births and endometrial cancer risk in Swedish women. Cancer Causes Control 2009; 20:1441–1449.

49. Brinton LA, Sakoda LC, Lissowska J, et al. Reproductive risk factors for endometrial cancer among Polish women. Br J Cancer 2007; 96:1450–1456.

50. Kaaks R, Lukanova A, Kurzer MS. Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 2002; 11:1531–1543.

51. Albrektsen G, Heuch I, Tretli S, Kvåle G. Is the risk of cancer of the corpus-uteri reduced by a recent pregnancy – a prospective study of 765,756 Norwegian women. Int J Cancer 1995; 61:485–490.

52. Jick H, Watkins NW, Hunter JR, et al. Replacement estrogens and endometrial cancer. N Eng J Med 1979; 300:218–222.

53. Henderson, B. E., Ross, R. K., Bernstein, L. Estrogens as a cause of human cancer: the Richard and Hinda Rosenthal Foundation Award Lecture. Cancer Res1988; 48:246–253.

54. Weiderpass E, Adami HO, Baron JA, et al. Risk of endometrial cancer following estrogen replacement with and without progestins. J Natl Cancer Inst 1999; 91:1131–1137.

55. Grady D, Gebretsadik T, Kerlikowske K, Ernster V,Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol 1995; 85:304–313.

56. Whitehead MI, Fraser D. The effects of estrogens and progestogens on the endometrium. Modern approach to treatment. Obstet Gynecol Clin North Am 1987; 14:299–320.

57. Pike MC, Peters RK, Cozen W, et al. Estrogen-progestin replacement therapy and endometrial cancer. J Natl Cancer Inst 1997; 89:1110–1116.

58. Doherty JA, Cushing-Haugen KL, Saltzman BS, et al. Long-term use of postmenopausal estrogen and progestin hormone therapies and the risk of endometrial cancer. Am J Obstet Gynecol 2007; 197:139.e1–7.

59. Newcomb PA, Trentham-Dietz A. Patterns of postmenopausal progestin use with estrogen in relation to endometrial cancer (United States). Cancer Causes Control 2003; 14:195–201.

60. Jain MG, Rohan TE, Howe GR. Hormone replacement therapy and endometrial cancer in Ontario, Canada. J Clin Epidemiol 2000; 53:385–391.

61. Razavi P, Pike MC, Horn-Ross PL, Templeman C,Bernstein L,Ursin G. Long-term postmenopausal hormone therapy and endometrial cancer. Cancer Epidemiol Biomarkers Prev 2010; 19: 75–483.

62. Crosbie EJ, Zwahlen M, Kitchener HC, Egger M,Renehan AG. Body mass index, hormone replacement therapy, and endometrial cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2010; 19:3119–3130.

63. Beral V, Bull D, Reeves G. Million Women Study Collaborators. Endometrial cancer and hormone replacement therapy in the Million Women Study. Lancet 2005; 365:1543–1551.

64. Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999; 80:827–841.

65. Terry P, Vainio H, Wolk A, Weiderpass E. Dietary factors in relation to endometrial cancer: a nationwide case–control study in Sweden. Nutr Cancer 2002; 42:25–32.

66. McCann SE, Freudenheim JL, Marshall JR, Brasure JR, Swanson MK, Graham S. Diet in the epidemiology of endometrial cancer in western New York (United States). Cancer Causes Control 2000; 11:965–974.

67. Littman AJ, Beresford SA, White E. The association of dietary fat and plant foods with endometrial cancer (United States). Cancer Causes Control 2001; 12:691–702.

68. Jain MG, Rohan TE, Howe GR, Miller AB. A cohort study of nutritional factors and endometrial cancer. Eur J Epidemiol 2000; 16:899–905.

69. Furberg AS, Thune I. Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer 2003; 104:669–676.

70. Nagata C, Takatsuka N, Kawakami N, Shimizu H. Total and monounsaturated fat intake and serum estrogen concentrations in premenopausal Japanese women. Nutr Cancer 2000; 38:37–39.

71. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006; 295:1549–1555.

72. Stoll BA. Western diet, early puberty, and breast cancer risk. Breast Cancer Res Treat 1998; 49:87–93.

73. Lindemann K, Vatten LJ, Ellstrøm-Engh M, Eskild A. Body mass, diabetes and smoking, and endometrial cancer risk: a follow-up study. Br J Cancer 2008; 98:1582–1585.

74. Iemura A, Douchi T, Yamamoto S, Yoshimitsu N,Nagata Y. Body fat distribution as a risk factor of endometrial cancer. J Obstet Gynaecol Res 2000; 26:421–425.

