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Łukasiewicz M, Pastuszak K, Łapińska-Szumczyk S, Różański R, Veld SGJGI‘, Bieńkowski M, Stokowy T, Ratajska M, Best MG, Würdinger T, Żaczek AJ, Supernat A, Jassem J. Diagnostic Accuracy of Liquid Biopsy in Endometrial Cancer. Cancers (Basel) 2021; 13:5731. [PMID: 34830891 PMCID: PMC8616122 DOI: 10.3390/cancers13225731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Liquid biopsy is a minimally invasive collection of a patient body fluid sample. In oncology, they offer several advantages compared to traditional tissue biopsies. However, the potential of this method in endometrial cancer (EC) remains poorly explored. We studied the utility of tumor educated platelets (TEPs) and circulating tumor DNA (ctDNA) for preoperative EC diagnosis, including histology determination. METHODS TEPs from 295 subjects (53 EC patients, 38 patients with benign gynecologic conditions, and 204 healthy women) were RNA-sequenced. DNA sequencing data were obtained for 519 primary tumor tissues and 16 plasma samples. Artificial intelligence was applied to sample classification. RESULTS Platelet-dedicated classifier yielded AUC of 97.5% in the test set when discriminating between healthy subjects and cancer patients. However, the discrimination between endometrial cancer and benign gynecologic conditions was more challenging, with AUC of 84.1%. ctDNA-dedicated classifier discriminated primary tumor tissue samples with AUC of 96% and ctDNA blood samples with AUC of 69.8%. CONCLUSIONS Liquid biopsies show potential in EC diagnosis. Both TEPs and ctDNA profiles coupled with artificial intelligence constitute a source of useful information. Further work involving more cases is warranted.
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Affiliation(s)
- Marta Łukasiewicz
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (M.Ł.); (K.P.); (A.J.Ż.)
| | - Krzysztof Pastuszak
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (M.Ł.); (K.P.); (A.J.Ż.)
- Department of Algorithms and Systems Modelling, Faculty of Electronics, Telecommunication and Informatics, Gdańsk University of Technology, 80-233 Gdańsk, Poland
| | - Sylwia Łapińska-Szumczyk
- Department of Gynecology, Gyneacological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (S.Ł.-S.); (R.R.)
| | - Robert Różański
- Department of Gynecology, Gyneacological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (S.Ł.-S.); (R.R.)
| | - Sjors G. J. G. In ‘t Veld
- Department of Neurosurgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.G.J.G.I.V.); (M.G.B.); (T.W.)
- Brain Tumor Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam Medical Center, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Michał Bieńkowski
- Department of Pathomorphology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Tomasz Stokowy
- Department of Clinical Science, University of Bergen, 7800 Bergen, Norway;
- Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Magdalena Ratajska
- Department of Biology and Medical Genetics, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
- Department of Pathology, University of Otago, Dunedin 9016, New Zealand
| | - Myron G. Best
- Department of Neurosurgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.G.J.G.I.V.); (M.G.B.); (T.W.)
- Brain Tumor Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam Medical Center, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Thomas Würdinger
- Department of Neurosurgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.G.J.G.I.V.); (M.G.B.); (T.W.)
- Brain Tumor Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam Medical Center, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Anna J. Żaczek
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (M.Ł.); (K.P.); (A.J.Ż.)
| | - Anna Supernat
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-211 Gdańsk, Poland; (M.Ł.); (K.P.); (A.J.Ż.)
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
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Collins A, Taylor A, Guttery DS, Moss EL. Innovative Follow-up Strategies for Endometrial Cancer. Clin Oncol (R Coll Radiol) 2021; 33:e383-e392. [PMID: 34172343 DOI: 10.1016/j.clon.2021.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 01/22/2023]
Abstract
Increasing recognition of the heterogeneous nature of endometrial cancer, the excellent prognosis of low-risk cases and improvements in risk stratification offer opportunities for innovative, personalised follow-up strategies. This review article outlines the evidence base for alternative follow-up strategies in the different risk categories of endometrial cancer, cancer survivorship programmes and considers future directions in endometrial cancer follow-up, including emerging new techniques, such as the liquid biopsy, and opportunities for combining molecular and clinicopathological features to personalise endometrial cancer follow-up.
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Affiliation(s)
- A Collins
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - A Taylor
- Royal Marsden NHS Foundation Trust, London, UK
| | - D S Guttery
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - E L Moss
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
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