Liquid biopsy for non-invasive assessment of liver injury in hepatitis B patients.

BACKGROUND: Hepatitis B is a major public health problem in China. Accurate liver injury assessment is essential for clinical evidence-based treatment. Liver biopsy is considered the gold standard method to stage liver disease, but it is not widely used in resource-limited settings. Therefore, non-invasive liquid biopsy tests are needed. AIM: To assess liver injury in hepatitis B patients using quantified cell free DNA combined with other serum biomarker as a liquid biopsy-based method. METHODS: A cohort of 663 subjects including 313 hepatitis B patients and 350 healthy controls were enrolled. Ultrasound-guided liver biopsies followed by histopathological assessments were performed for the 263 chronic hepatitis B patients to determine the degree of liver injury. Cell-free DNA was quantified using a novel duplex real-time polymerase chain reaction assay. RESULTS: Compared with healthy controls, patients with hepatitis B virus (HBV) infection had significantly higher plasma DNA, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, and HBV DNA levels (P < 0.01). Serum ALT, AST, bilirubin, and plasma DNA levels of patients with marked-severe inflammation were significantly higher than those with mild-moderate inflammation (P < 0.01). There was a statistically significant correlation between hepatocyte inflammation severity and serum bilirubin (R 2 = 0.673, P < 0.01) or plasma DNA (R 2 = 0.597, P < 0.01) levels. The areas under the curves of serum ALT, bilirubin, plasma DNA, and their combination to distinguish between patients with mild-moderate and marked-severe inflammation were 0.8059, 0.7910, 0.7921, and 0.9564, respectively. CONCLUSION: The combination of plasma DNA, serum ALT, and bilirubin could be a candidate liquid biopsy for non-invasive assessment of liver injury in hepatitis B patients.

miR-638 is a new biomarker for outcome prediction of non-small cell lung cancer patients receiving chemotherapy.

MicroRNAs (miRNAs), a class of small non-coding RNAs, mediate gene expression by either cleaving target mRNAs or inhibiting their translation. They have key roles in the tumorigenesis of several cancers, including non-small cell lung cancer (NSCLC). The aim of this study was to investigate the clinical significance of miR-638 in the evaluation of NSCLC patient prognosis in response to chemotherapy. First, we detected miR-638 expression levels in vitro in the culture supernatants of the NSCLC cell line SPC-A1 treated with cisplatin, as well as the apoptosis rates of SPC-A1. Second, serum miR-638 expression levels were detected in vivo by using nude mice xenograft models bearing SPC-A1 with and without cisplatin treatment. In the clinic, the serum miR-638 levels of 200 cases of NSCLC patients before and after chemotherapy were determined by quantitative real-time PCR, and the associations of clinicopathological features with miR-638 expression patterns after chemotherapy were analyzed. Our data helped in demonstrating that cisplatin induced apoptosis of the SPC-A1 cells in a dose- and time-dependent manner accompanied by increased miR-638 expression levels in the culture supernatants. In vivo data further revealed that cisplatin induced miR-638 upregulation in the serum derived from mice xenograft models, and in NSCLC patient sera, miR-638 expression patterns after chemotherapy significantly correlated with lymph node metastasis. Moreover, survival analyses revealed that patients who had increased miR-638 levels after chemotherapy showed significantly longer survival time than those who had decreased miR-638 levels. Our findings suggest that serum miR-638 levels are associated with the survival of NSCLC patients and may be considered a potential independent predictor for NSCLC prognosis.

[Quantitative detection of APC/RASSF1A promoter methylation in the plasma of patients with cervical diseases].

OBJECTIVE: To quantitatively detect adenomatous polyposis coli(APC) and Ras association domain family 1A( RASSF1A) promoter methylation levels in the plasma of patients with cervical disease and to determine the diagnostic value of the indicators of cervical disease. METHODS: Preoperative blood samples were collected from 25 cases of healthy women and 118 cases of cervical disease, and tissue samples were also collected from 31 cases of them. The APC/RASSF1A promoter methylation levels of plasma and tissue were determined by duplex real-time quantitative methylation specific PCR (qMSP). RESULTS: Among 31 paired plasma and tissue samples, true negative rate of APC and RASSF1A genes were all 100%, and true positive rate of APC and RASSF1A genes were 3/5 and 7/9, respectively. In 143 cases of plasma samples, total positive rate of APC and (or) RASSF1A methylation was 3% (2/59) for control/low-grade lesions groups and 48% (40/84) for high-grade lesions/tumor groups (P < 0.01) . RASSF1A methylation rate was related to lymph node metastasis and International Federation of Gynecology and Obstetrics (FIGO) stage (P < 0.05). CONCLUSION: The plasma APC/RASSF1A methylation detection may be with some application prospect in the diagnosis of cervical diseases.

