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Krasic J, Skara L, Bojanac AK, Ulamec M, Jezek D, Kulis T, Sincic N. The utility of cfDNA in TGCT patient management: a systematic review. Ther Adv Med Oncol 2022; 14:17588359221090365. [PMID: 35656387 PMCID: PMC9152191 DOI: 10.1177/17588359221090365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Testicular germ cell tumors (TGCTs) are the most common young male malignancy with a steadily rising incidence. Standard clinical practice is radical orchidectomy of suspicious lumps followed by histopathological diagnosis and tumor subtyping. This practice can lead to complications and quality of life issues for the patients. Liquid biopsies, especially cell-free DNA (cfDNA), promised to be true surrogates for tissue biopsies, which are considered dangerous to perform in cases of testicular tumors. In this study, we have performed a systematic review on the potential of cfDNA in TGCT patient management, its potential challenges in translation to clinical application and possible approaches in further research. Materials & Methods: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines on EuropePMC and PUBMED electronic databases, with the last update being on October 21, 2021. Due to the high heterogeneity in identified research articles, we have performed an overview of their efficacy. Results: Eight original articles have been identified on cfDNA in TGCT patients published from 2004 to 2021, of which six had more than one TGCT patient enrolled and were included in the final analysis. Three studies investigated cfDNA methylation, one has investigated mutations in cfDNA, two have investigated cfDNA amount, and one has investigated cfDNA integrity in TGCT. The sensitivity of cfDNA for TGCT was found to be higher than in serum tumor markers and lower than miR-371a-3p, with comparable specificity. cfDNA methylation analysis has managed to accurately detect teratoma in TGCT patients. Conclusion: Potential challenges in cfDNA application to TGCT patient management were identified. The challenges relating to the biology of TGCT with its low mutational burden and low cfDNA amounts in blood plasma make next-generation sequencing (NGS) methods especially challenging. We have also proposed possible approaches to help find clinical application, including a focus on cfDNA methylation analysis, and potentially solving the challenge of teratoma detection.
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Affiliation(s)
- Jure Krasic
- Department of Medical Biology, School of Medicine, University of Zagreb, Zagreb, Croatia
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, Zagreb, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Lucija Skara
- Department of Medical Biology, School of Medicine, University of Zagreb, Zagreb, Croatia
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, Zagreb, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Katusic Bojanac
- Department of Medical Biology, School of Medicine, University of Zagreb, Zagreb, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Monika Ulamec
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, Zagreb, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Davor Jezek
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Histology and Embryology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tomislav Kulis
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, Zagreb, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Urology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Nino Sincic
- Department of Medical Biology, School of Medicine, University of Zagreb, Šalata 3, Zagreb, 10 000, Croatia
- Group for Research on Epigenetic Biomarkers (Epimark), School of Medicine, University of Zagreb, Šalata 3, Zagreb, 10 000, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, Zagreb, 10 000, Croatia
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Abramovic I, Vrhovec B, Skara L, Vrtaric A, Nikolac Gabaj N, Kulis T, Stimac G, Ljiljak D, Ruzic B, Kastelan Z, Kruslin B, Bulic-Jakus F, Ulamec M, Katusic-Bojanac A, Sincic N. MiR-182-5p and miR-375-3p Have Higher Performance Than PSA in Discriminating Prostate Cancer from Benign Prostate Hyperplasia. Cancers (Basel) 2021; 13:cancers13092068. [PMID: 33922968 PMCID: PMC8123314 DOI: 10.3390/cancers13092068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Prostate cancer (PCa) is the most prevalent neoplasia among men worldwide but is commonly “mimicked” by benign prostate hyperplasia (BPH). Their discrimination by the prostate-specific antigen (PSA) is often uncertain, resulting in lengthy diagnostic protocols and recurrent tissue biopsies. The development of more appropriate biomarkers, possibly present in liquid biopsy, would significantly improve PCa and BPH patient management. To address this challenge, in this study miR-375-3p, miR-182-5p, miR-21-5p, and miR-148a-3p were analyzed by ddPCR in blood plasma and seminal plasma of patients with PCa and BPH prior to tissue biopsy. Among other findings, miR-182-5p and miR-375-3p were found to have statistically significantly higher expression in PCa patients compared to BPH in blood, with a combined specificity of 90.2% to predict positive or negative biopsy results. The data presented emphasize the great potential of miRNAs as liquid biopsy biomarkers for PCa. Abstract Prostate cancer (PCa) is the most commonly diagnosed neoplasm among men. Since it often resembles benign prostate hyperplasia (BPH), biomarkers with a higher differential value than PSA are required. Epigenetic biomarkers in liquid biopsies, especially miRNA, could address this challenge. The absolute expression of miR-375-3p, miR-182-5p, miR-21-5p, and miR-148a-3p were quantified in blood plasma and seminal plasma of 65 PCa and 58 BPH patients by digital droplet PCR. The sensitivity and specificity of these microRNAs were determined using ROC curve analysis. The higher expression of miR-182-5p and miR-375-3p in the blood plasma of PCa patients was statistically significant as compared to BPH (p = 0.0363 and 0.0226, respectively). Their combination achieved a specificity of 90.2% for predicting positive or negative biopsy results, while PSA cut-off of 4 µg/L performed with only 1.7% specificity. In seminal plasma, miR-375-3p, miR-182-5p, and miR-21-5p showed a statistically significantly higher expression in PCa patients with PSA >10 µg/L compared to ones with PSA ≤10 µg/L. MiR-182-5p and miR-375-3p in blood plasma show higher performance than PSA in discriminating PCa from BPH. Seminal plasma requires further investigation as it represents an obvious source for PCa biomarker identification.
