Discovery of biomarkers for endometrial cancer: current status and prospects

Introduction: Endometrial cancer is the most frequent gynecological malignancy in the developed world. Currently, endometrial histology is the gold standard for diagnosis, as there are no valid noninvasive diagnostic methods available. Biomarkers for endometrial cancer would be invaluable for screening of high-risk women, detection of primary and recurrent disease, and preoperative stratification of patients as high-risk and low-risk categories, enabling personalized therapeutic approaches. Areas covered: This report reviews publications of blood biomarkers evaluated in patients with endometrial cancer and/or control patients, over the last five years. Relevant studies were identified by searching the PubMed database from January 2010 to July 2016. The limitations of these studies, their diagnostic and prognostic accuracies, and options for translation to the clinic are discussed. Expert commentary: Very good diagnostic accuracy has been reported for individual proteins HE-4, GDF-15, SPAG9, YKL-40, IL-31, and IL-33, for panels of proteins with ApoA1, TTR, and TF, for amino acids His, Ile, Val, and Pro, and for micro-RNAs miR222, miR223, miR186, and miR204. CA-125, HE-4, resistin, and a panel of miR203, miR200a*, and miR449 can accurately distinguish high-risk from low-risk patients. After successful validation, these candidate biomarkers have a good chance to enter the further phases of biomarker discovery.