Endometrial Cancer Driver Mutations Detectable in Uterine Lavage Fluid

December 27, 2016

SAN FRANCISCO -- December 27, 2016 -- Mutations that have been linked to endometrial cancer can be found in the uterine lavage fluid of pre- and post-menopausal women both with and without detectable cancer, according to a study published in PLOS Medicine.

There are no effective screening methods for endometrial cancer, which is currently increasing in both incidence and mortality in the United States.

For the current study, John Martignetti, MD, Icahn School of Medicine at Mount Sinai, New York, New York, and colleagues performed uterine lavage on 107 women undergoing diagnostic hysteroscopy due to post-menopausal uterine bleeding or abnormal pelvic ultrasound results.

The cells and DNA collected were analysed with either 1 of 2 next-generation sequencing panels to detect previously established driver mutations of endometrial cancer. Hysteroscopy samples were analysed using classic histopathology.

Of the 107 women in the study, 7 were found to have histopathological evidence of endometrial cancer and all 7, even those with only microscopic evidence of cancer, had significant cancer-driver gene mutations in their uterine lavage fluid. However, 51 women without histopathological evidence of cancer also carried cancer-driver mutations in the cells and DNA from their lavage fluid.

Age and post-menopausal status were both positively associated with the likelihood of harbouring these mutations. Due to this unexpected finding, uterine lavage fluid was not able to distinguish between women with and without clinically relevant evidence of endometrial cancer.

According to the authors, more research is needed to shed light on the significance of driver mutations in women without evidence of cancer.

“Given that a uterine lavage can be easily and quickly performed even outside of the operating room and in a physician's office-based setting, our findings suggest the future possibility of this approach for screening women for the earliest stages of endometrial cancer,” the authors wrote. “However, our findings suggest that further insight into development of endometrial cancer or its interruption are needed before translation to the clinic.”

SOURCE: PLOS Medicine

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