Table 1.
Clinical research approaches to liquid biopsy in endometrial cancer.
| Liquid Biopsy | Technology | Clinical Setting | Biomarkers | References |
|---|---|---|---|---|
| Uterine Aspirate | Targeted Proteomics | Diagnosis | ABRACL and PGAM2; KPYM, MMP9, to identify the disease; CTNB1, XPO2, and CAPG to discriminate between endometrioid endometrial carcinomas (EEC) and serous endometrial carcinoma (SEC) | [25,26] |
| Targeted Sequencing | Diagnosis | PTEN, PIK3CA, CTNNB1, TP53, FGFR2, KRAS, CDKN2A (most common mutated genes in endometrial cancer (EC)) | [8,27] | |
| Circulating Tumour Cells (CTC) | EpCAM-Based Immunoisolation (CellSearch®) and IF | Prognosis | CK-8, CK-18, CK-19, ETV5, NOTCH1, SNAI1, TGFB1, ZEB1 and ZEB2 | [28,29,30,31] |
| Density-based Enrichment (Oncoquick) and RTqPCR | Prognosis | CCNE2, DKFZp762E1312, EMP2, MAL2, PPIC, and SLC6A8 | [32] | |
| RTqPCR and flow cytometry | Prognosis | TTF-1 and the mRNA expression of: survivin, β-catenin, miR-15a, and PTEN | [33] | |
| Size-Based Enrichment (Metacell®) and Immunodetection | Prognosis | CTCs were defined based on: (i) cell size ≥ 15 μm; (ii) nuclear size ≥ 10 μm); (iii) irregularity of the nuclear contour; (iv) visible cytoplasm; (v) prominent nucleoli; (vi) high nuclear-cytoplasmic ratio; (vii) cluster presence; (viii) mitosis presence. | [34] | |
| Endothelial Progenitor Cells (EPC) | Flow Cytometry | Diagnosis | VEGFR2/KDR and CD34 | [35] |
| Cell Free DNA (cfDNA) | PCR-RFLP | Prognosis | KRAS | [36] |
| RTqPCR | Prognosis | Alu sequences | [37] | |
| Alu-RTqPCR | Prognosis | cfDNA content and integrity index | [38] | |
| NGS | Diagnosis | Copy number variations (CNVs) | [39] | |
| Circulating Tumour DNA (ctDNA) | Droplet Digital PCR | Response to Treatment | Various tumour-specific fusions and mutations in ctDNA | [40] |
| Circulating miRNA | RTqPCR | Diagnosis/Prognosis | miR-99a/miR-199b, miR-9/miR-1228 and miR-9/miR-92a, miR-222, miR-223, miR-186, miR-204 and miR-21 | [38,39,40,41] |