Objective: The aim of our study was to explore the value of DNA (CDO1m/CELF4m) methylation detection in exfoliated cervical cells collected for screening endometrial cancer in premenopausal women with abnormal uterine bleeding.

Methods: A total of 296 premenopausal women with abnormal uterine bleeding admitted to the Department of Obstetrics and Gynecology at the Third Xiangya Hospital of Central South University from November 2021 to October 2022 were selected. Clinical characteristics, endometrial thickness measured by transvaginal ultrasound and serum CA125 were collected. Exfoliated cervical cells from the thinPrep cytogic test were collected for DNA (CDO1m/CELF4m) methylation testing. Endometrial tissue was collected under hysteroscopy for pathological diagnosis as the gold standard. A univariate logistic regression model was used to analyze risk factors for endometrial cancer. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to measure the diagnostic efficacy of DNA methylation detection in endometrial cancer screening of women with abnormal uterine bleeding.

Results: Univariate logistic regression analysis showed that age, body mass index (BMI) ≥25 kg/m², endometrial thickness ≥11 mm, CDO1 methylation (CDO1mΔCt≤8.4), CELF4 methylation (CELF4mΔCt≤8.8), and dual gene methylation (CDO1mΔCt≤8.4 or CELF4mΔCt≤8.8) were independent risk factors for endometrial cancer in women with abnormal uterine bleeding. The odds ratio (OR) values (95% confidence interval (CI) were 0.87 (0.80-0.95), 4.76 (1.89-11.96), 8.41 (3.13-22.59), 64.49 (20.46-203.33), 12.79 (4.91-33.30), and 42.53 (11.90-152.04), respectively. Among these indicators, dual gene methylation had the higher sensitivity and specificity for endometrial cancer screening (85.7% and 87.6%). Moreover, dual gene methylation combined with BMI or endometrial thickness could further improve the screening efficiency of endometrial cancer in women with abnormal uterine bleeding.

Conclusions: In premenopausal women with abnormal uterine bleeding, the clinical efficacy of DNA (CDO1m/CELF4m) methylation detection in exfoliated cervical cells for endometrial cancer screening was better than that of other noninvasive clinical indicators. In addition, dual gene methylation combined with BMI or endometrial thickness was a good predictor of endometrial cancer screening.

Keywords: Endometrial Neoplasms.

© 2024 IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.

目的: 我们的研究目的是探讨DNA (CDO1m/CELF4m)甲基化检测在筛查绝经前异常子宫出血女性子宫内膜癌中的价值。

方法: 从2021年11月至2022年10月，选取中南大学第三湘雅医院妇产科收治的296名绝经前异常子宫出血女性作为研究对象。收集了患者的临床特征、通过阴道超声测量的子宫内膜厚度和血清CA125水平。从薄Prep细胞学检查中采集脱落宫颈细胞进行DNA (CDO1m/CELF4m)甲基化检测，并在宫腔镜下采集子宫内膜组织用于病理诊断，作为金标准。使用单因素逻辑回归模型分析子宫内膜癌的风险因素。采用受试者工作特征（ROC）曲线和曲线下面积（AUC）来测量DNA甲基化检测在异常子宫出血女性中筛查子宫内膜癌的诊断效能。

结果: 单因素逻辑回归分析显示，年龄、体重指数 (BMI) ≥25 kg/m²、子宫内膜厚度 ≥11 mm、CDO1甲基化（CDO1mΔCt≤8.4）、CELF4甲基化（CELF4mΔCt≤8.8）和双基因甲基化（CDO1mΔCt≤8.4 或 CELF4mΔCt≤8.8）是异常子宫出血女性患子宫内膜癌的独立风险因素。优势比 (OR) 值（95% 置信区间 (CI) 分别为 0.87（0.80-0.95）、4.76（1.89-11.96）、8.41（3.13-22.59）、64.49（20.46-203.33）、12.79（4.91-33.30）和 42.53（11.90-152.04）。在这些指标中，双基因甲基化对子宫内膜癌筛查的敏感性和特异性较高（分别为85.7% 和 87.6%）。此外，结合BMI或子宫内膜厚度可进一步提高异常子宫出血女性中子宫内膜癌的筛查效率。

结论: 在绝经前异常子宫出血的女性中，脱落宫颈细胞DNA (CDO1m/CELF4m)甲基化检测在子宫内膜癌筛查中的临床效果优于其他非侵入性临床指标。此外，双基因甲基化结合BMI或子宫内膜厚度是子宫内膜癌筛查的良好预测指标。

关键词: 子宫内膜肿瘤。

© 2024 IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.