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Phillips S, Cassells K, Garland SM, Machalek DA, Roberts JM, Templeton DJ, Jin F, Poynten IM, Hillman RJ, Grulich AE, Murray GL, Tabrizi SN, Molano M, Cornall AM. Gene methylation of CADM1 and MAL identified as a biomarker of high grade anal intraepithelial neoplasia. Sci Rep 2022; 12:3565. [PMID: 35241698 PMCID: PMC8894372 DOI: 10.1038/s41598-022-07258-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 02/08/2022] [Indexed: 11/09/2022] Open
Abstract
Human papillomavirus (HPV) is detected in up to 96% of anal squamous cell cancers, where screening programs needed. However, the best methodology is still undetermined. Host DNA methylation markers CADM1, MAL and miR124 have been identified in cervical disease, but not anal disease. Anal swabs varying by disease grade were assessed for DNA methylation of CADM1, MAL and miR124-2. Each marker was compared across disease grades, stratified by HPV and HIV status. Receiver operating characteristic curves identified the predictive value of significant gene candidates. CADM1 methylation was significantly higher in high-grade squamous intraepithelial lesions (HSIL) compared with low-grade (LSIL) (p = 0.005) or normal (p < 0.001) samples with 67.2% correctly identified as HSIL. MAL methylation was significantly (p = 0.002) increased in HSIL compared with LSIL in HIV positive participants with 79.8% correctly indicated as HSIL. Gene miR124-2, showed no difference between disease grades. Biomarkers with established diagnostic value in cervical disease have limited utility in the prediction of anal disease, with CADM1 identified as a marker with screening potential in a gay and bisexual men (GBM) population and MAL in HIV positive GBM population. New markers specific to the anal mucosa are required to improve triage of high-risk individuals.
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Affiliation(s)
- Samuel Phillips
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, 3052, Australia. .,Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia. .,Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
| | - Kahli Cassells
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Suzanne M Garland
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, 3052, Australia.,Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia.,Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Dorothy A Machalek
- Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia.,HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia
| | | | - David J Templeton
- HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia.,Department of Sexual Health Medicine, Sydney Local Health District, Camperdown, NSW, 2050, Australia.,Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Fengyi Jin
- HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia
| | - I Mary Poynten
- HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Richard J Hillman
- HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia.,Dysplasia and Anal Cancer Services, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia
| | - Andrew E Grulich
- HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Gerald L Murray
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, 3052, Australia.,Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia.,Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Sepehr N Tabrizi
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, 3052, Australia.,Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia.,Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Monica Molano
- Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | - Alyssa M Cornall
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, 3052, Australia.,Centre Women's Infectious Diseases Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia.,Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
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Cunha-e-Silva JA, Povedano A, Vassalo E, Kneipp A, Arbex G, do-Val IC. Anal Intraepithelial Neoplasia Associated with High-Grade Vulva Injury (Usual-Type Vulvar Intraepithelial Neoplasia): Surgical Treatment with Cutaneous Flap Advancement. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1055/s-0041-1730941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractThe aim of the present article is to report the case of a young patient with bowenoid papulosis who was a carrier of other sexually-transmitted infections (STIs), such as HIV and high-grade vulva lesion (usual-type vulvar intraepithelial neoplasia, VIN), and to demonstrate the strategy used to manage the case, as well as to discuss important issues regarding the standardization of intraepithelial lesions.8
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Affiliation(s)
| | - Andrea Povedano
- Department of Coloproctology, Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, RJ, Brazil
| | - Eduardo Vassalo
- Department of Coloproctology, Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, RJ, Brazil
| | - Angélica Kneipp
- Department of Coloproctology, Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, RJ, Brazil
| | - Guilherme Arbex
- Department of Plastic Surgery, Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, RJ, Brazil
| | - Isabel Chulvis do-Val
- Department of Gynecology, Hospital Universitário Antônio Pedro, Niterói, Rio de Janeiro, RJ, Brazil
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van der Zee RP, Richel O, van Noesel CJM, Ciocănea-Teodorescu I, van Splunter AP, Ter Braak TJ, Nathan M, Cuming T, Sheaff M, Kreuter A, Meijer CJLM, Quint WGV, de Vries HJC, Prins JM, Steenbergen RDM. Cancer Risk Stratification of Anal Intraepithelial Neoplasia in Human Immunodeficiency Virus-Positive Men by Validated Methylation Markers Associated With Progression to Cancer. Clin Infect Dis 2021; 72:2154-2163. [PMID: 32266940 PMCID: PMC8204787 DOI: 10.1093/cid/ciaa397] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/07/2020] [Indexed: 12/16/2022] Open
Abstract
Background High-grade anal intraepithelial neoplasia (HGAIN; AIN2–3) is highly prevalent in HIV+ men, but only a minority of these lesions progress towards cancer. Currently, cancer progression risk cannot be established; therefore, no consensus exists on whether HGAIN should be treated. This study aimed to validate previously identified host cell DNA methylation markers for detection and cancer risk stratification of HGAIN. Methods A large independent cross-sectional series of 345 anal cancer, AIN3, AIN2, AIN1, and normal control biopsies of HIV+ men was tested for DNA methylation of 6 genes using quantitative methylation-specific PCR. We determined accuracy for detection of AIN3 and cancer (AIN3+) by univariable and multivariable logistic regression analysis, followed by leave-one-out cross-validation. Methylation levels were assessed in a series of 10 anal cancer cases with preceding HGAIN at similar anatomic locations, and compared with the cross-sectional series. Results Methylation levels of all genes increased with increasing severity of disease (P < .05). HGAIN revealed a heterogeneous methylation pattern, with a subset resembling cancer. ZNF582 showed highest accuracy (AUC = 0.88) for AIN3+ detection, slightly improved by addition of ASCL1 and SST (AUC = 0.89), forming a marker panel. In the longitudinal series, HGAIN preceding cancer displayed high methylation levels similar to cancers. Conclusions We validated the accuracy of 5 methylation markers for the detection of anal (pre-) cancer. High methylation levels in HGAIN were associated with progression to cancer. These markers provide a promising tool to identify HGAIN in need of treatment, preventing overtreatment of HGAIN with a low cancer progression risk.
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Affiliation(s)
- Ramon P van der Zee
- Department of Pathology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam, The Netherlands.,Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Olivier Richel
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Iuliana Ciocănea-Teodorescu
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Annina P van Splunter
- Department of Pathology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Timo J Ter Braak
- Department of Pathology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Mayura Nathan
- Homerton Anal Neoplasia Service, Homerton University Hospital, London, United Kingdom
| | - Tamzin Cuming
- Homerton Anal Neoplasia Service, Homerton University Hospital, London, United Kingdom
| | - Michael Sheaff
- Department of Cellular Pathology, Barts Health National Health Service (NHS) Trust, London, United Kingdom
| | - Alexander Kreuter
- Department of Dermatology, Venerology, and Allergology, Helios St Elisabeth Hospital Oberhausen, University Witten/Herdecke, Oberhausen, Germany
| | - Chris J L M Meijer
- Department of Pathology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Rijswijk, The Netherlands
| | - Henry J C de Vries
- Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.,Sexually Transmitted Infections Outpatient Clinic, Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands
| | - Jan M Prins
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam, The Netherlands
| | - Renske D M Steenbergen
- Department of Pathology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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