Introduction/Background*Endometrial cancer (EC) is the most common gynecological malignancy in more developed countries. At present, endometrial histology is needed for diagnosis, as there are no valid, accurate noninvasive diagnostic methods. Screening of patients’ plasma biomarkers might enable a more precise diagnosis of EC and a tailored treatment approach. The aim of our prospective case-control pilot study was to quantify 37 different angiogenic factors to evalute their potential diagnostic and/or prognostic value.
Methodology 76 postmenopausal women (38 patients with endometrioid EC and 38 control patients with prolapsed uterus or chronic pelvic pain) that underwent surgical treatment at the University Medical Centre Ljubljana were included in this prospective case-control pilot study. Plasma samples were evaluated using commercially available kit that enables simultaneous determination of 37 different proteins with the Luminex xMAP™ multiplexing technology.
Result(s)*The case group comprised 38 patients with endometrioid EC, with mean age 65.9 ± 8.2 years and mean body mass index (BMI) of 31.8 ± 6.1 kg/m2. Lymphovascular invasion (LVI) was present in five patients while deep myometrial invasion (DMI) was present in 12 patients. The control group included 38 patients with mean age 66.8 ± 8.3 years and mean BMI of 27.6 ± 3.9 kg/m2. There was a significant difference in the BMI distribution between the case and control group (p<0.01). The plasma levels of sTie-2 and G-CSF were significantly decreased in EC patients compared to those of control patients, while the plasma levels of leptin were significantly higher in EC patients. Within the EC group, Tie-2 levels were lower in patients with LVI and DMI; however, these differences did not reach statistical significance. Additionally, follistatin, IL-8 and neuropilin-1 were also showing promising results.
Conclusion*The results of our study indicate that the plasma levels of different AFs might be involved in the growth of endometrioid EC. The plasma levels of G-CSF, Tie-2, and leptin significantly differ between EC and control patients. The plasma concentrations of these AFs could represent an important additional diagnostic tool for the early detection and characterization of EC and could guide the decision-making regarding the extent of surgery. Further validation studies with larger patient numbers are currently ongoing.
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