Introduction/Background Endometriosis-related ovarian cancer (EROC) is an entity characterized by the concomitant presence of both endometriosis and ovarian carcinoma. EROC is considered a lesion potentially deriving from endometriotic ovarian lesions with borderline transition. MicroRNAs (miRNAs) have been shown to play important roles in oncogenesis, however their role in EROC is still controversial. The primary aim of this study was to identify dysregulated miRNAs in EROC compared to benign endometriotic tissue.

Methodology This prospective study funded by the Italian Ministry of Health (ENDO-2021–12371926), enrolled patients with ovarian cancer who underwent surgery. MiRNA profiles were analyzed in tissue samples of EROC and borderline/atypical endometriosis and benign endometriotic lesions using the Illumina NextSeq 500 high-output platform. Deregulated miRNA analysis was performed using DESeq2 package. Enrichment analysis was carried out using MiEAA (MicroRNA Enrichment Analysis and Annotation) and Gene Ontology (GO) pathways.

Results The miRNA profile of 39 samples (n=16 EROC, n=7 borderline, n=16 endometriosis samples) obtained from 22 patients with histological diagnosis of EROC were analyzed. Out of the 793 miRNAs identified, differential expression analysis between EROC and endometriosis showed 155 upregulated miRNAs and 175 downregulated in the EROC group (adjusted p-value <0.05) (figure 1). We found a significant enrichment in pathways related to immune signaling, cell migration and proliferation, drug response, oxidative stress response, hypoxia, and estrogen response. ROC (Receiver Operating Characteristics) analysis of the topmost upregulated miRNAs showed high accuracies (1–0.94) in discriminating EROC from endometriosis.

Conclusion Specific miRNAs may serve as valuable diagnostic indicators for early detection of EROC, providing a promising avenue for improving the early diagnosis and management of EROC. Further research and validation studies are warranted to fully establish the clinical utility of these markers.

Disclosures The authors do not have conflicts of interest that could affect the research, or the presentation of the results contained in this abstract.