{"paper_id":"f29e5bca-d0a9-47dd-bb37-dd5503e1b406","body_text":"North American Proceedings in\nGynecology & Obstetrics\nSpecial Issue\nCAOG Conference Abstracts\nWinter 2022\nPURPOSE/OBJECTIVES: Endometrial cancer (EC) is the most commonly diagnosed malignancy of the female genital \ntract with approximately 3% of women being diagnosed with EC at some point during their lifetime. Well established risk \nfactors for type 1 EC, which makes up ~80% of ECs, include obesity and tobacco use. Recent studies suggest that socio-eco-\nnomic factors, such as race, rural residence, insurance status and income, also correlate to morbidity and mortality associ-\nated with EC. Furthermore, obesity and low socioeconomic status have been shown to correlate with a pro-inflammatory \nphenotype, with elevated levels of C-reactive protein and interleukin-6, two commonly measured systemic inflammatory \nmarkers. An imbalance of immunotolerant regulatory T cells (Treg) and T helper cells (Th17) has been characterized in dis-\neases such as diabetes and cancer. We sought to further evaluate the relationship between cancer grade and stage, peripheral \nimmune phenotypes, BMI, and socio-economic status, including rural vs. urban location, income, education level, insurance \nstatus and tobacco use. We hypothesized that socio-economic factors correlate with altered inflammatory profiles (elevated \nTh17:Treg ratio) and subsequent higher stage and/or grade of EC at the time of surgery.\nMETHODS: This study was approved by the local IRB under protocol #16-493. Women scheduled for surgery, with biop-\nsy confirmed EC or benign gynecologic conditions (controls), were enrolled within SIU School of Medicine, Department \nof Ob/Gyn, Division of Gynecologic Oncology. All eligible women who consented completed a questionnaire including \nsocio-demographic data. Pathological analysis was performed at the time of surgery based on primary tumor samples and \nperipheral blood was collected to assess immune cell populations via FACS analysis. Wilcoxon rank sum test, Spearman \ncoefficient and Cochran Armitage trend test were used for statistical analysis.\nRESULTS: Our data did not show any significant differences in EC stage or grade at time of surgery based on income, ed-\nucation level, insurance type or tobacco use. We observed a significant immune shift toward a pro-inflammatory phenotype, \nas seen by the elevated Th17:Treg ratio, in peripheral blood from EC patients compared to control patients (3.50 ± 0.40 vs. \n1.74 ± 0.32, respectively; P-value=0.031). Our data also confirmed significantly higher BMIs in EC patients compared to \ncontrol subjects (P-value=0.003). We were not able to identify any correlations between the ratio of Th17:Treg and insur -\nance status, tumor grade, BMI, income or education level.\nEvaluation of socio-economic and immune \nfactors related to endometrial cancer\nAbstract\n1. Department of Obstetrics and Gynecology, SIU School of Medicine, Springfield, IL, USA\n2. Center for Clinical Research, SIU School of Medicine, Springfield, IL, USA\n3. Department of Medical Microbiology, Immunology and Cell Biology, SIU School of Medicine, Springfield, IL, USA\n4. Simmons Cancer Institute, SIU  School of Medicine, Springfield, IL, USA\n34CAOG Conference Abstracts Special Issue\nAneesh S. Chawla, MD   , Stacy Paar, MD   , Taylor Badger, BS   , Emily Dirks, BS   , Kathleen \nGroesch, MS    , Teresa Wilson, BA    , Paula Diaz-Sylvester, PhD       , Kristin Delfino, PhD   , Sarah \nNelson, BS   , J. Ricardo Loret de Mola, MD    , Laurent Brard, MD, PhD    , Andrea Braundmeier-\nFleming, PhD\n1\n1,2\n31 3\n1,2 1,2,4 2\n3 1,3 1,4\n1,3,4\n\nCAOG Conference Abstracts Special Issue\nNorth American Proceedings in Gynecology & Obstetrics Winter 2022\nCONCLUSIONS: While our data failed to show any significant correlations between socio-economic status and inflam-\nmatory phenotypes or EC stage/grade, one major limitation of our study is the small sample size (58 patients) and the fact \nthat all subjects were enrolled at a single institution. Our data confirms previous studies indicating obesity is associated with \nEC and shows the presence of a pro-inflammatory phenotype in EC patients. More data are needed to further evaluate this \nphenotype and its impact on cancer progression.\n35","source_license":"CC0","license_restricted":false}