[Methylation quantification of adenomatous polyposis coli (APC) gene promoter in plasma of lung cancer patients].

BACKGROUND AND OBJECTIVE: The protein encoded by adenomatous polyposis coli (APC) gene participates in the signaling transduction pathway. Substantial studies have revealed that hypermethylation of APC gene promoter is closely related to the pathogenesis and development of cancer. This study was to develop a real-time quantitative methylation specific PCR (real-time QMSP) method, and detect the methylation of APC gene promoter in plasma of lung cancer patients. METHODS: Genomic DNA with methylated APC gene promoter was extracted from the lung cancer cell line NCI-H460 using phenol-chloroform and quantified by spectrophotometric measurements. DNA was added into 200 microL plasma samples of healthy volunteers to make 10-fold serial dilutions. Circulating DNA from simulated plasma samples, 78 lung cancer patients, 31 patients with benign lung diseases and 23 health controls was extracted using magnetic beads and modified by bisulfite. The concentration of cell-free methylated APC gene promoter in the plasma samples was quantified by the external reference method with the standard curve constructed using simulated plasma. RESULTS: The linear range of the real-time QMSP assay was 1.5x10(2)-1.5x10(5) copies/ mL and its lowest detectability was 1.5x10(2) copies per milliliter plasma. Of 78 lung cancer patients, positive methylation of the APC gene promoter was detected in tumor tissues of 40 cases. Among the 40 lung cancer patients, positive methylation of the APC gene promoter was found in the plasma of 19 patients (47.5%). The concentrations of methylated APC promoter in the 19 lung cancer patients ranged from 1.67x10(2) to 6.78x10(3) copies/mL, with a median concentration of 1.67x10(3) copies/mL. No positive methylation of the APC gene promoter was detected in the plasma of 38 lung cancer patients without APC gene methylation in tissues, 31 benign lung diseases and 23 healthy controls. CONCLUSIONS: The newly developed real-time QMSP method allows the quantitative measurement of APC gene promoter methylation in plasma. Hypermethylation of the APC gene promoter in plasma is a potential diagnostic marker for lung cancer diagnosis.

[Effect of adenomatous polyposis coli(APC) promoter methylation on gene transcription in lung cancer cell lines].

BACKGROUND & OBJECTIVE: Hypermethylation of CpG islands in adenomatous polyposis coli (APC) gene has been detected in a variety of human tumors, which is involved in the pathogenesis of these tumors. In previous research, we detected APC promoter methylation in 47% lung tumor tissues. This study was to analyze the effect of APC promoter methylation on the gene transcription in 3 lung cancer cell lines. METHODS: The methylation status of APC promoter 1A in lung adenocarcinoma cell line SPCA1, small cell lung cancer cell line NCI-H446, and big cell lung cancer cell line NCI-H460 was detected by methylation-specific polymerase chain reaction (MSP) and microarray methylated cord blood DNA served as positive control, and unmethylated cord blood DNA served as negative control. The expression of APC was examined by real-time quantitative polymerase chain reaction (PCR) with Sybr-Green I staining. After treatment of 1, 5, 10, 15 micromol/L DNA methyltransferase inhibitor 5-aza-2-deoxycytidine (5-aza-dC), the expression of APC in NCI-H460 cells was detected by real-time PCR. RESULTS: APC promoter 1A was methylated in NCI-H460 cells, and unmethylated in NCI-H446 and SPC-A1 cells. Hypermethylation was detected in all 5 CpG islands (687, 707, 714, 719, 726) of APC promoter 1A in NCI-H460 cells. The expression of APC in NCI-H460 cells was decreased by 26.04% of that in NCI-H446 cells and by 32.36% of that in SPCA1 cells. After treatment of 1, 5, 10, 15 micromol/L 5-aza-dC, the expression of APC promoter 1A in NCI-H460 cells was enhanced by 4.59, 5.78, 9.58, 5.98 folds, respectively. CONCLUSION: APC gene is hypermethylated in HCI-H460 cells, and its transcription coud be activated by 5-aza-dC.