Analysis of , , and Gene Methylation in Early Endometrial Cancer for Prediction of Medical Treatment Outcomes

Objective Of The Study: To determine , , and gene methylation levels in early endometrial cancer and atypical hyperplasia specimens obtained before organ-preserving treatment in the patients with adequate response and with insufficient response to hormonal treatment.

Materials And Methods: A total of 41 endometrial specimens obtained during diagnostic uterine curettage in women with EC ( = 28) and AEH ( = 13), willing to preserve reproductive function, were studied; 18 specimens of uterine cancer IA stage G1 from peri- and early postmenopausal women (comparison group) were included in the study. The control group included 18 endometrial specimens from healthy women obtained by diagnostic curettage for missed abortion and/or intrauterine adhesions. Methylation levels were analyzed using the modified MS-HRM method.

Results: All 13 women with AEH had a complete response (CR) to medical treatment. In the group undergoing organ-preserving treatment for uterine cancer IA stage G1 ( = 28), 14 patients had a complete response (EC CR group) and 14 did not (EC non-CR group). It was found that all groups had statistically significant differences in gene methylation levels compared to the control group ( < 0.001) except for the EC CR group ( = 0.21). The -value for the difference between EC CR and EC non-CR groups was <0.001. The differences in gene methylation levels between the control and study groups were also significantly different ( < 0.001), except for the AEH group ( = 0.21). For the difference between EC CR and EC non-CR groups, the -value was 0.43. For gene methylation levels, statistically significant differences were found between the control and EC non-CR groups ( < 0.001), and the control and EC comparison groups ( = 0.005). When comparing the EC CR group with EC non-CR group, the -value for this gene was <0.001. The simultaneous assessment of and genes methylation allowed for an accurate distinction between EC CR and EC non-CR groups (AUC = 0.96).

Conclusion: The assessment of and gene methylation in endometrial specimens from patients with endometrial cancer (IA stage G1), scheduled for medical treatment, can predict the treatment outcome.