Chromosomal instability in peripheral blood lymphocytes of endometrial cancer patients: impact of clinical and reproductive factors

Abstract

Endometrial cancer (EC) is one of the most common invasive gynecological malignancies in developed countries. In Serbia, it ranks as the sixth most frequent cancer among women, with approximately 700 new cases diagnosed each year. The objective of this research was to investigate chromosomal instability in peripheral blood lymphocytes (PBLs) of patients with EC in relation to potential risk factors. The study included 60 participants, including 30 patients with newly diagnosed EC (mean age 67.77 ± 7.99 years) and 30 healthy control women (mean age 60.23 ± 11.55 years). Chromosomal instability was assessed using the cytokinesis-block micronucleus (CBMN) assay in cultured PBLs. The results showed that cancer patients had a significantly increased average frequency of micronuclei (MN), and nuclear buds (NBUDs) compared to healthy controls (MN: 18.20 ± 2.50 vs. 8.33 ± 1.83; NBUDs: 1.00 ± 1.20 vs. 0.10 ± 0.31; p < 0.0005). The average frequency of nucleoplasmic bridges (NPBs) and the nuclear division index (NDI) did not show significant differences between groups (NPBs: 0.03 ± 0.18 vs. 0.00 ± 0.00; NDI: 1.52 ± 0.20 vs. 1.55 ± 0.15; p > 0.05). Linear regression analysis revealed that health status (diagnosis), histopathological tumor grade, body mass index (BMI), and number of pregnancies significantly influenced the level of chromosomal instability (p < 0.0005), whereas age, smoking habits, place of residence, and history of induced or spontaneous abortions were not significantly associated. These findings suggest that patients with EC exhibit increased chromosomal instability in PBLs, evidenced by elevated frequencies of MN and NBUDs. This instability is significantly associated with clinical and reproductive risk factors, such as tumor grade, BMI, and number of pregnancies, highlighting its potential value as a biomarker for disease monitoring and prognosis.