Metabolomics for Diagnosis and Prognosis of Uterine Diseases? A Systematic Review

Abstract

This systematic review analyses the contribution of metabolomics to the identification of diagnostic and prognostic biomarkers for uterine diseases. These diseases are diagnosed invasively, which entails delayed treatment and a worse clinical outcome. New options for diagnosis and prognosis are needed. PubMed, OVID, and Scopus were searched for research papers on metabolomics in physiological fluids and tissues from patients with uterine diseases. The search identified 484 records. Based on inclusion and exclusion criteria, 44 studies were included into the review. Relevant data were extracted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist and quality was assessed using the QUADOMICS tool. The selected metabolomics studies analysed plasma, serum, urine, peritoneal, endometrial, and cervico-vaginal fluid, ectopic/eutopic endometrium, and cervical tissue. In endometriosis, diagnostic models discriminated patients from healthy and infertile controls. In cervical cancer, diagnostic algorithms discriminated patients from controls, patients with good/bad prognosis, and with/without response to chemotherapy. In endometrial cancer, several models stratified patients from controls and recurrent from non-recurrent patients. Metabolomics is valuable for constructing diagnostic models. However, the majority of studies were in the discovery phase and require additional research to select reliable biomarkers for validation and translation into clinical practice. This review identifies bottlenecks that currently prevent the translation of these findings into clinical practice.

Metabolomic Biomarkers for the Detection of Obesity-Driven Endometrial Cancer

“…Pertubations in critical pathways involving fatty acid metabolism, choline metabolism, tricarboxylic acid cycle and glycolysis have all been described in the pathogenesis of cancer [ 21 , 33 , 34 ]. Metabolomic biomarkers have shown promise for the early detection of several cancers, including those of the breast [ 35 ], colon [ 36 ] and prostate [ 37 ], and may be particularly relevant in endometrial cancer, given its strong association with obesity, insulin resistance and type 2 diabetes mellitus [ 38 ].…”

Integrative Multi-Omics Approaches for Identifying Cervical Cancer Therapeutic Targets

“…Therefore, metabolomic profiles of cancer patients (blood, urine, tissue samples, and cervicovaginal lavage) were analyzed and differentiated from those of healthy women and those with benign uterine diseases (e.g., precancerous cervical intraepithelial neoplasia [CIN], cervicitis (Yang et al 2017; Abudula et al 2020; Khan et al 2019; Ilhan et al 2019; Tokareva et al 2020; M. zhu Yin et al 2016; Tokarz, Adamski, and Rižner 2020). As a result, algorithms with high diagnostic properties have been reported (Yang et al, 2017; Abudula et al, 2020; M.…”

“…Several investigations found different quantities of aa in plasma or serum for CC, though the results were inconsistent. In plasma, Hasim et al found reduced valine, isoleucine, alanine, histidine, glycine, and glutamine, but Ye et al found greater levels of alanine and glycine in serum (Tokarz, Adamski, and Rižner 2020). Although these metabolites are the basic units for tumours, biomass levels in the blood are aberrant in cancer patients (Wishart 2019).…”

Understanding Cervical Cancer through Proteomics

“…Metabolomics involves the detailed investigation of metabolites and small molecules closely related to the disease. In CINs and CC, it has been used extensively to study cancer metabolism and identify biomarkers indicative of disease, states, and underlying etiology [155].…”