Endometrial cancer: multiplexed Luminex approaches for early detection

Abstract

Endometrial carcinoma is the most common gynecologic cancer. Despite the advances that have been made in other cancers, both the annual incidence of and the death rate associated with endometrial cancer appear to be rising, both in the US and around the world. In the US, ∼ 41,000 cases are diagnosed and about 7000 women die from the disease each year. Adenocarcinoma, which originates in surface cells of the endometrium, accounts for ∼ 90% of cases of endometrial cancer. At this time, there are no early detection tests or exams that can find endometrial cancer early in women without symptoms. There is growing interest in the use of biomarker approaches for the early detection of endometrial cancer. Endometrial cancer has been linked to altered growth factor signaling, immune inflammatory responses and angiogenesis. This article provides an overview of endometrial cancer and outlines the rationale and need for the clinical application of multiplexed ELISA-based assays for the early detection of cancer. Although endometrial cancer has a generally favorable long-term outcome, its screening and diagnosis pose a challenge in women without symptoms. An extensive literature review of biomarker approaches to endometrial cancer detection has been performed. Also, several studies conducted by the present team at the University of Pittsburgh Cancer Institute were reviewed. In the authors' published studies, it was hypothesized that an expanded panel of biomarkers comprised of cytokines, chemokines, growth factors and other tumor markers, which individually may show some promising correlation with disease status, might provide higher diagnostic power if used in combination, especially in the case of endometrial cancer detection. It was also discovered that prolactin may be very important for endometrial cancer detection. In this article, the potential clinical role for using multimarker testing in the early detection of endometrial cancer and for tumor surveillance to permit early identification of recurrence in patients with recurrent disease is discussed. Additionally, the role of lifestyle factors in the endometrial cancer development and prevention is discussed.