A multiplex methylation-specific PCR assay for detection of early-stage ovarian cancer using cell-free serum DNA.

Authors

null

Beihua Kong

Qilu Hospital, Shandong University, Jinan City, China

Beihua Kong , Qing Zhang , Guohong Hu , Qifeng Yang , Ruifen Dong , Xing Xie , Ding Ma , Keng Shen

Organizations

Qilu Hospital, Shandong University, Jinan City, China, Qilu Hospital, Shandong Univesity, Ji'nan City, China, The Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences & Shanghai Jiao Tong University School of Medicine, Shanghai, China, Department of Breast Surgery, Qilu Hospital, Shandong University, Ji'nan, China, Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Ji'nan, China, Department of Gynecologic Oncology, Women’s Reproductive Health Key Laboratory of Zhejiang Province, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China

Research Funding

No funding sources reported

Background: Epithelial ovarian cancer (EOC) remains the most lethal disease among gynecological malignancies. Prompt diagnosis is challenging because of the non-specific symptoms exhibited during the early stage of the disease. So there is an urgent need for better detection methods. Here we performed this work to build up a platform of multiplex methylation-specific PCR (MSP) assay to improve the early detection of ovarian cancer, via identifying the methylation status of cell-free serum DNA. Methods: After screening, we chose seven genes (APC, RASSF1A, CDH1, RUNX3, TFPI2, SFRP5 and OPCML) with a high frequency of methylation as candidate genes to construct the multiplex-MSP assay. When methylation of at least one of the seven genes was observed, the multiplex-MSP assay was considered positive. We performed the retrospective and screening study to verify its specificity and sensitivity in the detection of EOC. Results: The methylation status of cell-free serum DNA was examined in the preoperative serum of 202 patients, including 87 EOC cases (stage I, n=41, stage II-IV, n=46), 53 benign ovarian tumors and 62 healthy controls. As expected, multiplex MSP assay achieved a sensitivity of 85.3% and a specificity of 90.5% in stage I EOC, strikingly higher than that of single CA125, producing a sensitivity of 56.1% at 64.15% specificity [p=0.0036](Table). Conclusions: Multiplex MSP assay analyzing the methylation status of cell-free serum DNA is a suitable and reliable approach to improve the early detection of ovarian cancer, potentially benefiting a broad range of applications in clinical oncology.

Retrospective study
Screening study
CA125 Multiplex-MSP CA125 Multiplex-MSP
Specificity All 64.15% 90.57% 72.41% 82.76%
Sensitivity All 73.56% 89.66% 82.05% 92.31%
Early stage 56.10% 85.37% 50.00% 83.33%
Advanced stage 89.13% 93.48% 84.85% 93.94%
ROC-AUC
(95% CI)
All 0.8090
(0.7376-0.8805)
0.9126
( 0.8643-0.9609)
0.8837
(0.8017-0.9658)
0.8988
(0.8192-0.9783)
Early stage 0.6986
(0.5904-0.8068)
0.8916
(0.8258-0.9574)
0.8103
(0.5984-1.022)
0.8218
(0.6375-1.006)
Advanced stage 0.9075
(0.8461-0.9689)
0.9313
(0.8788-0.9838)
0.8970
1(0.8146-0.9796)
0.9127
(0.8364-0.9891)

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Citation

J Clin Oncol 31, 2013 (suppl; abstr 5535)

DOI

10.1200/jco.2013.31.15_suppl.5535

Abstract #

5535

Poster Bd #

24

Abstract Disclosures

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