75. Xu WH, Matthews CE, Xiang YB, et al. Effect of adiposity and fat distribution on endometrial cancer risk in Shanghai women. Am J Epidemiol 2005; 161:939–947.

76. Schmeler KM, Soliman PT, Sun CC, Slomovitz BM, Gershenson DM, Lu KH. Endometrial cancer in young, normal-weight women. Gynecol Oncol 2005; 99:388–992.

77. Haidopoulos D, Simou M, Akrivos N, et al. Risk factors in women 40 years of age and younger with endometrial carcinoma. Acta Obstet Gynecol Scand 2010; 89:1326–1330.

78. Trentham-Dietz A, Nichols HB, Hampton JM, Newcomb PA. Weight change and risk of endometrial cancer. Int J Epidemiol 2006; 35:151–158.

79. Charneco E, Ortiz AP, Venegas-Ríos HL, Romaguera J, Umpierre S. Clinic-based case-control study of the association between body mass index and endometrial cancer in Puerto Rican women. P R Health Sci J 2010; 29:272–278.

80. Thomas CC, Wingo PA, Dolan MS, Lee NC, Richardson LC. Endometrial cancer risk among younger, overweight women. Obstet Gynecol 2009; 114:22–27.

81. Chang SC, Lacey JV, Brinton LA, et al. Cancer Epidemiol Biomarkers Prev 2007; 16:723–730.

82. Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ 2007; 335:1134–1145.

83. Chia VM, Newcomb PA, Trentham-Dietz A, Hampton JM. Obesity, diabetes, and other factors in relation to survival after endometrial cancer diagnosis. Int J Gynecol Cancer 2007; 17:441–446.

84. Key T, Appleby P, Barnes I, Reeves G. Endogenous hormones and Breast Cancer Collaborative Group. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 2002; 94:606–616.

85. Ali AT, Ferris WF, Naran NH, Crowther NJ. Insulin resistance in the control of body fat distribution: a new hypothesis. Horm Metab Res 2011; 43:77–80.

86. Soliman PT, Wu D, Tortolero-Luna G, et al. Association between adiponectin , insulin resistance, and endometrial cancer. Cancer 2006; 106:2376–2381.

87. La Vecchia C, Negri E, Franceschi S, D’Avanzo B, Boyle P. A case-control study of diabetes mellitus and cancer risk. Br J Cancer 1994; 70:950–953.

88. Saltzman BS, Doherty JA, Hill DA, et al. Diabetes and endometrial cancer: an evaluation of the modifying effects of other known risk factors. Am J Epidemiol 2008; 167:607–614.

89. Friberg E, Mantzoros CS, Wolk A. Diabetes and risk of endometrial cancer: a population-based prospective cohort study. Cancer Epidemiol Biomarkers Prev 2007; 16:276–280.

90. Zendehdel K, Nyrén O, Ostenson CG, Adami HO, Ekbom A, Ye W. Cancer incidence in patients with type 1 diabetes mellitus: a population-based cohort study in Sweden. J Natl Cancer Inst 2003; 95:1797–1800.

91. Serdar Serin I, Ozcelik B, Basbug M, Ozsahin O, Yilmazsoy A, Erez R. Effects of hypertension and obesity on endometrial thickness. Eur J Obstet Gynecol Reprod Biol 2003; 109:72–75.

92. Jahanzeb M. Reducing the risk for breast cancer recurrence after completion of tamoxifen treatment in postmenopausal women. Clin Ther 2007; 29:1535–1547.

93. Love CD, Muir BB, Scrimgeour JB, Leonard RC, Dillon P, Dixon JM. Investigation of endometrial abnormalities in asymptomatic women treated with tamoxifen and an evaluation of the role of endometrial screening. J Clin Oncol 1999; 17:2050–2054.

94. Bergman L, Beelen ML, Gallee MP, Hollema H, Benraadt J, Van Leeuwen FE. Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Lancet 2000; 356:881–887.

95. Mignotte H, Lasset C, Bonadona V, et al. Latrogenic risks of endometrial carcinoma after treatment for breast cancer in a large French case-control study. Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC). Int J Cancer 1998; 76:325–330.

96. Stockwell HG, Lyman GH. Cigarette smoking and the risk of female reproductive cancer. Am J Obstet Gynecol 1987; 157:35–40.

97. Parazzini F, La Vecchia C, Bocciolone L, Franceschi S. The epidemiology of endometrial cancer. Gynecol Oncol 1991; 41:1–16.

98. Parazzini F, La Vecchia C, Negri E, Moroni S, Chatenoud L. Smoking and risk of endometrial cancer: results from an Italian case-control study. Gynecol Oncol 1995; 56:195–199.

