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Hulstaert E, Levanon K, Morlion A, Van Aelst S, Christidis AA, Zamar R, Anckaert J, Verniers K, Bahar-Shany K, Sapoznik S, Vandesompele J, Mestdagh P. RNA biomarkers from proximal liquid biopsy for diagnosis of ovarian cancer. Neoplasia 2022; 24:155-164. [PMID: 34998206 PMCID: PMC8740458 DOI: 10.1016/j.neo.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/20/2021] [Indexed: 10/29/2022]
Abstract
BACKGROUND Most ovarian cancer patients are diagnosed at an advanced stage and have a high mortality rate. Current screening strategies fail to improve prognosis because markers that are sensitive for early stage disease are lacking. This medical need justifies the search for novel approaches using utero-tubal lavage as a proximal liquid biopsy. METHODS In this study, we explore the extracellular transcriptome of utero-tubal lavage fluid obtained from 26 ovarian cancer patients and 48 controls using messenger RNA (mRNA) capture and small RNA sequencing. RESULTS We observed an enrichment of ovarian and fallopian tube specific messenger RNAs in utero-tubal lavage fluid compared to other human biofluids. Over 300 mRNAs and 41 miRNAs were upregulated in ovarian cancer samples compared with controls. Upregulated genes were enriched for genes involved in cell cycle activation and proliferation, hinting at a tumor-derived signal. CONCLUSION This is a proof-of-principle that mRNA capture sequencing of utero-tubal lavage fluid is technically feasible, and that the extracellular transcriptome of utero-tubal lavage should be further explored in larger cohorts to assess the diagnostic value of the biomarkers identified in this study. IMPACT Proximal liquid biopsy from the gynecologic tract is a promising source for mRNA and miRNA biomarkers for diagnosis of early-stage ovarian cancer.
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Affiliation(s)
- Eva Hulstaert
- Department of Biomolecular Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; OncoRNALab, Cancer Research Institute Ghent (CRIG), Corneel Heymanslaan 10, 9000 Ghent, Belgium; Department of Dermatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Keren Levanon
- Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Annelien Morlion
- Department of Biomolecular Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; OncoRNALab, Cancer Research Institute Ghent (CRIG), Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | | | | | - Ruben Zamar
- Department of Statistics, University of British Columbia, Vancouver, Canada
| | - Jasper Anckaert
- Department of Biomolecular Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; OncoRNALab, Cancer Research Institute Ghent (CRIG), Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Kimberly Verniers
- Department of Biomolecular Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; OncoRNALab, Cancer Research Institute Ghent (CRIG), Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Keren Bahar-Shany
- Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Stav Sapoznik
- Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Jo Vandesompele
- Department of Biomolecular Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; OncoRNALab, Cancer Research Institute Ghent (CRIG), Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Pieter Mestdagh
- Department of Biomolecular Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; OncoRNALab, Cancer Research Institute Ghent (CRIG), Corneel Heymanslaan 10, 9000 Ghent, Belgium.
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Jacobson M, Coakley N, Bernardini M, Branco KA, Elit L, Ferguson S, Kim R. Risk reduction strategies for BRCA1/2 hereditary ovarian cancer syndromes: a clinical practice guideline. Hered Cancer Clin Pract 2021; 19:39. [PMID: 34565426 PMCID: PMC8474940 DOI: 10.1186/s13053-021-00196-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The purpose of this guideline is to make recommendations regarding the care of women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2. METHODS Draft recommendations were formulated based on evidence obtained through a systematic review of RCTs, comparative retrospective studies and guideline endorsement. The draft recommendations underwent an internal review by clinical and methodology experts, and an external review by clinical practitioners. RESULTS The literature search yielded 1 guideline, 5 systematic reviews, and 15 studies that met the eligibility criteria. CONCLUSIONS In women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2 screening for ovarian cancer is not recommended. Risk-reducing surgery is recommended to reduce the risk of ovarian cancer. In the absence of contraindications, premenopausal women undergoing RRSO should be offered hormone therapy until menopause. Systemic hormone replacement therapy, is not recommended for women who have had a personal history of breast cancer. RRSO should be considered for breast cancer risk reduction in women younger than 50 years. After a breast cancer diagnosis, RRSO for breast cancer mortality reduction can be considered within two years to women who harbour a pathogenic or likely pathogenic variant in BRCA1 if younger than the recommended age range for ovarian cancer risk reduction. RRSO before the age of 40 and specifically for breast cancer treatment in BRCA2 should be considered only if recommended by their breast cancer oncologist. Following RRSO, it is not recommended to do surveillance for peritoneal cancer.
