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Endometrial cancer diagnostic and prognostic algorithms based on proteomics, metabolomics, and clinical data: a systematic review.

ABSTRACT: Endometrial cancer is the most common gynaecological malignancy in developed countries. Over 382,000 new cases were diagnosed worldwide in 2018, and its incidence and mortality are constantly rising due to longer life expectancy and life style factors including obesity. Two major improvements are needed in the management of patients with endometrial cancer, i.e., the development of non/minimally invasive tools for diagnostics and prognostics, which are currently missing. Diagnostic tools are needed to manage the increasing number of women at risk of developing the disease. Prognostic tools are necessary to stratify patients according to their risk of recurrence pre-preoperatively, to advise and plan the most appropriate treatment and avoid over/under-treatment. Biomarkers derived from proteomics and metabolomics, especially when derived from non/minimally-invasively collected body fluids, can serve to develop such prognostic and diagnostic tools, and the purpose of the present review is to explore the current research in this topic. We first provide a brief description of the technologies, the computational pipelines for data analyses and then we provide a systematic review of all published studies using proteomics and/or metabolomics for diagnostic and prognostic biomarker discovery in endometrial cancer. Finally, conclusions and recommendations for future studies are also given.

SUBMITTER: Romano A

PROVIDER: S-EPMC10118013 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Endometrial cancer diagnostic and prognostic algorithms based on proteomics, metabolomics, and clinical data: a systematic review.

Romano Andrea A Rižner Tea Lanišnik TL Werner Henrica Maria Johanna HMJ Semczuk Andrzej A Lowy Camille C Schröder Christoph C Griesbeck Anne A Adamski Jerzy J Fishman Dmytro D Tokarz Janina J

Frontiers in oncology 20230406

Endometrial cancer is the most common gynaecological malignancy in developed countries. Over 382,000 new cases were diagnosed worldwide in 2018, and its incidence and mortality are constantly rising due to longer life expectancy and life style factors including obesity. Two major improvements are needed in the management of patients with endometrial cancer, i.e., the development of non/minimally invasive tools for diagnostics and prognostics, which are currently missing. Diagnostic tools are nee ...[more]

PMID: 37091170

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Project description:ObjectivesTo determine the diagnostic accuracy of different endometrial sampling tests for detecting endometrial carcinoma.DesignSystematic review and meta-analysis of studies of diagnostic accuracy.Data sourcesCochrane Library, MEDLINE/PubMed, CINAHL, Web of Science and Scopus, from the date of inception of the databases to 18 January 2023. Additionally, the reference lists of included studies and other systematic reviews were thoroughly searched.Eligibility criteriaWe included published cross-sectional studies that evaluated any endometrial sampling test (index tests) in women (participants) with clinical suspicion of endometrial carcinoma (target condition) in comparison with histopathology of hysterectomy specimens (reference standard). We excluded case-control and case series studies. No restrictions on language or date of publication were applied.Data extraction and synthesisTwo independent reviewers extracted study data and assessed study quality using the revised quality assessment tool for diagnostic accuracy studies (QUADAS-2). We used bivariate diagnostic random-effects meta-analysis and presented the results in a summary receiver operating characteristic curve. We assessed the certainty of evidence as recommended by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach.ResultsTwelve studies (1607 participants), published between 1986 and 2022, contributed data to the meta-analysis results. Seven studies were judged to be at a low risk of bias in all domains and all studies had low applicability concerns. The most studied index tests were Pipelle and conventional dilation and curettage (D&C). The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio (95% CIs) for Pipelle were 0.774 (0.565 to 0.900), 0.985 (0.927 to 0.997), 97.000 (14.000 to 349.000) and 0.241 (0.101 to 0.442) and for conventional D&C were 0.880 (0.281 to 0.993), 0.984 (0.956 to 0.995), 59.300 (14.200 to 153.000) and 0.194 (0.007 to 0.732), respectively.ConclusionHigh certainty evidence indicates that endometrial sampling using Pipelle or conventional D&C is accurate in diagnosing endometrial cancer. Studies assessing other endometrial sampling tests were sparse.Trial registration numberhttps://osf.io/h8e9z.