99. Terry PD, Rohan TE, Franceschi S, Weiderpass E. Cigarette smoking and the risk of endometrial cancer. Lancet Oncol 2002; 3:470–480.

100. Viswanathan AN, Feskanich D, De Vivo I, et al. Smoking and the risk of endometrial cancer: results from Nurses’ Health Study. Int J Cancer 2005; 114:996–1001.

101. Zhou B, Yang L, Sun Q, et al. Cigarette smoking and the risk of endometrial cancer: a meta-analysis. Am J Med 2008; 121:501–508.

102. Polesel J, Serraino D, Zucchetto A, et al. Cigarette smoking and endometrial cancer risk: the modifying effect of obesity. Eur J Cancer Prev 2009; 18:476–481.

103. Henderson BE, Feigelson HS. Hormonal carcinogenesis. Carcinogenesis 2000; 21:427–433.

104. Brenner RM, Slayden OD, Nayak NR, Baird DT,Critchley HO. A role for the androgen receptor in the endometrial antiproliferative effects of progesterone antagonists. Steroids 2003; 68:1033–1039.

105. Baron JA, La Vecchia C, Levi F. The antiestrogenic effect of cigarette smoking in women. Am J Obstet Gynecol 1990; 162:502–514.

106. Pothuri B, Ramondetta L, Martino M, Alektiar K, Eifel PJ, Deavers MT. Development of endometrial cancer after radiation treatment for cervical carcinoma. Obstet Gynecol 2003; 101:941–945.

107. Pothuri B, Ramondetta L, Eifel P, Deavers MT, Wilton A, Alektiar K. Radiation-associated endometrial cancers are prognostically unfavorable tumors: a clinicopathologic comparison with 527 sporadic endometrial cancers. Gynecol Oncol 2006; 103:948–951.

108. Kumar S, Shah JP, Bryant CS, Seward S, Ali-Fehmi R, Morris RT, Malone JM Jr. Radiation associated-endometrial cancer. Obstet Gynecol 2009; 113:319–325.

109. De Ruyck K, Van Eijkeren M, Claes K, et al. Radiation-induced damage to normal tissues after radiotherapy in patients treated for gynecologic tumors: Association with single nucleotide polymorphisms in genes and chromosomal radio-sensitivity in lymphocytes. Int J Radiat Oncol Biol Phys 2005; 15:1140–1149.

110. Lacey JV Jr., Brinton LA, Lubin JH, Sherman ME,Schatzkin A, Schairer C. Endometrial carcinoma risks among menopausal estrogen plus progestin and unopposed estrogen users in a cohort of postmenopausal women. Cancer Epidemiol Biomarkers Prev 2005; 14:1724– 1731.

111. Jemal A, Clegg LX, Ward E, et.al. Annual report to the nation on the status of cancer, 1975–2000, with special feature regarding survival. Cancer 2004; 101:3–27.

112. Hicks ML, Phillips JL, Parham G, et al. The national cancer data base report on endometrial carcinoma in African-American women. Cancer 1998; 83:2629–2637.

113. Kogevinas M, Pearce N, Susser M, Boffetta P. Social inequalities and cancer. IARC Sci. Publ. No. 138. Lyon: IARC; 1997.

114. Albano JD, Ward E, Jemal A, et al. Cancer mortality in the United States by education level and race. J Natl Cancer Inst 2007; 99:1384–1394.

115. Hemminki K, Li X. Level of education and the risk of cancer in Sweden. Cancer Epidemiol Biomarkers Prev 2003; 12:796–802.

116. Mouw T, Koster A, Wright ME, Blank MM, Moore SC, Hollenbeck A, Schatzkin A. Education and risk of cancer in a large cohort of men and women in the United States. PLoS ONE 2008; 3: e3639–e3651.

Dětská gynekologie Gynekologie a porodnictví Reprodukční medicína

Článek vyšel v časopise

Česká gynekologie

Číslo 5

2013 Číslo 5

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Zvyšte si kvalifikaci online z pohodlí domova

Jak na psoriázu v každodenní ambulantní praxi?
nový kurz
Autoři: MUDr. Jan Šternberský, Ph. D.

Biologická léčba Crohnovy nemoci
Autoři: MUDr. Přemysl Falt, Ph.D.

Pacient na antikoagulační léčbě v akutní situaci
Autoři: MUDr. Jana Michalcová

Kopřivka a její terapie
Autoři: MUDr. Petra Brodská

Uroinfekce v primární péči
Autoři: MUDr. Marek Štefan

Všechny kurzy
Kurzy Doporučená témata Časopisy
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.


Nemáte účet?  Registrujte se