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Affiliation(s)
- Michelle Jacobson
- Women’s College Hospital, Toronto, ON Canada
- University of Toronto, Toronto, ON Canada
| | - Nadia Coakley
- Department of Oncology, McMaster University, Hamilton, ON Canada
- Ontario Health’s Cancer Care Ontario’s Program in Evidence-based care, McMaster University, Juravinski Site, G Wing, 2nd Floor room 227, 711 Concession Street, Hamilton, ON L8V 1C3 Canada
| | - Marcus Bernardini
- University of Toronto, Toronto, ON Canada
- Princess Margaret Cancer Center, University Health Network (UHN) Toronto, Mount Sinai, Toronto, ON Canada
| | | | - Laurie Elit
- Department of Oncology, McMaster University, Hamilton, ON Canada
- Hamilton Health Sciences Centre-Juravinski Cancer Centre, Hamilton, ON Canada
| | - Sarah Ferguson
- University of Toronto, Toronto, ON Canada
- Ontario Health, Cancer Care Ontario, Toronto, ON Canada
- University Health Network (UHN), Toronto, ON Canada
| | - Raymond Kim
- University of Toronto, Toronto, ON Canada
- Princess Margaret Cancer Centre, Toronto, ON Canada
- Sick Kids Hospital, Toronto, ON Canada
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Gant KL, Jambor AN, Li Z, Rentchler EC, Weisman P, Li L, Patankar MS, Campagnola PJ. Evaluation of Collagen Alterations in Early Precursor Lesions of High Grade Serous Ovarian Cancer by Second Harmonic Generation Microscopy and Mass Spectrometry. Cancers (Basel) 2021; 13:cancers13112794. [PMID: 34199725 PMCID: PMC8200041 DOI: 10.3390/cancers13112794] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The collagen architecture in the extracellular matrix (ECM) is highly remodeled in high grade serous ovarian cancer (HGSOC). Many of these tumors begin in the fallopian tubes (FT) before metastasizing to the ovaries and it is important to study ECM alterations in carcinogenesis. Here, we used Second Harmonic Generation (SHG) microscopy to classify changes in the collagen fiber morphology in normal FT, and precursor pure p53 signatures and serous tubal intraepithelial carcinoma (STICs) in tissues with no HGSOC. Using a machine learning approach based on image features, we were able to discriminate the tissue groups with good classification accuracy. We additionally performed mass spectrometry analysis of normal and HGSOC tissues to associate the differential expression of collagen isoforms with fiber morphology alterations. This work provides new insights into ECM remodeling in early stage HGSOC and suggests the combined use of SHG microscopy and mass spectrometry as a new diagnostic/prognostic approach. Abstract Background: The collagen architecture in high grade serous ovarian cancer (HGSOC) is highly remodeled compared to the normal ovary and the fallopian tubes (FT). We previously used Second Harmonic Generation (SHG) microscopy and machine learning to classify the changes in collagen fiber morphology occurring in serous tubal intraepithelial carcinoma (STIC) lesions that are concurrent with HGSOC. We now extend these studies to examine collagen remodeling in pure p53 signatures, STICs and normal regions in tissues that have no concurrent HGSOC. This is an important distinction as high-grade disease can result in distant collagen changes through a field effect mechanism. Methods: We trained a linear discriminant model based on SHG texture and image features as a classifier to discriminate the tissue groups. We additionally performed mass spectrometry analysis of normal and HGSOC tissues to associate the differential expression of collagen isoforms with collagen fiber morphology alterations. Results: We quantified the differences in the collagen architecture between normal tissue and the precursors with good classification accuracy. Through proteomic analysis, we identified the downregulation of single α-chains including those for Col I and III, where these results are consistent with our previous SHG-based supramolecular analyses. Conclusion: This work provides new insights into ECM remodeling in early ovarian cancer and suggests the combined use of SHG microscopy and mass spectrometry as a new diagnostic/prognostic approach.
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Affiliation(s)
- Kristal L. Gant
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53706, USA;
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA; (A.N.J.); (E.C.R.)
| | - Alexander N. Jambor
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA; (A.N.J.); (E.C.R.)
| | - Zihui Li
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI 53706, USA; (Z.L.); (L.L.)
| | - Eric C. Rentchler
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA; (A.N.J.); (E.C.R.)
| | - Paul Weisman
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI 53706, USA;
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Lingjun Li
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI 53706, USA; (Z.L.); (L.L.)
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53706, USA
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Manish S. Patankar
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53706, USA;
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53706, USA
- Correspondence: (M.S.P.); (P.J.C.)
| | - Paul J. Campagnola
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA; (A.N.J.); (E.C.R.)
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53706, USA
- Correspondence: (M.S.P.); (P.J.C.)
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Uppal S, Medlin E, Felder M, Kapur A, Sterner RC, Vazquez J, Lindner PN, Stanic AK, Barroilhet L, Gonzalez-Bosquet J, Patankar MS. Identifying novel ovarian tumor biomarkers through mining of the transcriptome of circulating immune cells: A proof-of-concept study. Am J Reprod Immunol 2021; 86:e13469. [PMID: 34022086 DOI: 10.1111/aji.13469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Treatment of high-grade serous ovarian cancer (HGSOC) will benefit from early detection of cancer. Here, we provide proof-of-concept data supporting the hypothesis that circulating immune cells, because of their early recognition of tumors and the tumor microenvironment, can be considered for biomarker discovery. METHODS Longitudinal blood samples from C57BL/6 mice bearing syngeneic ovarian tumors and peripheral blood mononuclear cells (PBMC) from healthy postmenopausal women and newly diagnosed for HGSOC patients were subjected to RNASeq. The results from human immune cells were validated using Affymetrix microarrays. Differentially expressed transcripts in immune cells from tumor-bearing mice and HGSOC patients were compared to matching controls. RESULTS A total of 1282 transcripts (798 and 484, up- and downregulated, respectively) were differentially expressed in the tumor-bearing mice as compared with controls. Top 100 genes showing longitudinal changes in gene expression 2, 4, 7, and 18 days after tumor implantation were identified. Analysis of the PBMC from healthy post-menopausal women and HGSOC patients identified 4382 differentially expressed genes and 519 of these were validated through Affymetrix microarray analysis. A total of 384 genes, including IL-1R2, CH3L1, Infitm1, FP42, CXC42, Hdc, Spib, and Sema6b, were differentially expressed in the human and mouse datasets. CONCLUSION The PBMC transcriptome shows longitudinal changes in response to the progressing tumor. Several potential biomarker transcripts were identified in HGSOC patients and mouse models. Monitoring their expression in individual PBMC subsets can serve as additional discriminator for the diagnosis of HGSOC.
