1
|
Lippert J, Dischinger U, Appenzeller S, Prete A, Kircher S, Skordilis K, Elhassan YS, Altieri B, Fassnacht M, Ronchi CL. Performance of DNA-based biomarkers for classification of adrenocortical carcinoma: a prognostic study. Eur J Endocrinol 2023; 189:262-270. [PMID: 37590967 DOI: 10.1093/ejendo/lvad112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/16/2023] [Accepted: 06/14/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Adrenocortical carcinoma (ACC) is a rare aggressive malignancy with heterogeneous clinical outcomes. Recent studies proposed a combination of clinical/histopathological parameters (S-GRAS score) or molecular biomarkers (BMs) to improve prognostication. We performed a comparative analysis of DNA-based BMs by evaluating their added prognostic value to the S-GRAS score. DESIGN AND METHODS A total of 194 formalin-fixed, paraffin-embedded (FFPE) ACC samples were analysed, including a retrospective training cohort (n = 107) and a prospective validation cohort (n = 87). Targeted DNA sequencing and pyrosequencing were used to detect somatic single-nucleotide variations in ACC-specific genes and methylation in the promoter region of paired box 5 (PAX5). The European Network for the Study of Adrenocortical Tumors (ENSAT) tumour stage, age, symptoms at presentation, resection status, and Ki-67 were combined to calculate S-GRAS. Endpoints were overall (OS), progression-free (PFS), and disease-free survival (DFS). Prognostic role was evaluated by multivariable survival analysis and their performance compared by Harrell's concordance index (C index). RESULTS In training cohort, an independent prognostic role was confirmed at multivariate analysis for two DNA-based BMs: alterations in Wnt/β-catenin and Rb/p53 pathways and hypermethylated PAX5 (both P< .05 for PFS and DFS, hazard ratio [HR] 1.47-2.33). These were combined to S-GRAS to obtain a combined (COMBI) score. At comparative analysis, the best discriminative prognostic model was COMBI score in both cohorts for all endpoints, followed by S-GRAS score (C index for OS 0.724 and 0.765, PFS 0.717 and 0.670, and DFS 0.699 and 0.644, respectively). CONCLUSIONS Targeted DNA-based BM evaluated on routinely available FFPE samples improves prognostication of ACC beyond routinely available clinical and histopathological parameters. This approach may help to better individualise patient's management.
Collapse
Affiliation(s)
- Juliane Lippert
- Division of Endocrinology and Diabetes, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Ulrich Dischinger
- Division of Endocrinology and Diabetes, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Silke Appenzeller
- Core Unit Bioinformatics, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, 97078 Würzburg, Germany
| | - Alessandro Prete
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B152TT, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham B152TT, United Kingdom
- NIHR Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham B152TT, United Kingdom
| | - Stefan Kircher
- Department of Pathology, University of Würzburg, 97078 Würzburg, Germany
| | - Kassiani Skordilis
- Department of Histopathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B152GW, United Kingdom
| | - Yasir S Elhassan
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B152TT, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham B152TT, United Kingdom
| | - Barbara Altieri
- Division of Endocrinology and Diabetes, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Martin Fassnacht
- Division of Endocrinology and Diabetes, University Hospital of Würzburg, 97080 Würzburg, Germany
- Comprehensive Cancer Centre Mainfranken (CCCM), University of Würzburg, 97078 Würzburg, Germany
- Central Labor, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Cristina L Ronchi
- Division of Endocrinology and Diabetes, University Hospital of Würzburg, 97080 Würzburg, Germany
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B152TT, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham B152TT, United Kingdom
| |
Collapse
|
2
|
Birknerova N, Mancikova V, Paul ED, Matyasovsky J, Cekan P, Palicka V, Parova H. Circulating Cell-Free DNA-Based Methylation Pattern in Saliva for Early Diagnosis of Head and Neck Cancer. Cancers (Basel) 2022; 14:4882. [PMID: 36230805 PMCID: PMC9563959 DOI: 10.3390/cancers14194882] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
Head and neck cancer (HNC) remains one of the leading causes of mortality worldwide due to tumor diagnosis at a late stage, loco-regional aggression, and distant metastases. A standardized diagnostic procedure for HNC is a tissue biopsy that cannot faithfully portray the in-depth tumor dynamics. Therefore, there is an urgent need to develop simple, accurate, and non-invasive methods for cancer detection and follow-up. A saliva-based liquid biopsy allows convenient, non-invasive, and painless collection of high volumes of this biofluid, with the possibility of repetitive sampling, all enabling real-time monitoring of the disease. No approved clinical test for HNC has yet been established. However, epigenetic changes in saliva circulating cell-free DNA (cfDNA) have the potential for a wide range of clinical applications. Therefore, the aim of this review is to present an overview of cfDNA-based methylation patterns in saliva for early detection of HNC, with particular attention to circulating tumor DNA (ctDNA). Due to advancements in isolation and detection technologies, as well as next- and third-generation sequencing, recent data suggest that salivary biomarkers may be successfully applied for early detection of HNC in the future, but large prospective clinical trials are still warranted.
Collapse
Affiliation(s)
- Natalia Birknerova
- Department of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Kralove and University Hospital, Charles University, 50005 Hradec Kralove, Czech Republic
- MultiplexDX s.r.o., Comenius University Science Park, Ilkovicova 8, 84104 Bratislava, Slovakia
- MultiplexDX Inc., One Research Court, Suite 450, Rockville, MD 20850, USA
| | - Veronika Mancikova
- MultiplexDX s.r.o., Comenius University Science Park, Ilkovicova 8, 84104 Bratislava, Slovakia
- MultiplexDX Inc., One Research Court, Suite 450, Rockville, MD 20850, USA
| | - Evan David Paul
- MultiplexDX s.r.o., Comenius University Science Park, Ilkovicova 8, 84104 Bratislava, Slovakia
- MultiplexDX Inc., One Research Court, Suite 450, Rockville, MD 20850, USA
| | - Jan Matyasovsky
- MultiplexDX s.r.o., Comenius University Science Park, Ilkovicova 8, 84104 Bratislava, Slovakia
- MultiplexDX Inc., One Research Court, Suite 450, Rockville, MD 20850, USA
| | - Pavol Cekan
- MultiplexDX s.r.o., Comenius University Science Park, Ilkovicova 8, 84104 Bratislava, Slovakia
- MultiplexDX Inc., One Research Court, Suite 450, Rockville, MD 20850, USA
| | - Vladimir Palicka
- Department of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Kralove and University Hospital, Charles University, 50005 Hradec Kralove, Czech Republic
| | - Helena Parova
- Department of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Kralove and University Hospital, Charles University, 50005 Hradec Kralove, Czech Republic
| |
Collapse
|
3
|
Zheng L, He J, Li M, Yuan H, Li H, Hu F, Chen L, Tang W, Sheng M. Clinical significance and mechanism of long noncoding RNA HAGLROS in triple negative breast cancer. Pathol Res Pract 2022; 231:153810. [DOI: 10.1016/j.prp.2022.153810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/27/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
|