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Detecting Endometrial Cancer by Blood Spectroscopy: A Diagnostic Cross-Sectional Study

27 Pages Posted: 8 May 2020

See all articles by Maria Paraskevaidi

Maria Paraskevaidi

University of Central Lancashire - School of Pharmacy and Biomedical Sciences

Camilo L.M. Morais

affiliation not provided to SSRN

Katherine M. Ashton

affiliation not provided to SSRN

Helen F. Stringfellow

affiliation not provided to SSRN

Rhona J. McVey

affiliation not provided to SSRN

Neil A.J. Ryan

affiliation not provided to SSRN

Helena O’Flynn

affiliation not provided to SSRN

Vanitha N Sivalingam

The University of Manchester - Division of Cancer Sciences

Sarah J. Kitson

The University of Manchester - Division of Cancer Sciences

Michelle L. MacKintosh

affiliation not provided to SSRN

Abigail E. Derbyshire

affiliation not provided to SSRN

Cecilia Pow

affiliation not provided to SSRN

Olivia Raglan

affiliation not provided to SSRN

Kássio M.G. Lima

affiliation not provided to SSRN

Maria Kyrgiou

affiliation not provided to SSRN

Pierre L. Martin-Hirsch

affiliation not provided to SSRN

Francis L. Martin

affiliation not provided to SSRN

Emma J. Crosbie

The University of Manchester

More...

Abstract

Background: Endometrial cancer is the sixth most common cancer in women with a rising incidence worldwide. Current approaches for the diagnosis and screening of endometrial cancer are invasive, expensive and of moderate diagnostic accuracy, limiting their clinical utility. There is a need for cost-effective and minimally invasive biomarkers to facilitate the early detection and timely management of endometrial cancer.

Methods: We analysed blood plasma samples in a cross-sectional diagnostic accuracy study of women with endometrial cancer(n=342), its precursor lesion atypical hyperplasia(n=68) and healthy controls(n=242, total n=652) using attenuated total reflection-Fourier transform infrared(ATR-FTIR) spectroscopy and machine learning algorithms.

Findings : We show that blood-based infrared spectroscopy has the potential to detect endometrial cancer with 87% sensitivity and 78% specificity. Its accuracy is highest for type I endometrial cancer, the most common subtype, and for atypical hyperplasia, with sensitivities of 91% and 100%, and specificities of 81% and 88%, respectively.

Interpretation: Our large-cohort study shows that a simple blood test could enable the early detection of endometrial cancer of all stages in symptomatic women and provide the basis of a screening tool in high-risk groups. Such a test will not only differentially diagnose endometrial cancer but also detect its precursor lesion atypical hyperplasia, the early recognition of which may allow fertility-sparing management and cancer prevention.

Funding Statement: The authors were supported by the Rosemere Cancer Foundation, CAPES–Brazil, Wellcome Trust, Wellbeing of Women, MRC, NIHR and the Department of Health. The views expressed are those of the authors and not necessarily of the funders.

Declaration of Interests: The authors declare no potential conflicts of interest.

Ethics Approval Statement: All women gave written, informed consent to participate and donated their clinical data and blood samples for future research. Ethical approval was obtained as follows: Weight loss study (North West Research Ethics Committee ref. 12/NW/0050), PROTEC study (Cambridge East Research Ethics Committee ref. 15/EE/0063), PREMIUM study (North West Research Ethics Committee ref. 14/NW/1236), Metformin study (North West Research Ethics Committee ref. 11/NW/0442), PETALS study (NRES Committee North West – Lancaster ref. 15/NW/0733), DETECT study (North West Research Ethics Committee - Greater Manchester 16/NW/0660), and East of England – Cambridge Central Research Ethics Committee ref. 16/EE/0010.

Keywords: blood diagnostics; endometrial cancer; screening; spectroscopy

Suggested Citation

Paraskevaidi, Maria and Morais, Camilo L.M. and Ashton, Katherine M. and Stringfellow, Helen F. and McVey, Rhona J. and Ryan, Neil A.J. and O’Flynn, Helena and Sivalingam, Vanitha N and Kitson, Sarah J. and MacKintosh, Michelle L. and Derbyshire, Abigail E. and Pow, Cecilia and Raglan, Olivia and Lima, Kássio M.G. and Kyrgiou, Maria and Martin-Hirsch, Pierre L. and Martin, Francis L. and Crosbie, Emma J., Detecting Endometrial Cancer by Blood Spectroscopy: A Diagnostic Cross-Sectional Study (3/22/2020). Available at SSRN: https://ssrn.com/abstract=3559533 or http://dx.doi.org/10.2139/ssrn.3559533

Maria Paraskevaidi (Contact Author)

University of Central Lancashire - School of Pharmacy and Biomedical Sciences ( email )

Preston
United Kingdom

Camilo L.M. Morais

affiliation not provided to SSRN

Katherine M. Ashton

affiliation not provided to SSRN

Helen F. Stringfellow

affiliation not provided to SSRN

Rhona J. McVey

affiliation not provided to SSRN

Neil A.J. Ryan

affiliation not provided to SSRN

Helena O’Flynn

affiliation not provided to SSRN

Vanitha N Sivalingam

The University of Manchester - Division of Cancer Sciences

Oxford Road
Manchester, M13 9PL
United Kingdom

Sarah J. Kitson

The University of Manchester - Division of Cancer Sciences

Oxford Road
Manchester, M13 9PL
United Kingdom

Michelle L. MacKintosh

affiliation not provided to SSRN

Abigail E. Derbyshire

affiliation not provided to SSRN

Cecilia Pow

affiliation not provided to SSRN

Olivia Raglan

affiliation not provided to SSRN

Kássio M.G. Lima

affiliation not provided to SSRN

Maria Kyrgiou

affiliation not provided to SSRN

Pierre L. Martin-Hirsch

affiliation not provided to SSRN

Francis L. Martin

affiliation not provided to SSRN

Emma J. Crosbie

The University of Manchester