Objective:To study the relation between SUVmax, hypoxia inducible factor 1 alpha (HIF-1 alpha), angiogenetic factor adrenomedullin (AM) and antiapoptotic factor Bcl-2 in endometrial cancer. Subjects and Methods:Thirthy eight patients who were diagnosed after a preoperative endometrial biopsy with endometriuni cancer underwent pre-operative positron emission tomography/computed tomography (PET/CT) utilizing fluorine-18-fluorodeoxy glucose (F-18-FDG). Maximum standardized uptake values (SUVmax) of the primary tumor were measured. After hysterectomy and bilateral salpingo-oophorectomy, microscopic slides of the 38 endometrial adenocarcinoma patients were evaluated by a surgical pathologist to confirm the diagnosis. Immunohistochemical staining for AM, Bcl-2 and HIF-1 alpha was studied. Results: In all patients, F-18-FDG uptake was detected. The mean SUVmax of the tumors was 11.8 +/- 5.9. Although SUVmax was higher in HIF-1 alpha positive tumors, this finding was not statistically important. No correlation was found between SUVmax and HIF-1 alpha positivity. Mean SUVmax was 6.4 +/- 3 and 12.3 +/- 1.4 in AM negative and AM positive patients, respectively. Mean SUVmax was 10.6 +/- 4.9 and 12.3 +/- 1.4 in Bcl-2 negative and Bcl-2 positive patients, respectively.We found no correlation between SUVmax, AM or Bcl-2 expression.Allred scores were not related with SUVmax in regression analysis. Conclusion:Our study in a small number of patients is the first to show that SUVmax, although expected is not associated with HIF-1 alpha, AM or with Bcl-2 in endometrial cancer. Increased uptake of F-18-FDG in endometrial cancer seems to be independent of HIF-1 alpha and its downstream factors.