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Affiliation(s)
- Shitanshu Uppal
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Erin Medlin
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Mildred Felder
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Arvinder Kapur
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Robert C Sterner
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Jessica Vazquez
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Payton N Lindner
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Aleksandar K Stanic
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lisa Barroilhet
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Manish S Patankar
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI, USA
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The Diagnostic Accuracy of Human Epididymis Factor 4 for the Prediction of Optimal Debulking in Patients With Ovarian Cancer: A Meta-Analysis of Observational Studies. Int J Gynecol Cancer 2019; 28:1471-1477. [PMID: 30036230 DOI: 10.1097/igc.0000000000001330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Human epididymis factor-4 (HE4) has been studied in the field of ovarian cancer with promising results during the last decade. The purpose of the present meta-analysis is to investigate the diagnostic accuracy of HE4, in terms of sensitivity and specificity, as a minimally invasive method to predict optimal debulking in women that experience ovarian cancer. METHODS We used the Medline (1966-2017), Scopus (2004-2017), EMBASE, ClinicalTrials.gov (2008-2017) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases in our primary search, along with the reference lists of electronically retrieved full-text articles. RESULTS Eleven articles were finally retrieved that enrolled 1065 women with ovarian cancer. Three of those were excluded because data were insufficient to introduce them in the meta-analysis. The sensitivity of HE4 for the prediction of optimal debulking was 0.81 (95% confidence interval [CI] 0.74-0.86) and the pooled specificity 0.80 (95% CI 0.75-0.84). The diagnostic odds ratio was 13.88 (95% CI 7.18-26.84) and the area under the curve, 0.86±0.03. After selecting only studies that enrolled patients with advanced disease who had primary debulking surgery, we observed that the pooled sensitivity reached 0.81 (95% CI 0.72-0.88), and the pooled specificity 0.70 (95% CI 0.62-0.78), with an area under the curve of 0.88±0.04. CONCLUSIONS Human epididymis factor-4 seems to be promising as a minimally invasive method to predict optimal cytoreduction among patients with ovarian cancer. However, interpretation of our findings should be approached with caution because of the significant heterogeneity of included studies.
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Giampaolino P, Della Corte L, Foreste V, Vitale SG, Chiofalo B, Cianci S, Zullo F, Bifulco G. Unraveling a difficult diagnosis: the tricks for early recognition of ovarian cancer. Minerva Med 2019; 110:279-291. [PMID: 31081307 DOI: 10.23736/s0026-4806.19.06086-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Epithelial ovarian cancer (EOC) is the predominant type of ovarian cancer (OC). The 5-year survival of patients has improved over the last three decades, although the overall cure rate of OC if about 30%. Despite high response rates after initial chemotherapy, most patients with advanced ovarian cancer ultimately develop the recurrent disease because of resistance to chemotherapy. A proper early diagnosis and treatment of patients with ovarian cancer are urgently needed. Nowadays the diagnosis is performed by means of clinical symptoms and signs, often indicators of a disease already at an advanced stage, tumor markers (CA125 and HE4), transvaginal ultrasonography and imaging, very useful in distinguishing adnexal masses. Understand the nature of an adnexal mass is the primary point to begin the diagnosis of OC. Validated different model to approach and characterize adnexal pathology preoperatively are described, such as the International Ovarian Tumor Analysis (IOTA) and the Assessment of Different NEoplasias in the AdneXa (ADNEX) model. New tumor markers, such as PRSS8, FOLR1, KLK6/7, GSTT1, and miRNAs, are getting ahead and are worth noting for early detection of ovarian cancer. Despite the development of numerous ultrasound models for the diagnosis of adnexal masses and the analysis of different tumor markers, the early diagnosis of ovarian cancer is still difficult to practice. Moreover, identifying genetic risk alleles, such as germline BRCA1 and BRCA2 mutations, for ovarian cancer has had a significant impact on disease prevention strategies.
