New Trends in the Detection of Gynecological Precancerous Lesions and Early-Stage Cancers

Abstract

The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.

Preoperative Assessment of MRI‐Invisible Early‐Stage Endometrial Cancer With MRI‐Based Radiomics Analysis

“…Although the prognostic impact of this condition has not been well investigated to date, attention is needed. Furthermore, blinded D&C may be insufficient to detect focal anomalies of the endometrium because blind sampling can sometimes be not comprehensive 11,21 . Chen et al reported that different uterine cavity surgeries may interfere with the assessment of the lesion's MI on MRI 10 .…”

“…Furthermore, blinded D&C may be insufficient to detect focal anomalies of the endometrium because blind sampling can sometimes be not comprehensive. 11,21 Chen et al reported that different uterine cavity surgeries may interfere with the assessment of the lesion's MI on MRI. 10 Therefore, our study chose MRI-based noninvasive examination to differentiate precancerous or malignant from benign endometrial lesions.…”

“…Intraperitoneal dissemination of malignant cells due to intrauterine manipulation is a noteworthy risk, although the prognostic impact of this condition is currently unclear 4,9 . Previous studies showed that hysteroscopy could underestimate the tumor grade of lesions and was not effective in focal malignancy and MI assessment of lesions 10,11 . In addition, intrauterine manipulation might interfere with MI depth assessment on MRI 10 …”

“…4,9 Previous studies showed that hysteroscopy could underestimate the tumor grade of lesions and was not effective in focal malignancy and MI assessment of lesions. 10,11 In addition, intrauterine manipulation might interfere with MI depth assessment on MRI. 10 Early detection of MRI-invisible EC might reduce the need for preoperative invasive tests or radical surgery, and in some patients could also preserve fertility.…”

Clinical Applicability of Tissue Polypeptide Antigen and CA-125 in Gynecological Malignancies

“…However, the early detection of gynecologic malignancies remains a challenge. For instance, although CA-125 is seen as one of the most promising biomarkers in epithelial ovarian cancers, 20% of tumors are missed in initial screenings [36][37][38]. The combination of promising biomarkers is an auspicious strategy to achieve higher diagnostic precision and reliability with respect to clinical applicability.…”