Comparison of long non-coding RNA expressions in endometrial polyp and endometrial cancer cases

Aim: The aim of this study is to investigate the diagnostic and prognostic values of four different long non-coding RNAs (XIST, UCA1, MALAT1 and ANRIL) expressions that we selected based on the latest literature data in endometrial polyp and endometrial cancer tissues, in the distinction between benign and malignant, by comparing them with healthy endometrium. Materials & Method: 150 women who underwent biopsy due to abnormal uterine bleeding and whose paraffin blocks were obtained between August 2021 and April 2024 were included in the study (Endometrial polyp = 50 patients, endometrial cancer = 50 patients, control = 50 patients). RNAs were isolated with the EcoSpin FFPE Total RNA kit and converted to cDNA with the OneScript Plus kit. XIST, MALAT1, UCA1 and ANRIL expressions were quantified with SYBR Green qRT-PCR using the 2^-ΔΔCt method using U6 snRNA as a reference. The groups were compared with Student's t-test; False Discovery Rate correction was applied for multiple tests. p<0.01 and ±2-fold change were considered significant. Results: The expression levels of ANRIL decreased 2.17-fold, MALAT1 3.10-fold, UCA1 4.52-fold and XIST 4.99-fold in endometrial polyp tissues compared to the control group (all p<0.001). The decrease was more pronounced in endometrial cancer tissues; ANRIL 21.53-fold, MALAT1 3.13-fold, UCA1 4.82-fold and XIST 14.98-fold (all p<0.001). Demographic data were homogeneous between the groups. Conclusions: XIST, MALAT1, UCA1 and ANRIL expressions were significantly decreased in both groups compared to the control group, being more pronounced in EC tissues. These four lncRNAs are potential diagnostic biomarkers for distinguishing benign-malignant endometrial lesions, and XIST and ANRIL in particular may be molecular indicators of malignant progression. The findings may pave the way for the clinical use of lncRNAs in early detection of premalignant polyps and development of personalized monitoring-treatment strategies for EC. Keywords: Endometrial cancer, endometrial polyp, long non-coding RNA, RNA expression