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Affiliation(s)
- Pierluigi Giampaolino
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Virginia Foreste
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Salvatore G Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy -
| | - Benito Chiofalo
- Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - Stefano Cianci
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Bifulco
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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Barnabas GD, Bahar-Shany K, Sapoznik S, Helpman L, Kadan Y, Beiner M, Weitzner O, Arbib N, Korach J, Perri T, Katz G, Blecher A, Brandt B, Friedman E, Stockheim D, Jakobson-Setton A, Eitan R, Armon S, Brand H, Zadok O, Aviel-Ronen S, Harel M, Geiger T, Levanon K. Microvesicle Proteomic Profiling of Uterine Liquid Biopsy for Ovarian Cancer Early Detection. Mol Cell Proteomics 2019; 18:865-875. [PMID: 30760538 DOI: 10.1074/mcp.ra119.001362] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Indexed: 12/28/2022] Open
Abstract
High-grade ovarian cancer (HGOC) is the leading cause of mortality from gynecological malignancies, because of diagnosis at a metastatic stage. Current screening options fail to improve mortality because of the absence of early-stage-specific biomarkers. We postulated that a liquid biopsy, such as utero-tubal lavage (UtL), may identify localized lesions better than systemic approaches of serum/plasma analysis. Further, while mutation-based assays are challenged by the rarity of tumor DNA within nonmutated DNA, analyzing the proteomic profile, is expected to enable earlier detection, as it reveals perturbations in both the tumor as well as in its microenvironment. To attain deep proteomic coverage and overcome the high dynamic range of this body fluid, we applied our method for microvesicle proteomics to the UtL samples. Liquid biopsies from HGOC patients (n = 49) and controls (n = 127) were divided into a discovery and validation sets. Data-dependent analysis of the samples on the Q-Exactive mass spectrometer provided depth of 8578 UtL proteins in total, and on average ∼3000 proteins per sample. We used support vector machine algorithms for sample classification, and crossed three feature-selection algorithms, to construct and validate a 9-protein classifier with 70% sensitivity and 76.2% specificity. The signature correctly identified all Stage I lesions. These results demonstrate the potential power of microvesicle-based proteomic biomarkers for early cancer diagnosis.
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Affiliation(s)
- Georgina D Barnabas
- From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Keren Bahar-Shany
- §Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel;; From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Stav Sapoznik
- §Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Limor Helpman
- ¶Division of Gynecologic Oncology, Meir Medical Center, Kfar Saba, Israel;; ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Yfat Kadan
- ¶Division of Gynecologic Oncology, Meir Medical Center, Kfar Saba, Israel
| | - Mario Beiner
- ¶Division of Gynecologic Oncology, Meir Medical Center, Kfar Saba, Israel
| | - Omer Weitzner
- **Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Nissim Arbib
- **Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Jacob Korach
- ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; ‡‡Department of Gynecologic Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Tamar Perri
- ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; ‡‡Department of Gynecologic Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Guy Katz
- ‡‡Department of Gynecologic Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Anna Blecher
- ‡‡Department of Gynecologic Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Benny Brandt
- ‡‡Department of Gynecologic Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Eitan Friedman
- ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; §§The Susanne-Levy Gertner Oncogenetics Unit, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - David Stockheim
- ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; ¶¶Department of Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Ariella Jakobson-Setton
- ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; ‖‖Department of Gynecologic Oncology, Rabin Medical Center, Petah Tikva, Israel
| | - Ram Eitan
- ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; ‖‖Department of Gynecologic Oncology, Rabin Medical Center, Petah Tikva, Israel
| | - Shunit Armon
- ‡‡‡Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Hadar Brand
- §Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel;; ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Oranit Zadok
- §§§Department of Pathology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Sarit Aviel-Ronen
- §§§Department of Pathology, Chaim Sheba Medical Center, Ramat Gan, Israel;; ¶¶¶The Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Michal Harel
- From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Tamar Geiger
- From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;.
| | - Keren Levanon
- §Sheba Cancer Research Center, Chaim Sheba Medical Center, Ramat Gan, Israel;; ‖Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;; ¶¶¶The Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Ramat Gan, Israel; From the ‡Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel;.
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Andersen MR, Karlan BY, Drescher CW, Paley P, Hawley S, Palomares M, Daly MB, Urban N. False-positive screening events and worry influence decisions about surgery among high-risk women. Health Psychol 2019; 38:43-52. [PMID: 30431292 PMCID: PMC6738558 DOI: 10.1037/hea0000647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Studies of cancer screening have found that false positive screening events (FPSE) can affect worry about cancer risk and screening program use, we sought to further explore this. METHOD In a study of 1,100 women at high risk for ovarian cancer who participated in a previously published randomized controlled trial (RCT), we sought to explore whether worry might also influence the use of risk-reducing surgical procedures by women. Participants included 234 women with BRCA1/2 mutations and 866 women with high-risk pedigrees. We followed the women for up to 6 years. RESULTS Worry predicted risk reducing prophylactic bilateral salpingo-oophorectomy (pBSO) for both mutation carriers (HR = 1.74; p = .02), and women with high-risk pedigree (HR = 3.41; p < .001). FPSE also predicted subsequent pBSO among women with a high-risk pedigree (HR 2.31; p < .01). While screening may reduce worry among those who never receive a positive result, FPSE increase worry at least temporarily. Worry about ovarian cancer risk predicted use of preventative pBSO among high-risk women including those with BRCA1/2 mutations enrolled in an ovarian cancer-screening program. FPSE also predicted risk-reducing ovarian surgery among high-risk women without a known mutation at the time of screening program enrollment. CONCLUSIONS Physicians who offer screening should know that false positive results may increase use of pBSO, how this should effect clinical practice is unclear. