Comparison of Serum and Urine as Sources of miRNA Markers for the Detection of Ovarian Cancer

Random forest algorithm identifies miRNA signatures for breast cancer detection and classification from patient urine samples

Background and objectives

Breast cancer is the most common cancer in women, with one in eight women suffering from this disease in her lifetime. The implementation of centrally organized mammography screening for women between 50 and 69 years of age was a major step in the direction of early detection. However, the participation rate reaches approximately 50% of the eligible women, one reason being the painful compression of the breast, cited as a major issue for not participating in this very important program. Therefore, focusing current research on less painful and less invasive techniques for the detection of breast cancer is highly clinically relevant. Liquid biopsies offer this option by detection of distinct molecules such as microRNAs (miRNAs) or circulating tumor DNA (ctDNA) or disseminated tumor cells.

Design and methods

Here, we present the first proof-of-concept approach for sequencing miRNAs in female urine to detect breast cancer and, subsequently, intrinsic subtype-specific miRNA patterns and implement in this regard a novel random forest algorithm. To this end, we performed miRNA sequencing on 82 urine samples, 32 samples from breast cancer patients (9× luminal A, 8× luminal B, 9× triple-negative, and 6× HER2) and 50 healthy control samples.

Results and conclusion

Using a random forest algorithm, we identified a signature of 275 miRNAs that allows the detection of invasive breast cancer in urine. Furthermore, we identified distinct miRNA expression patterns for the major intrinsic subtypes of breast cancer, specifically luminal A, luminal B, HER2-enriched, and triple-negative breast cancer. This experimental approach specifically validates miRNA sequencing as a technique for breast cancer detection in urine samples and opens the door to a new, easy, and painless procedure for different breast cancer-related medical procedures such as screening but also treatment monitoring.

A signature of circulating miRNAs predicts the prognosis and therapeutic outcome of taxane/platinum regimen in advanced ovarian carcinoma patients

PURPOSE

Ovarian carcinoma (OC) is ranked as the eighth most lethal gynecological cancer due to late diagnosis and high recurrence. Existing biomarkers are lacking to predict the recurrence and stratify patients who are likely to benefit from chemotherapy. MicroRNAs (miRNAs/miRs) are persistently present in humans and are capable of predicting treatment outcomes. Thus, the purpose of the study was to assess the potential of circulatory miRNAs to predict the efficacy of OC.

METHODS

Newly diagnosed n = 208 OC patients were administrated neoadjuvant/adjuvant chemotherapy (taxane + platinum) after surgery. Their demographic, gynecologic, clinical parameters, response, and survival were recorded. MiR-27a, miR-182, miR-199a, miR-214, and miR-591 were taken and the expression were analyzed using real-time PCR at different treatment intervals. Further, its prognostic value (Kaplan-Meier, and Cox regression analysis) and diagnostic importance (receiver operating characteristic curve) were validated.

RESULT

The mean age of patients with poorly differentiated (45.2%) serous OC was 48.69 ± 10.38. The majority experienced menarche at ≥ 12 (62.2%) with poor menstrual hygiene (81.8%) and were post-menopausal (69.4%), some were associated with high risk of survival (HR =  > 1). MiRNA signature showed three over-expression and two under-expression (miR-27a, miR-182, and miR-214; miR-199a and miR-591) in advanced OC compared to the control (P=  < 0.05). Also, a significant difference was detected at each time interval of treatment with the response (P =  ≤ 0.001) associated with resistance and overall survival (P =  ≤ 0.001) with risk (HR =  > 1). ROC analysis showed enhanced the diagnostics accuracy (< 0.001).

CONCLUSION

Our findings indicate that circulating miRNAs might be a potential minimally invasive diagnostic marker for treatment outcome and recurrence in ovarian carcinoma.

A Glimmer of Hope for Patients with a T3 Transformation Zone: miRNAs Are Potential Biomarkers for Cervical Dysplasia

BACKGROUND

This pilot study assesses the potential use of miRNAs in the triage of colposcopy patients with type 3 (nonvisible) cervical transformation zone (TZ). Type 3 TZ is a constitutional finding associated with many problems and controversies in colposcopy patient management. Here, we present miRNAs as a potential biomarker for the detection of CIN3 in these cases.

MATERIALS AND METHODS

Cervical mucosa samples (CMS) were collected from patients presenting with T3 transformation zone during routine workup using the Cytobrush. Depending on the histological and cytological result, as well as the result of the routinely performed HPV PCR, patients were divided into three groups: patients with a high-grade intraepithelial lesion (CIN3) and a positive high-risk HPV test (CIN3 group), patients without an intraepithelial lesion and a positive high-risk HPV test (HPV group), and healthy controls (N = no intraepithelial lesion and negative HPV test). The cervical mucus samples included in the study were tested for their expression levels of distinct miRNAs using qPCR.

RESULTS

All investigated miRNAs were consistently detectable in every sample. The CMSs of histologically graded CIN 3 showed consistently high expression levels of all eight miRNAs, whereas the CMSs from healthy patients (N) show generally lower expression levels. However, CMSs from patients of the HPV group represented a very heterogeneous group.

CONCLUSIONS

The data presented here can provide a solid basis for future research into a triage test for patients with a T3 transformation zone on the basis of commonly used clinical equipment.