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206 The application value of CDO1 and CELF4 dual-gene methylation testing in screening for endometrial cancer in women with abnormal uterine bleeding
  1. Bingxi Cai1,
  2. Liuyu Li1,
  3. Bo Liu1,
  4. Pei Liu2,
  5. Linhai Wang2,
  6. Huiqiong Lin2,
  7. Yishan Wang2,
  8. Yu-Ligh Liou2,
  9. Ziyun Wang2,
  10. Jun Du1 and
  11. Zhaoyan Meng1
  1. 1Department of Obstetrics and Gynaecology, Gansu Provincial Maternity and Child-care Hospital, Gansu, China
  2. 2Beijing Origin-Poly Bio-Tec Co., Ltd., Beijing, China

Abstract

Introduction/Background Endometrial cancer (EC) poses a significant challenge in early detection and non-invasive screening strategies, unlike its counterpart, cervical cancer, which benefits from well-established methods. This gap has prompted the exploration of innovative approaches, and one such promising avenue is the application of specific methylation PCR technology.

Methodology A total of 216 women referred to Gansu Provincial Maternity and Child-care Hospital due to abnormal uterine bleeding (AUB) and who underwent hysteroscopy between July 2021 and June 2022 were selected. Among them, 34 patients were diagnosed with EC by hysteroscopy. CDO1 and CELF4 dual-gene methylation testing (CDO1m/CELF4m) was performed on collected cervical exfoliated cells, and their sensitivity and specificity were analysed and statistically compared using hysteroscopy-based endometrial tissue histopathology as the gold standard. Patient demographics, tumour biological markers and information such as endometrial thickness under ultrasound examination were also collected.

Results In univariate chi-square analysis, age, BMI, diabetes, menopause and profiles of CDO1 methylation and CELF4 methylation were found to have statistically significant impacts on the incidence of EC. Odds ratio for BMI, menopause, CDO1m and CELF4m was 3.970 (1.058,14.895)(P=0.041), 18.702 (1.847,189.370)(P=0.013), 22.351 (2.250,221.989)(P=0.008) and 60.995 (5.992,620.920)(P=0.001), respectively, by binary logistic regression analysis. The sensitivity and specificity of ultrasound scanning and CA125 levels for detecting EC were 55.9% (37.9%-72.8%) and 78.6%(71.9%-84.3%) as well as 32.4%(17.4%-50.5%) and 76.4% (69.0%-82.8%), respectively, which was not satisfactory. The sensitivity and specificity of CDO1m/CELF4m were 91.2% (76.3%-98.1%) and 96.7% (93.0%-98.8%), respectively.

Conclusion For postmenopausal women, CDO1m/CELF4m demonstrated higher sensitivity and specificity compared to CA125 levels and ultrasound scanning, indicating a more robust method for EC detection. Performing CDO1m/CELF4m in patients with AUB suspected of EC in outpatient settings may reduce the risk of repeated hysteroscopy and the likelihood of women undergoing repetitive invasive examinations, thereby improving the ability to detect early-stage EC non-invasively in outpatient settings.

Disclosures The European Society of Gynaecological Oncology requires clear disclosures from all presenters at its annual congress regarding any financial holdings, funding sources, or affiliations that might raise questions of bias or be perceived to have potentially influenced presentation content.

Please disclose any financial relationship from the past three years (dating from the month of submission) of any size.

NAME: BingXin Cai

AFFILIATION: Department of Obstetrics and Gynaecology, Gansu Provincial Maternity and Child-care Hospital

I have no potential conflict of interest to report

Signature: BingXin Cai Date: November 9th.

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