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Gschwantler-Kaulich D, Weingartshofer S, Rappaport-Fürhauser C, Zeilinger R, Pils D, Muhr D, Braicu EI, Kastner MT, Tan YY, Semmler L, Sehouli J, Singer CF. Diagnostic markers for the detection of ovarian cancer in BRCA1 mutation carriers. PLoS One 2017; 12:e0189641. [PMID: 29244844 PMCID: PMC5731824 DOI: 10.1371/journal.pone.0189641] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 11/28/2017] [Indexed: 11/18/2022] Open
Abstract
Background Screening for ovarian cancer (OC) in women at high risk consists of a combination of carbohydrate antigen 125 (CA125) and transvaginal ultrasound, despite their low sensitivity and specificity. This could be improved by the combination of several biomarkers, which has been shown in average risk patients but has not been investigated until now in female BRCA mutation carriers. Methods Using a multiplex, bead-based, immunoassay system, we analyzed the concentrations of leptin, prolactin, osteopontin, insulin-like growth factor II, macrophage inhibitory factor, CA125 and human epididymis antigen 4 in 26 healthy wild type women, 26 healthy BRCA1 mutation carriers, 28 wildtype OC patients and 26 OC patients with BRCA1 mutation. Results Using the ROC analysis, we found a high overall sensitivity of 94.3% in differentiating healthy controls from OC patients with comparable results in the wildtype subgroup (sensitivity 92.8%, AUC = 0.988; p = 5.2e-14) as well as in BRCA1 mutation carriers (sensitivity 95.2%, AUC = 0.978; p = 1.7e-15) at an overall specificity of 92.3%. The used algorithm also allowed to identify healthy BRCA1 mutation carriers when compared to healthy wildtype women (sensitivity 88.4%, specificity 80.7%, AUC = 0.895; p = 6e-08), while this was less pronounced in patients with OC (sensitivity 66.7%, specificity 67.8%, AUC = 0.724; p = 0.00065). Conclusion We have developed an algorithm, which can differentiate between healthy women and OC patients and have for the first time shown, that such an algorithm can also be used in BRCA mutation carriers. To clarify a suggested benefit to the existing early detection program, large prospective trials with mainly early stage OC cases are warranted.
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Affiliation(s)
- Daphne Gschwantler-Kaulich
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
- * E-mail:
| | - Sigrid Weingartshofer
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
| | | | - Robert Zeilinger
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
| | - Dietmar Pils
- Section for Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems (CeMSIIS), Medical University of Vienna, Vienna, Austria
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Daniela Muhr
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
| | - Elena I. Braicu
- Department of Gynecology with Center for Oncological Surgery, European Competence Center for Ovarian Cancer, Charité - Campus Virchow-Klinikum, University Medicine of Berlin, Berlin, Germany
| | - Marie-Therese Kastner
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
| | - Yen Y. Tan
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
- QIMR Berghofer Medical Research Institute, Herston QLD, Australia
| | - Lorenz Semmler
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, European Competence Center for Ovarian Cancer, Charité - Campus Virchow-Klinikum, University Medicine of Berlin, Berlin, Germany
| | - Christian F. Singer
- Department of Obstetrics and Gynecology, Cancer Comprehensive Center, Medical University Vienna, Vienna, Austria
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10
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Jones MR, Kamara D, Karlan BY, Pharoah PDP, Gayther SA. Genetic epidemiology of ovarian cancer and prospects for polygenic risk prediction. Gynecol Oncol 2017; 147:705-713. [PMID: 29054568 DOI: 10.1016/j.ygyno.2017.10.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 12/18/2022]
Abstract
Epithelial ovarian cancer (EOC) is a heterogeneous disease with a major heritable component. The different histotypes of invasive disease - high grade serous, clear cell, endometrioid and mucinous - are associated with different underlying genetic susceptibility and epidemiological and lifestyle risk factors, all of which contribute to the different biology and clinical characteristics of each histotype. A combination of familial and population based sequencing studies, and genome wide association studies (GWAS) have identified a range of genetic susceptibility alleles for EOC comprising rare but highly penetrant genes (e.g. BRCA1, BRCA2) that are responsible for familial clustering of ovarian cancer cases; more moderate penetrance susceptibility genes (e.g. BRIP1, RAD51C/D, MSH6); and multiple common but low penetrance susceptibility alleles identified by GWAS. Identifying genetic risk alleles for ovarian cancer has had a significant impact on disease prevention strategies; for example it is now routine clinical practice for individuals with germline BRCA1 and BRCA2 mutations to undergo risk reducing salpingo-oophorectomy. Because ovarian cancers are commonly diagnosed at a late clinical stage when the prognosis is poor, the continued development of genetic risk prediction and prevention strategies will represent an important approach to reduce mortality due to ovarian cancer. Advances in genomics technologies that enable more high-throughput genetic testing, combined with research studies that identify additional EOC risk alleles will likely provide further opportunities to establish polygenic risk prediction approaches, based on combinations of rare high/moderate penetrance susceptibility genes and common, low penetrance susceptibility alleles. This article reviews the current literature describing the genetic and epidemiological components of ovarian cancer risk, and discusses both the opportunities and challenges in using this information for clinical risk prediction and prevention.
