Evaluation of HE-4 and calprotectin with miRNA-9and miRNA-186 levels in endometrium cancer cases

Objective: Endometrium cancers are the most common type among gynecological cancers and the eighth cancer type that causes the death worldwide. In high-risk cases, biopsy or dilatation-curettage are the gold standard in diagnosis. These interventions are invasive and carry the risk of morbidity. Therefore, to distinguish the cases that have high risk for EC, non-invasive reliable methods are needed. Hence there is no effective non-invasive method to distinguish cases today, our study aims to reveal the effectiveness of emerging markers to distinguish cases that have high risk for EC. Method: The study was designed prospectively and consisted of 20 cases diagnosed with endometrium cancer underwent hysterectomy, and 22 controls with benign disease underwent hysterectomy. miRNA-9 and miRNA-186 were isolated from their tissue and serum, after that analyzed by the qRT-PCR method. Calprotectin, HE-4, SOD, MDA, GSH serum levels were analyzed colorimetrically using ELISA method. The effectiveness of miRNA molecules in early diagnosis has been shown by ROC curves and combined with serum markers to increase the diagnostic effectiveness. Results: Tissue miRNA-9 and miRNA-186 levels were significantly different between case and control group (p=0.011, p=0.03; respectively), AUC values in ROC analysis were calculated as 0.737 and 0.715, respectively. There was significant difference in serum miRNA-9 levels between case and control group (p = 0.047), no significant difference in serum miRNA-186 levels between case and control group (p = 0.077). AUC values in ROC analysis of serum miRNA-9 and miRNA-186 levels, were calculated as 0.696 and 0.703, respectively. There was a significant difference in serum HE-4 and SOD levels between case and control group (p = 0.023, p = 0.008; respectively), AUC values in ROC analysis were calculated as 0.745 and 0.724, respectively. There was no significant difference in serum calprotectin, GSH, MDA levels between case and control group (p = 0.156, p = 0.140, p = 0.256; respectively), AUC values in ROC analysis were calculated as 0.608, 0.361, 0.525, respectively. miRNA-9 levels was significantly correlated between tissue and serum and had a strong correlation (p = 0.001, r = 0.751). In the same way, there was a significant relationship between tissue and serum miRNA-186 levels and there was a strong correlation (p = 0.001, r = 0.789). Conclusion: According to the findings in EC cases, miRNA-9 and miRNA-186 have a significant increase in tissues and serum. According to the ROC analysis, it was evaluated as a moderately distinctive effectiveness. There was a significant correlation between miRNA-9 and miRNA-186 levels in tissue and serum separately. In ROC analysis, serum HE-4 and SOD levels were shown to increase the discriminative effectiveness. Therefore, we consider that; serum miRNA-9, miRNA-186, HE-4 and SOD analyses could be useful for cases that have high risk for EC.