Diagnostic and prognostic potential of microRNA profiles in endometrioid endometrial cancer

Gene regulation is influenced by microRNAs (miRNAs), a class of non-coding RNAs currently being studied as biomarkers for various diseases. miRNAs, which act as regulators of gene expression and potential biomarkers, were profiled in endometrioid type endometrial cancer (EEC). 28 miRNAs were selected based on their role in regulating EEC-related oncogenes and tumor suppressors (e.g., PTEN, KRAS, β-CATENIN), maintaining tissue stability, and their previous associations with endometrial cancer. This study investigated the expression of miRNAs and their association with key signalling pathways (PI3K/AKT, RAS/MAPK, Wnt/β-Catenin) and their potential as diagnostic biomarkers for EEC. The study also investigated the relationship between miRNA regulation, endometrial pathology, and PTEN, KRAS, and β-CATENIN mRNA expression levels. Women who had received an EEC diagnosis participated in a 14-month prospective cohort study at Gazi University Hospital. Samples were obtained from patients with EEC during frozen sections and healthy women who underwent hysterectomy for benign disease. qPCR examined the miRNA and mRNA levels. 97 women participated, comprising 47 EEC patients and 50 healthy controls. The association was identified between miRNA expression levels and cancer grade. As the tumor grade increases, the expression of miRNAs (miR-let-7c, miR-18a-3p, miR-21, miR-30b, miR-96, miR-130a, miR-141, miR-181b, miR-182, miR-183, miR-2001, miR-200b, miR-200c, miR-203, miR-205, and miR-429) gradually increases. Conversely, twelve miRNAs demonstrated relative expression during the transition from normal endometrium (NE) to EEC (miR-let-7c, miR-let-7e, miR-30c, miR-101, miR-125b, miR-126, miR-129-2, miR-217, miR-324-3p, miR-518b, miR-543, and miR-596). miRNAs could serve as valuable biomarkers for both early detection of EEC and for distinguishing between different tumor grades. We showed that miRNAs have good diagnostic sensitivity for identifying EEC and EC grading. In addition, miRNA improved the ability to discriminate between ECs of different grades.