Endometrial Cancer Detection Using a Cervical DNA Methylation Assay (MPap) in Women with Abnormal Uterine Bleeding: A Multicenter Hospital-Based Validation Study

Kuo Chang Wen, Rui Lan Huang, Lin Yu Chen, Tzu I. Wu, Chien Hsing Lu, Tang Yuan Chu, Yu Che Ou, Chen Hsuan Wu, Shih Tien Hsu, Dah Ching Ding, Ling Hui Chu, Chien Wen Chen, Heng Cheng Chang, Yu Shu Liu, Hui Chen Wang, Yu Chun Weng, Po Hsuan Su, Hao Lin, Hung Cheng Lai

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: We describe a DNA methylation assay, named MPap test, using cervical scraping as an alternative technique for endometrial cancer detection. Methods: A multicenter hospital-based, two-stage validation study was conducted to validate the cancer detection performance of the MPap test. The MPap value was determined from the DNA methylation status of two genes (BHLHE22, CDO1) and combined with two other clinical variables (age, BMI). The cutoff threshold of the MPap value was established in stage 1 and validated in stage 2. A total of 592 women with abnormal uterine bleeding were enrolled from five medical centers throughout Taiwan. Results: In stage 1, the sensitivity, specificity, and positive and negative predictive values of the MPap test for detecting endometrial cancer were 92.9%, 71.5%, 39.8%, and 98.0%, respectively. These values were validated in stage 2, being 92.5%, 73.8%, 40.2%, and 98.1%. Moreover, MPap outperformed transvaginal ultrasound in sensitivity and negative predictive values for detecting endometrial cancer. When we applied the algorithm for triage of endometrial cancer detection by MPap in the Taiwan National Health Insurance dataset, we found that it may reduce invasive procedures by 69~73%. Conclusions: MPap may provide a feasible alternative for endometrial cancer detection and can be considered as a triage test to reduce unnecessary invasive procedures.

Original languageEnglish
Article number4343
JournalCancers
Volume14
Issue number17
DOIs
Publication statusPublished - Sept 2022

Keywords

  • abnormal uterine bleeding
  • DNA methylation biomarker
  • early detection of endometrial cancer
  • MPap
  • triage tool

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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