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Affiliation(s)
- Michelle R Jones
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniella Kamara
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Paul D P Pharoah
- CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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11
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Xing X, Jia S, Wu J, Feng Q, Dong B, Li B, Jia Y, Shan F, Li Y, Zhang Y, Hu Y, Wang X, Liu X, Yu W, Zhang L, Bu Z, Wu A, Li Z, Ji J. Clonality analysis of synchronous gastro-oesophageal junction carcinoma and distal gastric cancer by whole-exome sequencing. J Pathol 2017; 243:165-175. [PMID: 28671728 DOI: 10.1002/path.4932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/18/2017] [Accepted: 06/13/2017] [Indexed: 12/22/2022]
Abstract
Gastro-oesophageal junction (GEJ) carcinoma and distal gastric cancer (GC) have distinct epidemiology and clinical features and their relationship is uncertain. Synchronous multiple gastric cancers located mostly at proximal and distal sites provide rare specimens for investigating the comprehensive genomic relationships among these cancers in the context of identical genetic circumstances. Formalin-fixed, paraffin-embedded (FFPE) samples from 12 patients with synchronous GEJ carcinoma and distal GC were collected in this study. Whole-exome sequencing (WES) was performed using normal tissues as a control. Mutational profiling, clonality analysis, a detailed clinico-pathological review, determination of MSI status, EBER in situ hybridization (ISH), and programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) immunohistochemical staining were performed. Twenty-three of the 24 samples were microsatellite-stable (MSS). Subclonal analysis revealed that nine pairs of GEJ and distal GC tumours in neoadjuvant chemotherapy naïve patients developed independently from different origins. Two patients who received neoadjuvant chemotherapy shared clonal origins with highly similar somatic alterations. The remaining one patient who shared a rare mutation died within 6.2 months at the N3 stage. However, the enriched pathway identified from the overall mutation spectra in distal GC and GEJ carcinoma showed the close relationship of these cancers. Thus, although these cancers may have similar characteristics, histopathological and genetic profiling from single tumour specimens may still underestimate the mutational burden and somatic heterogeneity of multiple GCs. In addition, this series of cases also showed a PD-L1 expression rate of 58.3% and 66.7% in distal GC and GEJ carcinoma, respectively, with all the cases expressing PD-1. This result suggests the potential benefit of immunotherapeutic treatments. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Xiaofang Xing
- Department of Gastrointestinal Translational Research, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Shuqin Jia
- Department of Molecular Diagnosis, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Jianmin Wu
- Center for Cancer Bioinformatics, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Qin Feng
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Bin Dong
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Bo Li
- Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Yongning Jia
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Fei Shan
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Ying'ai Li
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Yan Zhang
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Ying Hu
- Tissue Bank, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Xiaodong Wang
- CIPHER GENE LLC, TechCode Incubator, Beijing, PR, China
| | - Xiangtao Liu
- CIPHER GENE LLC, TechCode Incubator, Beijing, PR, China
| | - Weishi Yu
- CIPHER GENE LLC, TechCode Incubator, Beijing, PR, China
| | - Lianhai Zhang
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Zhaode Bu
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Aiwen Wu
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Ziyu Li
- Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
| | - Jiafu Ji
- Department of Gastrointestinal Translational Research, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China.,Department of Molecular Diagnosis, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China.,Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, Boston, MA, USA.,Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, PR, China
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12
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MALDI-TOF-MS analysis in discovery and identification of serum proteomic patterns of ovarian cancer. BMC Cancer 2017; 17:472. [PMID: 28683725 PMCID: PMC5501370 DOI: 10.1186/s12885-017-3467-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 06/30/2017] [Indexed: 12/11/2022] Open
Abstract
Background Due to high mortality and lack of efficient screening, new tools for ovarian cancer (OC) diagnosis are urgently needed. To broaden the knowledge on the pathological processes that occur during ovarian cancer tumorigenesis, protein-peptide profiling was proposed. Methods Serum proteomic patterns in samples from OC patients were obtained using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF). Eighty nine serum samples (44 ovarian cancer and 45 healthy controls) were pretreated using solid-phase extraction method. Next, a classification model with the most discriminative factors was identified using chemometric algorithms. Finally, the results were verified by external validation on an independent test set of samples. Results Main outcome of this study was an identification of potential OC biomarkers by applying liquid chromatography coupled with tandem mass spectrometry. Application of this novel strategy enabled the identification of four potential OC serum biomarkers (complement C3, kininogen-1, inter-alpha-trypsin inhibitor heavy chain H4, and transthyretin). The role of these proteins was discussed in relation to OC pathomechanism. Conclusions The study results may contribute to the development of clinically useful multi-component diagnostic tools in OC. In addition, identifying a novel panel of discriminative proteins could provide a new insight into complex signaling and functional networks associated with this multifactorial disease. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3467-2) contains supplementary material, which is available to authorized users.
