Is hemoglobin A1c valuable for predicting concurrent endometrial cancer in diabetic women with endometrial intraepithelial neoplasia?

Abstract

Aim

The purpose of this study was to determine the predictive value of preoperative hemoglobin A1c (HgA1c) level for endometrial cancer in diabetic women with endometrial intraepithelial neoplasia (EIN).

Materials and Methods

Six hundred patients with EIN were retrospectively studied in a tertiary referral center in Turkey between January 2014 and December 2021. One hundred and thirteen diabetic patients with EIN who met the inclusion criteria were enrolled in the study and divided into three groups according to the final pathological results: Group 1 with benign findings (n = 29), Group 2 with EIN (n = 34) and Group 3 with endometrial cancer (n = 50). Demographic, clinical and biochemical characteristics were compared among the three groups. Receiver operating characteristic analysis (ROC) was used to evaluate the predictive value of HgA1c for concurrent endometrial cancer in EIN.

Results

Mean preoperative HgA1c levels were different among three groups (5.41 ± 0.64, 6.01 ± 0.72, 6.65 ± 1.15, p < 0.001, respectively). The highest value of HgA1c level was found in cancer group and difference within pairs was statistically significant (p < 0.001). Age and duration of menopause were also different among groups (p < 0.005). After adjustment of HgA1c level for age and duration of menopause differences were maintained (p < 0.001), the cutoff value was detected as ≥6.05% for HgA1c and sensitivity, specificity was 60%, 70%, respectively (p < 0.001).

Conclusions

HgA1c could be used in prediction of endometrial cancer. The optimal cutoff value determined in our study could be considered in predicting endometrial cancer in diabetic women with EIN.

摘要

目的

探讨术前血红蛋白A1C(HgA1c)水平对糖尿病合并子宫内膜上皮内瘤变(EIN)患者子宫内膜癌的预测价值。

材料和方法

对土耳其一家三级转诊中心2014年1月至2021年12月的600名EIN患者进行了回顾性研究。纳入113例符合标准的糖尿病EIN患者, 根据最终病理结果分为3组：良性病变组(29例)、EIN组(34例)和子宫内膜癌组(50例)。比较三组患者的人口学、临床和生化特征。受试者工作特征分析(ROC)用于评估HgA1c对EIN并发子宫内膜癌的预测价值。

结果

3组术前HgA1c平均水平分别为5.41±0.64、6.01±0.72、6.65±1.15, P<0.001。HgA1c水平以癌组最高, 组间差异有统计学意义(P<0.001)。年龄、绝经年限的组间差异有统计学意义(P<0.005)。调整年龄、绝经年限等因素后, HgA1c的临界值为≥6.05%, 敏感性为60%, 特异性为70%(P<0.001)。

结论

HgA1c可用于子宫内膜癌的预测。我们研究中确定的最佳临界值可用于预测糖尿病合并EIN妇女的子宫内膜癌。

Keywords:

• Endometrial intraepithelial neoplasia (EIN)
• preoperative hemoglobin A1c (HgA1c)
• endometrial cancer
• diabetes mellitus (DM)

关键词:

• 子宫内膜上皮内瘤变(EIN)
• 术前血红蛋白A1c(HgA1c)
• 子宫内膜癌
• 糖尿病(DM)

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.