Abstract
Endometrial cancer is one of the most common gynecological malignancies in post-menopausal women. If detected at early stages, endometrial cancer can be effectively treated by abdominal hysterectomy. However, to date, there is no biochemical test available for early and easy detection of endometrial cancer. Our previous study has established that the total proprotein convertase (PC) activity is significantly increased in the uterine lavage of post-menopausal women with endometrial cancer. Uterine lavage can be obtained relatively non-invasively compared to uterine tissues, however, blood contamination and other factors limit the wide clinical use of uterine lavage. The aim of this study was to determine whether endocervical swab is a viable alternative to uterine lavage for the detection of endometrial cancer. We determined the correlation in PC activity between paired endocervical swabs and uterine lavages from individual post-menopausal women (control as well as endometrial cancer patients), and also compared the total PC activity in endocervical swabs between control and endometrial cancer patients. Our data demonstrated that the total PC activity in swab and lavage was highly correlative in post-menopausal women, and that the PC activity in endocervical swab was significantly increased in endometrial cancer patients compared to controls. These results strongly suggest that determining PC activity in endocervical swabs may provide a simple, non-invasive and novel method to detect endometrial cancer in post-menopausal women.
Highlights
Endometrial cancer, the fourth most common malignancy [1], predominantly affects women in their post-menopausal years [2]
Our previous study has established that the total proprotein convertase (PC) activity is significantly increased in the uterine lavage of post-menopausal women with endometrial cancer
Our data demonstrated that the total PC activity in swab and lavage was highly correlative in post-menopausal women, and that the PC activity in endocervical swab was significantly increased in endometrial cancer patients compared to controls
Summary
Endometrial cancer, the fourth most common malignancy [1], predominantly affects women in their post-menopausal years [2]. It is classified as type I or type II based on clinical, endocrine and epidemiological characteristics [3, 4]. Type I endometrial tumors are estrogen dependent, associated with endometrial hyperplasia and treatments lead to favorable outcomes [3]. Type II tumors are estrogen independent, associated with endometrial atrophy and have less favorable outcomes [3]. Endometrial cancer in post-menopausal women is often identified only when vaginal bleeding occurs, but the cancer is already well progressed. A simple and non-invasive www.impactjournals.com/oncotarget early detection method for endometrial cancer would fill a major gap in the management of endometrial cancer
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