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13
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Shao X, He Y, Ji M, Chen X, Qi J, Shi W, Hao T, Ju S. Quantitative analysis of cell-free DNA in ovarian cancer. Oncol Lett 2015; 10:3478-3482. [PMID: 26788153 PMCID: PMC4665352 DOI: 10.3892/ol.2015.3771] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 08/17/2015] [Indexed: 12/23/2022] Open
Abstract
The aim of the present study was to investigate the association between cell-free DNA (cf-DNA) levels and clinicopathological characteristics of patients with ovarian cancer using a branched DNA (bDNA) technique, and to determine the value of quantitative cf-DNA detection in assisting with the diagnosis of ovarian cancer. Serum specimens were collected from 36 patients with ovarian cancer on days 1, 3 and 7 following surgery, and additional serum samples were also collected from 22 benign ovarian tumor cases, and 19 healthy, non-cancerous ovaries. bDNA techniques were used to detect serum cf-DNA concentrations. All data were analyzed using SPSS version 18.0. The cf-DNA levels were significantly increased in the ovarian cancer group compared with those of the benign ovarian tumor group and healthy ovarian group (P<0.01). Furthermore, cf-DNA levels were significantly increased in stage III and IV ovarian cancer compared with those of stages I and II (P<0.01). In addition, cf-DNA levels were significantly increased on the first day post-surgery (P<0.01), and subsequently demonstrated a gradual decrease. In the ovarian cancer group, the area under the receiver operating characteristic curve of cf-DNA and the sensitivity were 0.917 and 88.9%, respectively, which was higher than those of cancer antigen 125 (0.724, 75%) and human epididymis protein 4 (0.743, 80.6%). There was a correlation between the levels of serum cf-DNA and the occurrence and development of ovarian cancer in the patients evaluated. bDNA techniques possessed higher sensitivity and specificity than other methods for the detection of serum cf-DNA in patients exhibiting ovarian cancer, and bDNA techniques are more useful for detecting cf-DNA than other factors. Thus, the present study demonstrated the potential value for the use of bDNA as an adjuvant diagnostic method for ovarian cancer.
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Affiliation(s)
- Xuefeng Shao
- Department of Clinical Laboratory, Maternity and Child Healthcare Hospital of Nantong, Nantong, Jiangsu 226018, P.R. China
| | - Yan He
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, P.R. China
| | - Min Ji
- Department of Internal Medicine, Maternity and Child Healthcare Hospital of Nantong, Nantong, Jiangsu 226018, P.R. China
| | - Xiaofang Chen
- Department of Gynecology, Maternity and Child Healthcare Hospital of Nantong, Nantong, Jiangsu 226018, P.R. China
| | - Jing Qi
- Department of Laboratory of Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226018, P.R. China
| | - Wei Shi
- Department of Laboratory of Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226018, P.R. China
| | - Tianbo Hao
- Department of Laboratory of Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226018, P.R. China
| | - Shaoqing Ju
- Department of Laboratory of Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226018, P.R. China
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14
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Kotowicz B, Fuksiewicz M, Sobiczewski P, Spiewankiewicz B, Jonska-Gmyrek J, Skrzypczak M, Kowalska M. Clinical value of human epididymis protein 4 and the Risk of Ovarian Malignancy Algorithm in differentiating borderline pelvic tumors from epithelial ovarian cancer in early stages. Eur J Obstet Gynecol Reprod Biol 2015; 194:141-6. [PMID: 26398337 DOI: 10.1016/j.ejogrb.2015.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/31/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The clinical value of human epididymis protein 4 (HE4) and the possibility of its use in the differential diagnosis in patients with benign, borderline and epithelial ovarian cancer in early International Federation of Gynaecology and Obstetrics (FIGO) stages. STUDY DESIGN The study group consisted of 205 women, including 60 with ovarian cancer, 18 with borderline tumors, 77 with benign lesions and 50 healthy subjects. In all the patients, before the treatment and in control groups, we determined CA 125 and HE4 in serum by electrochemiluminescence on the basis of the COBAS e601 system. For comparison of two independent groups, we used the U Mann-Whitney test. The analysis of the diagnostic power of the assessed parameters has been determined using the MedCalc statistical program. The probability of disease free survival (DFS) was evaluated using the log-rank test and Cox regression model. RESULTS Concentrations of HE4, CA 125 and Risk of Ovarian Malignancy Algorithm (ROMA) value were significantly higher in early ovarian cancer than in patients with benign (P<0.0001) and borderline tumors (P<0.002), the receiver operating characteristics (ROC) curves, demonstrated the highest diagnostic sensitivity for the ROMA score, as well post (AUC=0.817) as pre-menopausal (AUC=0.806). HE4 concentrations (P<0.021) and the value of the ROMA score (P<0.004) were significantly higher in patients with relapse than in patients in remission. There was no connection between concentrations of the studied tumor markers and DFS. CONCLUSIONS Determination of HE4 serum concentrations has a significant clinical value, especially in patients with benign lesions and elevated CA 125 levels. The combined assessment of HE4, CA 125 and the ROMA algorithm is helpful in differentiating benign tumors and borderline pelvic tumors from epithelial ovarian cancer in early FIGO stages. Determination of HE4, CA 125 and ROMA algorithm is not helpful in differentiating patients with borderline from benign lesions.
