Release date: 2016-11-22
This new method is different from any previous method because they not only detect DNA changes in human tissues, but also detect the DNA of the HPV virus, which can spread through sexually transmitted diseases and eventually lead to various diseases. The study was recently published in the journal Cancer Prevention Research. The authors believe that their new method for detecting genetic markers is more sensitive. The accuracy of the so-called CIN2 injury test is as high as 90.9%. The CIN2 injury refers not only to the possibility. It develops into cancer and may also develop cervical damage caused by abnormal cells of highly metastatic cancer. In addition, they also emphasized that the DNA needed to detect the human genes and viral genes can be extracted from the urine, and they can use this DNA to identify whether the patient carries the damage with a sensitivity of up to 75%. The commercial test sensitivity for testing DNA methylation by cervical smear last summer was only 64%.
“If further research validates these findings, then urine testing will be a quick, inexpensive and accurate way to determine if biopsy is necessary.†Senior paper author Rafael Guerrero-Preston explains that he is Johns Hopkins Medical School. Head and neck cancer surgeon and associate professor, "HPV-positive women with abnormal smear of the cervical tissue usually undergo biopsy to determine whether they have cervical cancer, but studies have shown that 50% of biopsy is not only unnecessary, but can lead to pain, anxiety, infertility And high medical expenses."
The study was developed on the basis of their previous research. They have found that three genes are associated with abnormal cells of cervical cancer and possibly cancer: FKBP6, INTS1, ZNF516, and the specificity of these three genes as the mutation progresses. Methylation occurs at the site. Rafael Guerrero-Preston believes that their new approach can be used as a molecular diagnostic tool to complement tissue smear testing, especially in developing countries where poverty, medical infrastructure, or cultural beliefs do not allow patients to undergo tissue smear testing. Particularly important.
First, they examined the DNA of 214 cervical tissue samples from women who received tissue smears to determine if the three genes could be used as markers of cancer. These patients were between 18 and 86 years old, 34 patients had no cervical abnormalities, 87 patients had at least one mutation in these three genes, and 90 patients showed significant cervical cancer characteristics. They then isolated DNA from cervical tissue for gene sequencing to determine DNA methylation levels. They found that if the methylation level is used as a cancer diagnosis, the sensitivity of these three genes is 90% (meaning that once the patient has such methylation, they have a 90% chance of cervical cancer), the specificity is 88.9%. (meaning that in the case of 88.9%, this test can correctly detect whether the patient has cervical cancer or not). In order to improve accuracy, they added the HPV16-L1 virus gene as a cancer marker, and this gene methylation is also associated with cervical cancer. They also used these four genes as markers to perform cervical tissue testing on 115 patients in another batch. The results showed that the sensitivity was as high as 90.9% and the specificity was 60.9%.
“When developing this new technology, we expect it to have a sensitivity of 90-95% so that it can compete with the detection methods used in the European market,†explains Guerrero-Preston.
Next, they performed blood tests and urine tests on patients, and tried to directly extract circulating DNA for testing. The detection of 40 samples found that the sensitivity of detecting cervical cancer by blood DNA was 85.7%, the specificity was 60.9%, and the sensitivity of urine test and The specificity was 75% and 83.3%, respectively, and the time required for the whole process was very short. It took only 4 days from tissue biopsy to completion of blood test and urine test. Their next plan is to optimize this method to improve the sensitivity of urine test. Go to the level of tissue smear detection.
According to the World Cancer Fund Research Institute, 84% of cervical cancers occur in less developed countries, with the highest incidence in Africa, Latin America and the Caribbean. In the United States, cervical cancer is also the leading cause of cancer death in women, but The prevalence of tissue smear testing 40 years ago has reversed this situation, but the incidence and mortality of cervical cancer in countries without basic medical facilities or cultures that do not allow tissue smear testing has remained high.
In order to reduce the time required for testing, Guerrero-Preston and colleagues have reached an agreement with Cepheid to develop this test. They plan to use Cephied equipment to reduce the current four days of laboratory testing to less than three hours. .
references
"Molecular Triage of Premalignant Lesions inLiquid-Based Cervical Cytology and CirculatingCell-Free DNA from Urine, Using a Panel ofMethylated Human Papilloma Virus and HostGenes"
Source: Translational Medicine Network
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