Prognostic Biomarkers in Endometrial Cancer: A Systematic Review and Meta-Analysis.
Eva Coll-de la RubiaElena Martinez-GarciaGunnar DittmarAntonio Gil-MorenoSilvia CabreraEva ColásPublished in: Journal of clinical medicine (2020)
Endometrial cancer (EC) is the sixth most common cancer in women worldwide and its mortality is directly associated with the presence of poor prognostic factors driving tumor recurrence. Stratification systems are based on few molecular, and mostly clinical and pathological parameters, but these systems remain inaccurate. Therefore, identifying prognostic EC biomarkers is crucial for improving risk assessment pre- and postoperatively and to guide treatment decisions. This systematic review gathers all protein biomarkers associated with clinical prognostic factors of EC, recurrence and survival. Relevant studies were identified by searching the PubMed database from 1991 to February 2020. A total number of 398 studies matched our criteria, which compiled 255 proteins associated with the prognosis of EC. MUC16, ESR1, PGR, TP53, WFDC2, MKI67, ERBB2, L1CAM, CDH1, PTEN and MMR proteins are the most validated biomarkers. On the basis of our meta-analysis ESR1, TP53 and WFDC2 showed potential usefulness for predicting overall survival in EC. Limitations of the published studies in terms of appropriate study design, lack of high-throughput measurements, and statistical deficiencies are highlighted, and new approaches and perspectives for the identification and validation of clinically valuable EC prognostic biomarkers are discussed.
Keyphrases
- endometrial cancer
- prognostic factors
- systematic review
- meta analyses
- risk assessment
- high throughput
- case control
- free survival
- type diabetes
- squamous cell carcinoma
- human health
- emergency department
- pregnant women
- skeletal muscle
- randomized controlled trial
- estrogen receptor
- coronary artery disease
- cardiovascular disease
- papillary thyroid
- risk factors
- tyrosine kinase
- metabolic syndrome
- electronic health record
- combination therapy
- drug induced