Chromosome fragility in lymphocytes of women with cervical uterine lesions produced by human papillomavirus

Prevalence of micronuclei in exfoliated uterine cervical cells from patients with risk factors for cervical cancer

CONTEXT AND OBJECTIVE

Pap smears are the most common and inexpensive screening method for cervical cancer. We analyzed micronucleus prevalence in exfoliated cervical mucosa cells, to investigate associations between increased numbers of micronuclei and risk factors for cervical cancer.

DESIGN AND SETTING

Analytical cross-sectional study, at Instituto de Pesquisa em Oncologia (IPON).

METHODS

Exfoliated cervical cells were obtained from 101 patients between September 2004 and November 2005. Patients' ages, habits (passive or active smoking, alcoholism and numbers of sexual partners), age at first sexual intercourse, contraceptive methods used, histories of sexually transmitted diseases, use of hormone replacement therapy, numbers of pregnancies and abortions, inflammatory cytology and cervical intraepithelial neoplasia (CIN) were obtained. Cells were collected using Ayre spatulas, transferred to vials containing 0.9% saline solution for micronucleus tests and analyzed at 1000x magnification. The number of micronuclei in 1,000 epithelial cells per patient sample was counted.

RESULTS

Comparisons between groups with active (7.9 +/- 7.8) and passive (7.2 +/- 10.6) smoking versus no smoking (3.7 +/- 5.1); with/without alcoholism (7.8 +/- 1.4 and 6.9 +/- 10.1); with/without inflammatory cytology (10.7 +/- 10.5 and 1.3 +/- 1.7); and with CIN I, II and III and no CIN (respectively 4.3 +/- 4.3, 10.6 +/- 5.3, 22.7 +/- 11.9 and 1.3 +/- 1.4) found elevated micronucleus prevalence (P < 0.05).

CONCLUSIONS

We concluded that the prevalence of micronuclei in exfoliated uterine cervical cells was greater in patients with one or more risk factors for uterine cervical cancer than in patients without risk factors.

Genetic alterations in cancer as a result of breakage at fragile sites

The organization and replication of DNA render fragile sites (FSs) prone to breakage, recombination as well as becoming preferential targets for mutagens-carcinogens and integration of oncogenic viruses. For many years, attempts to link FSs and cancer generated mostly circumstantial evidence. The discoveries that chromosome translocations, amplification of proto-oncogenes, deletion of tumor suppressor genes, and integration of oncogenic viruses all result from the specific breakage of genomic DNA at FSs, however, have provided compelling support for such a link, further suggesting a causative role for FSs in cancer.

Micronuclei in cervical smears and peripheral blood lymphocytes from women with and without cervical uterine cancer

Cervical cancer represents the second most common malignant neoplasia in women world-wide. In Mexico, cervical cancer is the most common female malignancy. It has been recently seen an increased frequencies of micronuclei (MN) lymphocytes and cervical epithelial cells of cervical cancer patients. The aim of this hospital-based unmatched case-control study was to investigate the association between progressive stages in development of cervical cancer and frequency of micronucleated cells in the cervical epithelium and peripheral lymphocytes of 40 women, grouped by disease stage. Women at the Obstetrics and Gynecology Hospital of the Instituto Mexicano del Seguro Social (IMSS) in Monterrey, Mexico were diagnosed and classified on the bases of the Papanicolaou (PAP) smear and colposcopy/biopsy into control, low-grade squamous intraepithelial lesions (LGSIL), high-grade squamous intraepithelial lesions (HGSIL), and invasive groups. Analysis of the MN data in both cell types revealed (a) homogeneity among women within each of the four groups with regard to MN frequency, (b) in general, a correlation between MN frequency and grade of cervical lesion, and (c) a positive linear trend between the MN frequency and increased cervical cancer risk. In conclusion, we suggest that MN are a useful biomarker of cancer risk. Nonetheless, these results should be validated by other researchers.

Sister chromatid exchanges in peripheral lymphocytes from women with carcinoma of the uterine cervix

Sister chromatid exchanges (SCE) are reciprocal exchanges between sister chromatids. It has been reported that in patients with cervical cancer, the frequency of SCE in peripheral lymphocytes is significantly higher than that in normal individuals; however, other studies have shown no significant difference. The aim of this unmatched case-control study was to compare the mean number of SCE per metaphase in lymphocytes from women with and without carcinoma of the cervix uteri. The SCE specimens were prepared by the fluorescence plus giemsa technique in peripheral lymphocytes from 28 women with carcinoma of cervix uteri and 28 controls. The mean number of SCE per metaphase in women with carcinoma of cervix uteri (7.80 +/- 1.05) was higher than the control group (6.98 +/- 1.13) (P < 0.05; t-test). This study had a statistical power of 0.80 and an alpha value of 0.05. This finding suggests that an increased number of SCE in peripheral lymphocytes is associated with cervical cancer. We consider that the lack of reported association of SCE and cervical cancer might be attributed to the none determination of the statistical power and sample size.

Telomeric association in women with breast and uterine cervix cancer

This study compares the frequency of telomeric associations in the peripheral blood of women suffering breast and cervix uterine cancer with a healthy control group. Two kinds of cultures were developed for each individual: with and without aphidicolin. In the normal cultures, the number of telomeric associations observed was 95.5 times higher in individuals affected by breast cancer and 41.3 times higher in those affected by cervix uterine cancer when compared to the control group (p < 0.001). In the cultures with aphidicolin, higher numbers of altered metaphases were observed in both groups as compared to the control groups (p < 0.001). Statistically significant differences (p < 0.001) could also be observed when comparing telomeric associations between the two types of cancer in both cultures. When we compared individuals affected by breast cancer in both types of cultures statistical differences were found (p < 0.05), and similar results were found in individuals affected by uterine cervix cancer (p < 0.001). The findings suggest that telomeric associations may be reflecting chromosome instability observed in cancer and that this instability behaves differently for various types of cancer.

Spontaneous genomic fragility and cell cycle progression in lymphocytes of patients with cervical carcinoma

Thirty patients with invasive carcinoma of the cervix, along with 15 age-matched healthy females as controls, were studied to examine the frequency of spontaneous SCEs, chromosomal aberrations (CAs), and cell cycle progression in lymphocytes. The frequency of SCEs and TCAs was statistically significant in the patients over the control group. The correlation of SCEs and TCAs with the stage of cancer, age, and number of pregnancies was also made. The cell cycle of lymphocytes showed its prolongation in the patients, as is evident from the higher proportion of cells at M1 (metaphase of first cell division after 72 hours).

Expression of aphidicolin-induced fragile sites in lymphocytes of patients with breast cancer

The expression of fragile sites induced by aphidicolin (APC) was evaluated on metaphase chromosomes obtained from the peripheral blood lymphocytes of 26 women with breast cancer and 15 sex- and age-matched normal controls. Both the proportion of damaged cells (P < 0.001) and the mean number of gaps and breaks per cell (0.02 < P < 0.05) were significantly higher in the patient group. There were no differences in either the age-related fragile site levels or the expression of single fragile sites between patients and controls. Our findings indicate an increased genetic instability in women with breast carcinoma.