Project description:BackgroundHeart failure (HF), affecting 1-4% of adults in industrialized countries, is a major public health priority. Several algorithms based on administrative health data (HAD) have been developed to detect patients with HF in a timely and inexpensive manner, in order to perform real-world studies at the population level. However, their reported diagnostic accuracy is highly variable.ObjectiveTo assess the diagnostic accuracy of validated HAD-based algorithms for detecting HF, compared to clinical diagnosis, and to investigate causes of heterogeneity.MethodsWe included all diagnostic accuracy studies that utilized HAD for the diagnosis of congestive HF in the general adult population, using clinical examination or chart review as the reference standard. A systematic search of MEDLINE (1946-2023) and Embase (1947-2023) was conducted, without restrictions. The QUADAS-2 tool was employed to assess the risk of bias and concerns regarding applicability. Due to low-quality issues of the primary studies, associated with both the index test and the reference standard definition and conduct, and to the high level of clinical heterogeneity, a quantitative synthesis was not performed. Measures of diagnostic accuracy of the included algorithms were summarized narratively and presented graphically, by population subgroups.ResultsWe included 24 studies (161,524 patients) and extracted 36 algorithms. Algorithm selection was based on type of administrative data and DOR. Six studies (103,018 patients, 14 algorithms) were performed in the general outpatient population, with sensitivities ranging from 24.8 to 97.3% and specificities ranging from 35.6 to 99.5%. Eight studies (14,957 patients, 10 algorithms) included hospitalized patients with sensitivities ranging from 29.0 to 96.0% and specificities ranging from 65.8 to 99.2%. The remaining studies included subgroups of the general population or hospitalized patients with cardiologic conditions and were analyzed separately. Fourteen studies had one or more domains at high risk of bias, and there were concerns regarding applicability in 9 studies.DiscussionThe considerable percentage of studies with a high risk of bias, together with the high clinical heterogeneity among different studies, did not allow to generate a pooled estimate of diagnostic accuracy for HAD-based algorithms to be used in an unselected general adult population.Systematic review registrationPROSPERO CRD42023487565.

Project description:Background: The diagnostic role of Wilms' tumor 1 (WT1) is well known in gynaeco-pathological setting, since it is considered a specific marker of serous histotype and adnexal origin. Moreover, its oncogenic role has been recently highlighted in many cancers and it has also been regarded as a promising target antigen for cancer immunotherapy. However, the relationship between its expression and prognostic role in uterine cancer remains unclear. We analyzed the diagnostic and prognostic role of WT1 expression in patients with uterine carcinoma by completing a search using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the PICOS (Participants, Intervention, Comparison, Outcomes, Study Design) model through PubMed, Scopus and Web of Science databases to identify studies that fit our search criteria. The objective of the current meta-analysis was to investigate the diagnostic and prognostic role of WT1 expression in patients with uterine carcinoma. Materials and Methods: A literature search was performed of the PubMed, Scopus, and Web of Science databases for English-language studies published from January 2000 to April 2020. Studies were considered eligible if they evaluated the WT1 expression in uterine carcinoma. Results: In total, 35 articles were identified that used uterine carcinoma criteria and provided data for 1616 patients. The overall rate of WT1 expression in uterine carcinoma was 25%. The subgroup analysis of uterine cancer types revealed that WT1 was expressed differently among different histotypes (endometrioid, clear cell, serous carcinoma and carcinosarcoma). Discussion and Conclusions: The WT1 immunohistochemical expression is not limited to serous histotype and/or ovarian origin. In fact, a significant proportion of endometrial adenocarcinomas can also show WT1 immunoreactivity. Moreover, our study suggests that WT1 may be a potential marker to predict the prognosis of patients with uterine cancer, but more studies are needed to confirm its role in clinical practice.

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Endometrial cancer diagnostic and prognostic algorithms based on proteomics, metabolomics, and clinical data: a systematic review.

Publications

Endometrial cancer diagnostic and prognostic algorithms based on proteomics, metabolomics, and clinical data: a systematic review.

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