Eesti Teadusinfosüsteem

Endometrial cancer (EC) is the most common gynecological malignancy in the developed world with 319,605 new cases and 76,160 deaths in 2012 only. The incidence and mortality for EC are still increasing. The majority of EC patients are postmenopausal, but 14% of patients are premenopausal and 4% of these women are in the reproductive age. Although most patients are diagnosed and treated at an early stage, the cancer recurs in 15% to 20% of patients with no signs of advanced disease at the time of primary intervention. There is no reliable screening test for asymptomatic women with high risk for EC, although there is a great need, as this population includes patients treated with tamoxifen, a standard therapy for the majority of 1.6 million breast cancer patients identified yearly worldwide and patients with Lynch syndrome (with 40-60% of lifetime risk for EC) with over one million of these patients in Europe alone. The endometrial biopsy has been recommended for the evaluation of women at high risk for EC, but this invasive approach is not used as a general screening test. Non-invasive diagnostics would reduce the requirement for biopsies in this population and would be important as a screening test for early diagnosis of cancer followed by tailored treatment. Biomarkers are also needed for prognosis, for pre-operative stratification of EC patients with high risk of progression and recurrence, who need radical surgery and adjuvant chemo/radio therapy from those with low risk, who have low chances to develop metastases and do not need radical surgery with lymphadenectomy. Biomarkers can contribute to early diagnosis in asymptomatic patients and improved clinical outcomes in patients who are likely to progress and recur and to decreased overtreatment of EC patients with good prognosis. As individual biomarker cannot provide sufficient sensitivity and specificity, identification of biomarker panels is crucial. A biomarker panel consisting of conventional tumor markers is less likely to diagnose early stage cancers with small tumor deposits, thus development of clinically applicable biomarker-based diagnostics requires global “omics” approaches. Combination of omics derived biomarkers with clinical data may lead to identification of algorithms with even better diagnostic characteristics.

Endometrial cancer (EC) is the most common gynecological malignancy in the developed world with 319,605 new cases and 76,160 deaths in 2012 only. The incidence and mortality for EC are still increasing. The majority of EC patients are postmenopausal, but 14% of patients are premenopausal and 4% of these women are in the reproductive age. Although most patients are diagnosed and treated at an early stage, the cancer recurs in 15% to 20% of patients with no signs of advanced disease at the time of primary intervention. There is no reliable screening test for asymptomatic women with high risk for EC, although there is a great need, as this population includes patients treated with tamoxifen, a standard therapy for the majority of 1.6 million breast cancer patients identified yearly worldwide and patients with Lynch syndrome (with 40-60% of lifetime risk for EC) with over one million of these patients in Europe alone. The endometrial biopsy has been recommended for the evaluation of women at high risk for EC, but this invasive approach is not used as a general screening test. Non-invasive diagnostics would reduce the requirement for biopsies in this population and would be important as a screening test for early diagnosis of cancer followed by tailored treatment. Biomarkers are also needed for prognosis, for pre-operative stratification of EC patients with high risk of progression and recurrence, who need radical surgery and adjuvant chemo/radio therapy from those with low risk, who have low chances to develop metastases and do not need radical surgery with lymphadenectomy. Biomarkers can contribute to early diagnosis in asymptomatic patients and improved clinical outcomes in patients who are likely to progress and recur and to decreased overtreatment of EC patients with good prognosis. As individual biomarker cannot provide sufficient sensitivity and specificity, identification of biomarker panels is crucial. A biomarker panel consisting of conventional tumor markers is less likely to diagnose early stage cancers with small tumor deposits, thus development of clinically applicable biomarker-based diagnostics requires global “omics” approaches. Combination of omics derived biomarkers with clinical data may lead to identification of algorithms with even better diagnostic characteristics.

http://www.transcanfp7.eu/index.php/abstract/bioendocar.html