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Affiliation(s)
- Irena Abramovic
- Department of Medical Biology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (I.A.); (L.S.); (F.B.-J.); (A.K.-B.)
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
| | - Borna Vrhovec
- Department of Urology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Lucija Skara
- Department of Medical Biology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (I.A.); (L.S.); (F.B.-J.); (A.K.-B.)
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
| | - Alen Vrtaric
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Department of Clinical Chemistry, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Nora Nikolac Gabaj
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Department of Clinical Chemistry, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Tomislav Kulis
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Department of Urology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Goran Stimac
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Department of Urology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Dejan Ljiljak
- Department of Gynecology and Obstetrics, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Boris Ruzic
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Department of Urology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Zeljko Kastelan
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Department of Urology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Bozo Kruslin
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Floriana Bulic-Jakus
- Department of Medical Biology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (I.A.); (L.S.); (F.B.-J.); (A.K.-B.)
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
| | - Monika Ulamec
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
- Department of Pathology, School of Dental Medicine and School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ana Katusic-Bojanac
- Department of Medical Biology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (I.A.); (L.S.); (F.B.-J.); (A.K.-B.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
| | - Nino Sincic
- Department of Medical Biology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (I.A.); (L.S.); (F.B.-J.); (A.K.-B.)
- Group for Research on Epigenetic Biomarkers (Epimark), University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (T.K.); (G.S.); (B.R.); (Z.K.); (M.U.)
- Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia; (A.V.); (N.N.G.); (B.K.)
- Correspondence: ; Tel.: +385-145-66-806
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Krasic J, Skara L, Ulamec M, Katusic Bojanac A, Dabelic S, Bulic-Jakus F, Jezek D, Sincic N. Teratoma Growth Retardation by HDACi Treatment of the Tumor Embryonal Source. Cancers (Basel) 2020; 12:cancers12113416. [PMID: 33217978 PMCID: PMC7698704 DOI: 10.3390/cancers12113416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Testicular germ cell tumors are the most common neoplasms in young male populations, with a rising incidence. Among them, teratomas may often be very aggressive and resistant to therapy. Our aim was to investigate the impact of two potential anti-tumor epigenetic drugs (Valproate and Trichostatin A) in a mammalian model of teratoma development from an early trilaminar mouse embryo. Both drugs applied to the embryonic tissue had a significant negative impact on the teratoma growth in a three-dimensional in vitro culture. However, Trichostatin A did not diminish some potentially dangerous features of teratomas in contrast to Valproate. This research is an original contribution to the basic knowledge of the origin and development of teratomas. Such knowledge is necessary for envisioning therapeutic strategies against human testicular tumors. Abstract Among testicular germ cell tumors, teratomas may often be very aggressive and therapy-resistant. Our aim was to investigate the impact of histone deacetylase inhibitors (HDACi) on the in vitro growth of experimental mouse teratoma by treating their embryonic source, the embryo-proper, composed only of the three germ layers. The growth of teratomas was measured for seven days, and histopathological analysis, IHC/morphometry quantification, gene enrichment analysis, and qPCR analysis on a selected panel of pluripotency and early differentiation genes followed. For the first time, within teratomas, we histopathologically assessed the undifferentiated component containing cancer stem cell-like cells (CSCLCs) and differentiated components containing numerous lymphocytes. Mitotic indices were higher than apoptotic indices in both components. Both HDACi treatments of the embryos-proper significantly reduced teratoma growth, although this could be related neither to apoptosis nor proliferation. Trichostatin A increased the amount of CSCLCs, and upregulated the mRNA expression of pluripotency/stemness genes as well as differentiation genes, e.g., T and Eomes. Valproate decreased the amount of CSCLCs, and downregulated the expressions of pluripotency/stemness and differentiation genes. In conclusion, both HDACi treatments diminished the inherent tumorigenic growth potential of the tumor embryonal source, although Trichostatin A did not diminish the potentially dangerous expression of cancer-related genes and the amount of CSCLC.
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Affiliation(s)
- Jure Krasic
- Department of Medical Biology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia; (J.K.); (L.S.); (A.K.B.); (F.B.-J.)
- Scientific Group for Research on Epigenetic Biomarkers, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
| | - Lucija Skara
- Department of Medical Biology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia; (J.K.); (L.S.); (A.K.B.); (F.B.-J.)
- Scientific Group for Research on Epigenetic Biomarkers, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
| | - Monika Ulamec
- Scientific Group for Research on Epigenetic Biomarkers, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre Milosrdnice University Hospital Center, 10 000 Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia
| | - Ana Katusic Bojanac
- Department of Medical Biology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia; (J.K.); (L.S.); (A.K.B.); (F.B.-J.)
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
| | - Sanja Dabelic
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10 000 Zagreb, Croatia;
| | - Floriana Bulic-Jakus
- Department of Medical Biology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia; (J.K.); (L.S.); (A.K.B.); (F.B.-J.)
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
| | - Davor Jezek
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Department of Histology and Embryology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia
| | - Nino Sincic
- Department of Medical Biology, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia; (J.K.); (L.S.); (A.K.B.); (F.B.-J.)
- Scientific Group for Research on Epigenetic Biomarkers, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia;
- Correspondence: ; Tel.: +385-1-45-66-806; Fax: +385-45-960-199
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