Polycystic ovary syndrome and endometrial cancer risk: results from a nationwide cohort study

Infrared and Raman spectroscopy of blood plasma for rapid endometrial cancer detection

BACKGROUND

Endometrial cancer (EC) is the 6th most common cancer among women worldwide. No effective non-invasive screening methods or approved blood biomarkers for EC exist. Previous research explored Attenuated Total Reflection-Fourier Transform Infrared (ATR-FtIR) and Raman spectroscopies, using dried blood plasma. Fresh, 'wet', blood samples, that might provide faster results, have not been investigated. This study compared ATR-FtIR and Raman spectroscopies on 'wet' and dry blood plasma samples for EC detection. It also conducted a preliminary exploration into their diagnostic potential for EC in high-risk individuals with polycystic ovary syndrome (PCOS).

METHODS

'Wet' and dry blood plasma samples from participants with EC, PCOS and healthy controls were analysed using ATR-FtIR and Raman spectroscopies. Machine learning algorithms and multivariate statistical analyses assessed spectral variance across datasets to evaluate the techniques' diagnostic performance.

RESULTS

Raman analysis of 'wet' plasma achieved 82% accuracy in detecting EC, while ATR-FtIR spectroscopy reached 78%. When combined, diagnostic accuracy reached 86%. In comparison, dry plasma analysis with ATR-FtIR detected EC with 83% accuracy. Spectral similarities were found between EC and PCOS.

CONCLUSIONS

Our study suggests that ATR-FtIR and Raman spectroscopies could revolutionise early diagnosis of EC. More research is required to validate these promising findings.

Prenatally androgenized PCOS mice have ovary-independent uterine dysfunction and placental inflammation aggravated by high-fat diet

Polycystic ovary syndrome (PCOS) is a common hyperandrogenic and metabolic condition in women. The syndrome is linked to subfertility and pregnancy complications, yet the independent effects of exposure to hyperandrogenism and obesity on endometrial function remain unclear. Here, PCOS-like mice were generated using prenatal androgenization (PNA) with dihydrotestosterone, followed by a prepubertal high-fat (HF) or standard diet. In ovariectomized mice, PNA impaired uterine closure during the implantation window, disrupted decidualization, and altered extracellular matrix- and inflammation-related gene expression. The effects were aggravated by the HF diet. In naturally mated, ovary-intact mice, PNA and HF diet affected decidual and placental gene expression, suggestive of placental dysfunction and inflammation, and induced fetal growth restriction. This study underlines the role of the uterus in adverse pregnancy outcomes in PCOS and identifies possible underlying mechanisms for future studies. Prepregnancy interventions targeting metabolic health and hyperandrogenism should be the next steps to optimize PCOS pregnancy outcomes.

Molecular and clinical insights into early-onset endometrial cancer

The global incidence of endometrial cancer is on the rise, marked by a notable surge in early-onset endometrial cancer (EOEC; age at diagnosis <50 years). By contrast to late-onset cases, EOEC displays distinct clinical, pathological, and molecular characteristics. The enhanced understanding of the disease's pathophysiology, enabling a more precise differentiation between low-risk and high-risk patients, could facilitate the establishment of risk-stratified treatments that preserve ovarian function and fertility in low-risk EOEC cases. In this review, we delve into the distinctive epidemiological, molecular, and clinical characteristics of EOEC, as well as early noninvasive screening and fertility preservation treatments.

Association Between Hepatic Steatosis Index and Endometrial Cancer Risk: A Cross-Sectional Study

Purpose

To investigate the relationship between hepatic steatosis index (HSI) and endometrial cancer (EC) and its diagnostic value for EC.

Patients and Methods

A total of 114 patients with pathologically diagnosed EC in Mindong Hospital, Ningde City, Fujian Province from 2016 to 2022 were retrospectively included as the EC group. A total of 175 patients with pathologically confirmed benign endometrial lesions (endometrial polyps and uterine submucosal fibroids) in the same hospital during the same period were selected as the control group. Non-parametric test were used to compare the differences in HSI and non-alcoholic fatty liver disease (NAFLD) between the two groups, and the diagnostic value of HSI and NAFLD levels on EC was analysed. The cut-off point of continuous variables was determined by receiver operating characteristic (ROC) curve analysis. Logistic regression analysis was used to calculate odds ratios (ORs).

Results

The results showed that compared with the control group, serum GGT, CA125, HDL-C and HSI were significantly increased in the EC group (P<0.05). 27.19% of the EC patients (31/114) and 12% of the control group (21/175) had NAFLD, and the difference between the two groups was statistically significant (P<0.05). The results of univariate logistic regression analysis showed that GGT, CA125, HDL-C, HSI and NAFLD were significantly correlated with the occurrence of EC (P<0.05). Further multivariate logistic regression analysis showed that CA125 and HSI elevation were independent risk factors for EC (P<0.05).

Conclusion

NAFLD is closely associated with EC, and elevated HSI is an independent risk factor for EC.

Analysis of macrophage polarization and regulation characteristics in ovarian tissues of polycystic ovary syndrome

Background

Polycystic ovary syndrome (PCOS) can lead to infertility and increase the risk of endometrial cancer. Analyzing the macrophage polarization characteristics in ovarian tissues of PCOS is crucial for clinical treatment.

Methods

We obtained 13 PCOS and nine control ovarian samples from the CEO database and analyzed differentially expressed genes (DEGs). Macrophage polarization-related genes (MPRGs) were sourced from the GeneCards and MSigDB databases. Intersection of DEGs with MPRGs identified DEGs associated with macrophage polarization (MPRDEGs). Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Protein-protein interaction (PPI) Network analysis were conducted on MPRDEGs. Moreover, the top 10 genes from three algorithms were identified as the hub genes of MPRGs. In addition, miRNAs, transcription factors (TFs), and drugs were retrieved from relevant databases for regulatory network analysis of mRNA-miRNA, mRNA-TF, and mRNA-Drug interactions. Immune cell composition analysis between the PCOS and control groups was performed using the CIBERSORT algorithm to calculate correlations across 22 immune cell types.

Results

A total of 13 PCOS samples and nine control ovarian samples were obtained in this study. We identified 714 DEGs between the two groups, with 394 up-regulated and 320 down-regulated. Additionally, we identified 774 MPRGs, from which we derived 30 MPRDEGs by intersecting with DEGs, among which 21 exhibited interaction relationships. GO and KEGG analyses revealed the enrichment of MPRDEGs in five biological processes, five cell components, five molecular functions, and three biological pathways. Immune infiltration analysis indicated a strong positive correlation between activated nature killer (NK) cells and memory B cells, while neutrophils and monocytes showed the strongest negative correlation. Further investigation of MPRDEGs identified nine hub genes associated with 41 TFs, 82 miRNAs, and 44 drugs or molecular compounds. Additionally, qRT-PCR results demonstrated overexpression of the CD163, TREM1, and TREM2 genes in ovarian tissues from the PCOS group.

Conclusion

This study elucidated the polarization status and regulatory characteristics of macrophages in ovarian tissues of the PCOS subjects, confirming significant overexpression of CD163, TREM1, and TREM2. These findings contribute to a deeper understanding of the pathogenesis of PCOS.