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      The feasibility of detecting endometrial and ovarian cancer using DNA methylation biomarkers in cervical scrapings

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          Abstract

          Objective

          We hypothesized that DNA methylation of development-related genes may occur in endometrial cancer (EC)/ovarian cancer (OC) and may be detected in cervical scrapings.

          Methods

          We tested methylation status by quantitative methylation-specific polymerase chain reaction for 14 genes in DNA pools of endometrial and OC tissues. Tissues of EC/normal endometrium, OC/normal ovary, were verified in training set using cervical scrapings of 10 EC/10 OC patients and 10 controls, and further validated in the testing set using independent cervical scrapings in 30 EC/30 OC patients and 30 controls. We generated cutoff values of methylation index (M-index) from cervical scrapings to distinguish between cancer patients and control. Sensitivity/specificity of DNA methylation biomarkers in detecting EC and OC was calculated.

          Results

          Of 14 genes, 4 ( PTGDR, HS3ST2, POU4F3, MAGI2) showed hypermethylation in EC and OC tissues, and were verified in training set. POU4F3 and MAGI2 exhibited hypermethylation in training set were validated in independent cases. The mean M-index of POU4F3 is 78.28 in EC and 20.36 in OC, which are higher than that in controls (6.59; p<0.001 and p=0.100, respectively), and that of MAGI2 is 246.0 in EC and 12.2 in OC, which is significantly higher that than in controls (2.85; p<0.001 and p=0.480, respectively). Sensitivity and specificity of POU4F3/MAGI2 were 83%–90% and 69%–75% for detection of EC, and 61% and 62%–69% for the detection of OC.

          Conclusion

          The findings demonstrate the potential of EC/OC detection through testing for DNA methylation in cervical scrapings.

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          Most cited references35

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            Global estimates of cancer prevalence for 27 sites in the adult population in 2008.

            Recent estimates of global cancer incidence and survival were used to update previous figures of limited duration prevalence to the year 2008. The number of patients with cancer diagnosed between 2004 and 2008 who were still alive at the end of 2008 in the adult population is described by world region, country and the human development index. The 5-year global cancer prevalence is estimated to be 28.8 million in 2008. Close to half of the prevalence burden is in areas of very high human development that comprise only one-sixth of the world's population. Breast cancer continues to be the most prevalent cancer in the vast majority of countries globally; cervix cancer is the most prevalent cancer in much of Sub-Saharan Africa and Southern Asia and prostate cancer dominates in North America, Oceania and Northern and Western Europe. Stomach cancer is the most prevalent cancer in Eastern Asia (including China); oral cancer ranks as the most prevalent cancer in Indian men and Kaposi sarcoma has the highest 5-year prevalence among men in 11 countries in Sub-Saharan Africa. The methods used to estimate point prevalence appears to give reasonable results at the global level. The figures highlight the need for long-term care targeted at managing patients with certain very frequently diagnosed cancer forms. To be of greater relevance to cancer planning, the estimation of other time-based measures of global prevalence is warranted. Copyright © 2012 UICC.
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              Epigenetic inactivation of the canonical Wnt antagonist SRY-box containing gene 17 in colorectal cancer.

              SRY-box containing gene 17 (Sox17) is a member of the high mobility group (HMG) transcription factor superfamily, which plays critical roles in the regulation of development and stem/precursor cell function, at least partly through repression of Wnt pathway activity. Modulators controlling aberrant Wnt signaling activation are frequently disrupted in human cancers through complementary effects of epigenetic and genetic changes. Our recent global analysis of CpG island hypermethylation and gene expression in colorectal cancer (CRC) cell lines revealed that SOX17 gene silencing is associated with DNA hypermethylation of a CpG island in the promoter region. Here, we report that CpG island methylation-dependent silencing of SOX17 occurs in 100% of CRC cell lines, 86% of colorectal adenomas, 100% of stage I and II CRC, 89% of stage III CRC, 89% of primary esophageal cancer, and 50% of non-small cell lung cancer. Overexpression of SOX17 in HCT116 CRC cells inhibits colony growth and beta-catenin/T-cell factor-dependent transcription. Structure-based deletion analysis further shows the presence of a Wnt signaling repression domain in the SOX17 HMG box. Together, our studies suggest that SOX17 is a negative modulator of canonical Wnt signaling, and that SOX17 silencing due to promoter hypermethylation is an early event during tumorigenesis and may contribute to aberrant activation of Wnt signaling in CRC.
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                Author and article information

                Journal
                J Gynecol Oncol
                J Gynecol Oncol
                JGO
                Journal of Gynecologic Oncology
                Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology
                2005-0380
                2005-0399
                January 2018
                16 November 2017
                : 29
                : 1
                : e17
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
                [2 ]Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.
                [3 ]Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
                [4 ]Division of Research and Analysis, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan.
                Author notes
                Correspondence to Hung-Cheng Lai. Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, No. 291, Jhongjheng Road, Jhonghe, New Taipei 23561, Taiwan. hclai30656@ 123456gmail.com , hclai@ 123456s.tmu.edu.tw
                Author information
                https://orcid.org/0000-0002-7356-446X
                https://orcid.org/0000-0002-7514-0126
                https://orcid.org/0000-0002-8551-6158
                https://orcid.org/0000-0002-5721-2317
                https://orcid.org/0000-0002-4829-8737
                https://orcid.org/0000-0003-4585-5224
                https://orcid.org/0000-0001-8048-3943
                Article
                10.3802/jgo.2018.29.e17
                5709527
                29185275
                4df60015-666f-4e58-a2d0-54a1dd665f68
                Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 October 2017
                : 22 August 2017
                : 04 November 2017
                Funding
                Funded by: Tri-Service General Hospital;
                Award ID: TSGH-C104-006-006-008-S01&S02
                Award ID: TSGH-C105-010
                Funded by: Ministry of Science and Technology, Taiwan, CrossRef http://dx.doi.org/10.13039/501100004663;
                Award ID: NSC 105-2628-B-038-011-MY3
                Award ID: NSC 103-2325-B-195-002
                Funded by: Taipei Medical University, CrossRef http://dx.doi.org/10.13039/501100004700;
                Award ID: 104TMU-SHH-07
                Funded by: Ministry of Health and Welfare, CrossRef http://dx.doi.org/10.13039/100008903;
                Award ID: MOHW105-TDU-PB-212-000007
                Funded by: National Health Research Institutes, CrossRef http://dx.doi.org/10.13039/501100004737;
                Award ID: NHRI-EX106-10406BI
                Funded by: Teh-Tzer Study Group for Human Medical Research Foundation;
                Categories
                Original Article
                Biomarker

                Oncology & Radiotherapy
                endometrial neoplasms,ovarian neoplasms,dna methylation
                Oncology & Radiotherapy
                endometrial neoplasms, ovarian neoplasms, dna methylation

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