. (2005) Search for cancer markers from endometrial tissues using differentially labeled tags iTRAQ and cleavable ICAT with multidimensional liquid chromatography and tandem mass spectrometry. J. Proteome Res. 4, 377-386) to discriminate malignant and benign endometrial tissue samples was verified in a 40-sample iTRAQ (isobaric tags for relative and absolute quantitation) labeling study involving normal proliferative and secretory samples and Types I and II endometrial cancer samples. None of these proteins had the sensitivity and specificity to be used individually to discriminate between normal and cancer samples. However, a panel of pyruvate kinase, chaperonin 10, and ␣ 1 -antitrypsin achieved the best results with a sensitivity, specificity, predictive value, and positive predictive value of 0.95 each in a logistic regression analysis. In addition, three new potential markers were discovered, whereas two other proteins showed promising trends but were not detected in sufficient numbers of samples to permit statistical validation. Differential expressions of some of these candidate biomarkers were independently verified using immunohistochemistry. Molecular & Cellular Proteomics 6:1170 -1182, 2007.Differential tagging with isotopic reagents, such as ICAT (1) or the more recent variation that uses isobaric tagging reagents, iTRAQ 1 (Applied Biosystems, Foster City, CA), followed by multidimensional LC and MS/MS analysis is quickly being recognized as one of the more powerful methodologies in the search for biomarkers for various disease states. Our recent studies using both ICAT and iTRAQ reagents as means to facilitate the identification and relative quantification of proteins from endometrial tissue homogenates have resulted in some interesting potential cancer markers (PCMs) (2, 3). Those studies, however, were performed on small sample sets. This study describes the results of a more detailed investigation using a larger cohort of 40 samples and the iTRAQ technology and was aimed at validating the earlier results as well as expanding the panel of biomarkers.Endometrial carcinoma (EmCa), a cancer of the lining of the uterus, is the fourth most common cancer in Canadian women.2 Current methods of diagnosis rely on invasive techniques (biopsy and curettage), and no screening is available. A panel of biomarkers that helps in early diagnosis would, therefore, be useful especially for high risk groups, e.g. women who are on tamoxifen treatment or have hereditary nonpolyposis colorectal cancer syndrome. Although the eventual diagnostic testing for such biomarkers would be most facile from bodily fluids, such as blood or urine, the iTRAQ experiments performed thus far have been on resected From the Departments of ‡Chemistry, §Biology, and ʈMathematics