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Affiliation(s)
- Beata Kotowicz
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Laboratory of Tumor Markers, Department of Pathology and Laboratory Diagnostics, Roentgen Street 5, 02-781 Warsaw, Poland.
| | - Malgorzata Fuksiewicz
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Laboratory of Tumor Markers, Department of Pathology and Laboratory Diagnostics, Roentgen Street 5, 02-781 Warsaw, Poland
| | - Piotr Sobiczewski
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Gynecologic Oncology, Roentgen Street 5, 02-781 Warsaw, Poland
| | - Beata Spiewankiewicz
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Gynecologic Oncology, Roentgen Street 5, 02-781 Warsaw, Poland
| | - Joanna Jonska-Gmyrek
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Urooncology, Roentgen Street 5, 02-781 Warsaw, Poland
| | - Maciej Skrzypczak
- Second Department of Gynecology, Prof. F. Skubiszewski University School of Medicine, Lublin, Poland
| | - Maria Kowalska
- The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Laboratory of Tumor Markers, Department of Pathology and Laboratory Diagnostics, Roentgen Street 5, 02-781 Warsaw, Poland
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15
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Why have ovarian cancer mortality rates declined? Part I. Incidence. Gynecol Oncol 2015; 138:741-9. [PMID: 26080287 DOI: 10.1016/j.ygyno.2015.06.017] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 06/09/2015] [Accepted: 06/12/2015] [Indexed: 12/20/2022]
Abstract
The age-adjusted mortality rate from ovarian cancer in the United States has declined over the past several decades. The decline in mortality might be the consequence of a reduced number of cases (incidence) or a reduction in the proportion of patients who die from their cancer (case-fatality). In part I of this three-part series, we examine rates of ovarian cancer incidence and mortality from the Surveillance Epidemiology and End Results (SEER) registry database and we explore to what extent the observed decline in mortality can be explained by a downward shift in the stage distribution of ovarian cancer (i.e. due to early detection) or by fewer cases of ovarian cancer (i.e. due to a change in risk factors). The proportion of localized ovarian cancers did not increase, suggesting that a stage-shift did not contribute to the decline in mortality. The observed decline in mortality paralleled a decline in incidence. The trends in ovarian cancer incidence coincided with temporal changes in the exposure of women from different birth cohorts to various reproductive risk factors, in particular, to changes in the use of the oral contraceptive pill and to declining parity. Based on recent changes in risk factor propensity, we predict that the trend of the declining age-adjusted incidence rate of ovarian cancer in the United States will reverse and rates will increase in coming years.
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Ricardo S, Marcos-Silva L, Pereira D, Pinto R, Almeida R, Söderberg O, Mandel U, Clausen H, Felix A, Lunet N, David L. Detection of glyco-mucin profiles improves specificity of MUC16 and MUC1 biomarkers in ovarian serous tumours. Mol Oncol 2014; 9:503-12. [PMID: 25454345 DOI: 10.1016/j.molonc.2014.10.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/11/2014] [Accepted: 10/17/2014] [Indexed: 11/15/2022] Open
Abstract
The CA125 assay detects circulating MUC16 and is one of the most widely used cancer biomarkers for the follow-up of ovarian cancer. We previously demonstrated that detection of aberrant cancer-associated glycoforms of MUC16 as well as MUC1 in circulation could improve the yield of these serum assays. Our aim was to refine ovarian cancer biomarkers by detection of aberrant glycoforms (Tn, STn, and T) of MUC16 and MUC1 in ovarian cancer tissue using Proximity Ligation Assays (PLA). We studied two series of serous ovarian tumours, a pilot series of 66 ovarian tumours (27 cystadenomas, 16 borderline tumours and 23 adenocarcinomas) from Centro Hospitalar S. João, Porto and a validation series of 89 ovarian tumours (17 cystadenomas, 25 borderline tumours and 47 adenocarcinomas) from the Portuguese Institute of Oncology Francisco Gentil, Lisbon. PLA reactions for MUC16/Tn, MUC16/STn, MUC1/Tn and MUC1/STn were negative in benign lesions but often positive in borderline and malignant lesions, in both series. An even better yield was obtained based on positivity for any of the four glyco-mucin profiles, further increasing sensitivity to 72% and 83% in the two series, respectively, with 100% specificity. The strategy is designated glyco-mucin profiling and provides strong support for development of PLA-based serum assays for early diagnosis.
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Affiliation(s)
- Sara Ricardo
- IPATIMUP, Institute of Molecular Pathology and Immunology of The University of Porto, Portugal
| | - Lara Marcos-Silva
- IPATIMUP, Institute of Molecular Pathology and Immunology of The University of Porto, Portugal; Faculty of Medicine of The University of Porto, Porto, Portugal; Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine and School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Daniela Pereira
- IPATIMUP, Institute of Molecular Pathology and Immunology of The University of Porto, Portugal
| | - Rita Pinto
- IPATIMUP, Institute of Molecular Pathology and Immunology of The University of Porto, Portugal
| | - Raquel Almeida
- IPATIMUP, Institute of Molecular Pathology and Immunology of The University of Porto, Portugal; Faculty of Medicine of The University of Porto, Porto, Portugal; Department of Biology, Faculty of Sciences of The University of Porto, Porto, Portugal
| | - Ola Söderberg
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Biomedical Center, Uppsala University, Uppsala, Sweden
| | - Ulla Mandel
- Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine and School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Clausen
- Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine and School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ana Felix
- Instituto Português de Oncologia de Lisboa, Lisboa, Portugal; Faculdade de Ciências Médicas - CEDOC, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Nuno Lunet
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, Portugal; Institute of Public Health, University of Porto (ISPUP), Porto, Portugal
| | - Leonor David
- IPATIMUP, Institute of Molecular Pathology and Immunology of The University of Porto, Portugal; Faculty of Medicine of The University of Porto, Porto, Portugal.
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