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DNA methylation detection is a significant biomarker for screening endometrial cancer in premenopausal women with abnormal uterine bleeding
  1. Xingping Zhao1,2,3,
  2. Yanfei Yang1,
  3. Yinqin Fu1,
  4. Weigang Lv1 and
  5. Dabao Xu1
    1. 1Gynecology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
    2. 2Jiangwan Research Institute, Central South University, Changsha, Hunan, China
    3. 3Postdoctoral Station of Clinical Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
    1. Correspondence to Dr Dabao Xu, Gynecology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China; dabaoxu2022{at}163.com; Dr Weigang Lv, Gynecology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China; lvweigang{at}sklmg.edu.cn

    Abstract

    Objective The aim of our study was to explore the value of DNA (CDO1m/CELF4m) methylation detection in exfoliated cervical cells collected for screening endometrial cancer in premenopausal women with abnormal uterine bleeding.

    Methods A total of 296 premenopausal women with abnormal uterine bleeding admitted to the Department of Obstetrics and Gynecology at the Third Xiangya Hospital of Central South University from November 2021 to October 2022 were selected. Clinical characteristics, endometrial thickness measured by transvaginal ultrasound and serum CA125 were collected. Exfoliated cervical cells from the thinPrep cytogic test were collected for DNA (CDO1m/CELF4m) methylation testing. Endometrial tissue was collected under hysteroscopy for pathological diagnosis as the gold standard. A univariate logistic regression model was used to analyze risk factors for endometrial cancer. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to measure the diagnostic efficacy of DNA methylation detection in endometrial cancer screening of women with abnormal uterine bleeding.

    Results Univariate logistic regression analysis showed that age, body mass index (BMI) ≥25 kg/m2, endometrial thickness ≥11 mm, CDO1 methylation (CDO1mΔCt≤8.4), CELF4 methylation (CELF4mΔCt≤8.8), and dual gene methylation (CDO1mΔCt≤8.4 or CELF4mΔCt≤8.8) were independent risk factors for endometrial cancer in women with abnormal uterine bleeding. The odds ratio (OR) values (95% confidence interval (CI) were 0.87 (0.80–0.95), 4.76 (1.89–11.96), 8.41 (3.13–22.59), 64.49 (20.46–203.33), 12.79 (4.91–33.30), and 42.53 (11.90–152.04), respectively. Among these indicators, dual gene methylation had the higher sensitivity and specificity for endometrial cancer screening (85.7% and 87.6%). Moreover, dual gene methylation combined with BMI or endometrial thickness could further improve the screening efficiency of endometrial cancer in women with abnormal uterine bleeding.

    Conclusions In premenopausal women with abnormal uterine bleeding, the clinical efficacy of DNA (CDO1m/CELF4m) methylation detection in exfoliated cervical cells for endometrial cancer screening was better than that of other noninvasive clinical indicators. In addition, dual gene methylation combined with BMI or endometrial thickness was a good predictor of endometrial cancer screening.

    • Endometrial Neoplasms

    Data availability statement

    Data are available upon reasonable request.

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • XZ and YY contributed equally.

    • Contributors Conception of study: XZ, YY, WL and DX. Guarantor: WL and DX. Design and development: XZ and YY. Data collection: XZ, YY and YF. Data analysis: XZ and YY. Preparation of tables: XZ, YY and YF. Initial draft of manuscript: XZ, YY, WL and DX. Manuscript writing, review, and approval: all authors. WL and DX are joint guarantors.

    • Funding This study was supported by grants from the Hunan Provincial Clinical Medical Technology Innovation Guiding Project (2021SK53704), the Scientific Research Program of FuRong Laboratory (No.2023SK2109) and the Key Research and Development Program of Hunan province (No. 2022SK2033).

    • 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.