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Detection of microRNA in urine to identify patients with endometrial cancer: a feasibility study
  1. Hannah Donkers1,
  2. Marc Hirschfeld2,3,
  3. Daniela Weiß2,
  4. Thalia Erbes2,
  5. Markus Jäger2,
  6. Johanna Pijnenborg4,
  7. Ruud Bekkers5,6 and
  8. Khadra Galaal1
  1. 1Royal Cornwall Hospital NHS Trust, Truro, UK
  2. 2Department of Obstetrics and Gynecology, University of Freiburg, Freiburg im Breisgau, Germany
  3. 3Institute of Veterinary Medicine, Georg-August-University Goettingen, Goettingen, Germany
  4. 4Department of Obstetrics & Gynecology, Radboud Institute for Health Science, Radboud University Medical Centre, Nijmegen, The Netherlands
  5. 5Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands
  6. 6Department of Obstetrics and Gynaecology and GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
  1. Correspondence to Dr Hannah Donkers, Royal Cornwall Hospital, Truro, TR1 3LJ, UK; hannahdonkerss{at}


Objective To find dysregulated urinary microRNAs associated with endometrial cancer as a first step in finding a non-invasive new diagnostic biomarker. The second objective is to determine the correlation of urinary microRNAs with clinicopathological characteristics.

Methods A prospective cohort study of patients presenting with abnormal bleeding between March and November 2019 was performed at the Royal Cornwall Hospital Trust Truro. Urine samples were obtained from women diagnosed with endometrial cancer and benign endometrial sampling. MicroRNA was isolated and quantitative real time PCR was used to detect expression levels of microRNAs.

Results A total of 61 women were included in this study: 24 endometrial cancer patients, and 37 controls. Median age was 64 years (range 45–94) and median body mass index was 29 kg/m2 (range 17–54). MiR-223 was significantly up-regulated in urine of endometrial cancers patients (p=0.003). Furthermore, let7-i, miR-34a, and miR-200c were significantly down-regulated and miR-424 was up-regulated in obese women. In addition, miR-148a and miR-222 were significantly down-regulated in elderly women, and miR-16, miR-26b, and miR-200c were significantly deregulated in women with multiple comorbidities.

Conclusion MicroRNA expression levels in urine can potentially be used as a non-invasive diagnostic test for endometrial cancer. Furthermore, aberrant microRNA expression in urine is associated with patient characteristics. Further research in larger trials is needed to validate the potential utility of urinary microRNAs.

  • uterine neoplasms
  • uterine cancer
  • endometrial neoplasms

Data availability statement

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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  • Contributors HD aided the design of the study and was responsible for data collection, analysis of the data and wrote the manuscript with input from all authors. MH and DW contributed to the design of the study, performed experiments and analyzed and interpreted the miRNA data. MJ performed the experiments. TE contributed to the design of the study, analysis and interpretation of the miRNA data. RB and JP revised and contributed to segments of the manuscript. KG was responsible for the conception and design of the study, data analysis, and contributed to the writing and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.