Are Papanicolaou Tests Useful in Diagnosing Ovarian Cancer?
Posted: Friday, August 28, 2020
According to Robert Fruscio, MD, PhD, of the San Gerardo Hospital, Monza, Italy, and colleagues, early molecular diagnosis of high-grade serous epithelial ovarian cancer may be achievable through detection of clonal TP53 variants in the DNA obtained during cervical cancer screening. The findings, which were published in JAMA Network Open, revealed these somatic single nucleotide variants in the exonic regions of the TP53 gene were detectable up to 6 years prior to tumor diagnosis.
“To our knowledge, this is the first experimental evidence that supports the mathematical model according to which high-grade serous epithelial ovarian cancer takes at least approximately 6 years to develop,” the investigators commented. “Considering the anatomical continuity between tubal lumen and cervical canal, it is plausible that cytological material could be a useful biological material to detect biomarkers associated with high-grade serous epithelial ovarian cancer many years before diagnosis.”
A total of 17 patients with histologically confirmed stage II through IV high-grade serous epithelial ovarian cancer were enrolled. Using next-generation sequencing technology, purified DNA from the formalin-fixed paraffin-embedded samples collected during primary tumor biopsy was analyzed for the presence of TP53 variants. Subsequently, droplet digital polymerase chain reaction experiments were performed to investigate the detected variants in the matched retrospective Papanicolaou (Pap) test samples.
In more than half of patients (64%), the variants were detectable in matched retrospective Pap test samples. Longitudinal Pap test samples from two patients were available for analysis. For the first patient, the variants were detectable in all three provided samples at 9 days (relative abundance = 0.24%), 25 months (relative abundance = 0.21%), and 49 months (relative abundance = 0.26%) prior to diagnosis. For the second patient, the variants were identified in both provided samples at 27 months (relative abundance = 0.05%) and 68 months (relative abundance = 0.07%) prior to diagnosis.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
