Level of DNA damage in peripheral blood mononuclear cells in endometrial cancer patients according to histological type and tumor differentiation
Genetic damage is a hallmark of cancer and plays a crucial role in the pathogenesis and progression of endometrial cancer (EC). This study aimed to evaluate the level of DNA damage, measured as the genetic damage index (GDI), in peripheral blood mononuclear cells (PBMCs) of patients with EC and to examine its relationship with clinical and pathological features. A total of 88 women were enrolled, including 58 with newly diagnosed EC and 30 healthy controls. DNA damage was assessed using the alkaline comet assay. GDI was calculated and examined in relation to age, body mass index (BMI), FIGO stage as defined by the International Federation of Gynecology and Obstetrics (2023), tumor grade, and histological type. Patients with EC showed significantly higher GDI compared to controls (p < 0.0005). GDI increased progressively with tumor grade and was significantly elevated in serous/clear cell cancer versus endometrioid type (p = 0.032). Although GDI was higher across tumor stages compared to controls, no significant differences were found between individual stages. A significant increase in GDI was also observed in patients with BMI ≥ 40 compared to those with BMI 25-29.9 (p = 0.010). Linear regression confirmed that tumor stage, tumor grade, and histological type were independent predictors of GDI (R² = 0.812). The findings suggest that the level of DNA damage may serve as a valuable indicator of tumor biology in EC. Its association with key pathological features highlights its potential role in early diagnosis, prognostic assessment, and personalized treatment planning.