Can Cervical Scrapings From Pap Tests Detect Ovarian Cancer?
Posted: Tuesday, February 25, 2020
Cervical scrapings from Papanicolaou tests (Pap tests) may prove to be a feasible alternative to collecting blood for the detection of ovarian cancer, according to findings presented in Clinical Epigenetics. The DNA methylation biomarkers AMPD3, NRN1, and TBX15 were particularly promising epigenetic biomarkers, concluded Tzu-I Wu, MD, of the College of Medicine at Taipei Medical University, Taiwan, and colleagues.
“The potential development of DNA methylation biomarkers from cervical scrapings expands the scope of the Pap test, a now-routinely used cytological exam especially prevalent in developed countries,” the authors said. “The detection of female genital tract malignancies, including [cervical cancer], [endometrial cancers], and [ovarian cancer], by combining cervical scrapings and molecular markers, is an attractive concept.”
In this study, the authors analyzed the methylomes of tissues from 50 patients with ovarian cancer and 6 with normal ovarian epithelia, as well as the cervical scrapings from 5 patients with ovarian cancer and 10 from normal controls. They integrated public methylomic data sets that included 79 patients with ovarian cancer and 6 patients with normal tubal epithelia. In total, 150 genes were classified into 4 clusters, and 9 hypermethylated genes were selected. Among the final group, four genes fulfilled the authors’ selection criteria.
For ovarian cancer detection accuracy, AMPD3 demonstrated an area under the receiver operating characteristic curve (AUC) of 0.80 to 0.83, AOX1 displayed an AUC of 0.79 to 0.85, NRN1 recorded an AUC of 0.78 to 0.88, and TBX15 exhibited an AUC of 0.82 to 0.85. From those results, the investigators calculated the ovarian cancer risk score—the equation generated by logistic regression in training sets and validating an ovarian cancer panel of AMPD3, NRN1, and TBX15—for a sensitivity of 81%, a specificity of 84%, and ovarian cancer detection accuracy of 0.91.
“Hopefully, the emergence of novel molecular markers could change the debate toward a willingness for further development of [ovarian cancer] screening,” the authors added.
Disclosure: For full disclosure of the study authors, visit clinicalepigeneticsjournal.com.