# Metabolomics biomarkers and related pathways in endometrial cancer: A systematic review and meta‐analysis

## TL;DR

This study identifies key metabolomics biomarkers and pathways in endometrial cancer to improve its screening and diagnosis.

## Contribution

The study provides a meta-analysis of metabolomics data to reveal consistent biomarkers and pathways in endometrial cancer.

## Key findings

- Estrone and proline levels are significantly increased in endometrial cancer.
- Glutamine and phosphatidylcholine diacyl C32:2 levels are significantly decreased in endometrial cancer.
- Branched-chain amino acid and sphingolipid metabolism are significantly elevated in endometrial cancer.

## Abstract

Endometrial cancer (EC) is the fourth most common malignant tumour afflicting postmenopausal women in the world. Although advances have been made in the metabolomics of EC, the controversial findings limited the clinical applicability of the research results. Therefore, we aimed to reveal metabolic characteristics disorders in EC. We included studies comparing metabolite levels between EC and controls by searching PubMed, EMBASE, Cochrane Library, Web of Science and other source databases. Biomarkers and metabolic pathways were subjected to meta‐analysis by calculating the standardized mean difference (SMD) with 95% confidence intervals (CI), and summarizing the effect size using the inverse variance random effect model. Thirty studies identified the differential metabolites of EC. A total of 8 studies involved 4,006 participants with good quality were included. In terms of biomarkers, estrone and proline increased significantly in EC, while glutamine and phosphatidylcholine diacyl C32:2 decreased significantly in EC, with low heterogeneity. In terms of metabolic pathways, the levels of branched‐chain amino acid metabolism and sphingolipid metabolism increased significantly in EC with low heterogeneity. This review highlights the significance of above four biomarkers and two metabolic pathways in EC, which will help to realize the accurate screening and diagnosis of EC.