Infrared Spectroscopy of Urine for the Non-Invasive Detection of Endometrial Cancer

Abstract

Current triage for women with post-menopausal bleeding (PMB) to diagnose endometrial cancer rely on specialist referral for intimate tests to sequentially image, visualise and sample the endometrium. A point-of-care non-invasive triage tool with an instant readout could provide immediate reassurance for low-risk symptomatic women, whilst fast-tracking high-risk women for urgent intrauterine investigations. This study assessed the potential for infrared (IR) spectroscopy and attenuated total reflection (ATR) technology coupled with chemometric analysis of the resulting spectra for endometrial cancer detection in urine samples. Standardised urine collection and processing protocols were developed to ensure spectroscopic differences between cases and controls reflected cancer status. Urine spectroscopy distinguished endometrial cancer (n = 109) from benign gynaecological conditions (n = 110) with a sensitivity of 98% and specificity of 97%. If confirmed in subsequent low prevalence studies embedded in PMB clinics, this novel endometrial cancer detection tool could transform clinical practice by accurately selecting women with malignant pathology for urgent diagnostic work up whilst safely reassuring those without.

Infrared Spectroscopy in Gynecological Oncology: A Comprehensive Review of Diagnostic Potentials and Challenges

“…The findings remained reliable when comparing the most common endometrial cancers to controls, as well as non-endometrial cancers (including serous, clear-cell, and carcinosarcoma) to controls. Additionally, high levels of diagnostic accuracy persisted even when early stage I cancers were compared to controls, and when comparing grade 1 endometrial stage IA cancers to controls, which represent the earliest stage and grade of the disease [ 27 ]. Moreover, ATR-FTIR spectroscopy was used to examine urine samples in a study on ovarian- and endometrial cancer patients.…”

Urinary Metabolic Biomarker Profiling for Cancer Diagnosis by Terahertz Spectroscopy: Review and Perspective

“…Fluorescence spectroscopy can be used to identify the biomolecules present in the sample and can be used to detect changes in the biomolecule structure due to disease or other factors. Several IR spectroscopic methods are used for biomarker detection in urine samples in far-, mid-and near-infrared regions [27,[114][115][116]. The IR spectral range covers wavelengths from 780 nm to 1000 µm, which can be further subdivided into the near-infrared (NIR) range from 780 nm to 2500 nm, the mid-infrared (MIR) range from 2500 nm to 50 µm and the far-infrared (FIR) range from 50 µm to 1000 µm [112].…”