Abstract
Simple SummaryThis review deals with the prospects of early diagnostics in cervical, endometrial, and ovarian cancers. Progress in cancer research has enabled the rapid development of cancer diagnostics, treatments, and preventions. Indeed, the current situation in genital tract tumors reflects the trend in contemporary oncology that emphasizes cancer prevention and early diagnostics. Cervical cancer screening using cytological examination has a long tradition, is highly effective, and is now being complemented with HPV triage, allowing early diagnostics even in precancerous stages due to the relative ease of accessibility of the uterine cervix. Moreover, vaccination against HPV, which is major cause of cervical cancer, is now recommended for both girls and boys at an early age. In contrast, endometrial and, particularly, ovarian cancers are poorly accessible by sampling, and neither prevention nor screening methods readily exist. Thus, other options leading to their early diagnostics are discussed, in which circulating biomarkers play key roles.The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.
Highlights
Current diagnostics for genital tract tumors, i.e., cervical, endometrial, and ovarian tumors, reflect the situation in contemporary oncology
We present the current screening options for gynecological precancerous lesions and describe novel liquid-based biomarkers that may be useful in the early cancer Cancers 2021, 13, x. https://doi.org/10.3390a/nxxdxxpxrecancer diagnostics of gynecological malignancies.www.mdpi.com/journal/cancers
In test studies with a specificity of 75%, ROMA showed a sensitivity of 94% in distinguishing benign tumors from Epithelial Ovarian Cancer (EOC) with an 85% sensitivity to the identification of the early stages (I and II) of disease [148]. Another possibility to detect early stages of EOC using liquid biopsies is via autoantibodies that have developed against proteins associated with the cancer
Summary
Current diagnostics for genital tract tumors, i.e., cervical, endometrial, and ovarian 2 of 23 tumors, reflect the situation in contemporary oncology. We present the current screening options for gynecological precancerous lesions and describe novel liquid-based biomarkers that may be useful in the early cancer Cancers 2021, 13, x. 2. Overview of Circulating Biomarkers An LB is the collection and analysis of non-solid biological tissues, especially blood, and urine, sputum, uterine lavage, cerebrossppiinnaall flfluuiidd,, ssaalliivvaa,, ssttooooll,, aanndd pplleeuurraall flfluuiidd (Figuurree 22)). Comcpoavraisgoninoaflvfalguinidal hswaavbes banedenuriindeesnatmifpieleds wbiythncuercvliecaalr msamgenarestfiocrrHePsoVnteasnticneg isnpceecrvtricoaslccoanpcyerasscrpeernoinmgising metabolomics biostmraatergkieesrs[20fo,2r1]EC detection [15]; alpha-actinin-4 as a promising biomarker for the detection of precancerous state of cervical cancer [16]; 2.1. CTCs are extremely rare (estimated to be one CTC per 109 normal blood cells in the circulation of patients with advanced cancer). CTCs are commonly enriched in two ways: cell surface marker-dependent and marker-independent approaches. Viable CTCs can serve in functional studies, such as in the creation of xenograft models in immunocompromised mice [27], the establishment of cell lines [28], and the formation of spheroids using 3D cultures [29,30]
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