New Trends in the Detection of Gynecological Precancerous Lesions and Early-Stage Cancers.

The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.

Electrochemical bioassay coupled to LAMP reaction for determination of high-risk HPV infection in crude lysates.

Electrochemical (EC) detection of DNA biomarkers represents an interesting tool in molecular oncology due to its sensitivity, simplicity, low cost or rapid times of measurement. However, majority of EC assays, same as most optical-based techniques, require preceding DNA extraction step to remove other cellular components, making these assays more laborious and time-consuming. One option to circumvent this is to use LAMP (loop-mediated amplification), an isothermal amplification technique that can amplify DNA directly in crude lysates in a short time at a constant temperature. Here, we coupled the LAMP reaction with EC readout to detect DNA from the two most common oncogenic human papillomavirus (HPV) types that cause cervical cancer in women, i.e. HPV 16 and HPV 18, directly in crude lysates without a need for DNA extraction step. We show that in crude lysates, the LAMP reaction was superior to PCR, with very good selectivity on a panel of cancer cell lines and with high sensitivity, enabling detection of HPV DNA from as few as 10 cells. As a proof of principle, we applied the assay to nineteen clinical samples both from uninfected women and from women suffering from cervical precancerous lesions caused by HPV 16 or HPV 18 genotypes. Clinical samples were simply boiled for 5 min in homogenization buffer without DNA extraction step, and amplified with LAMP. We obtained excellent concordance of our assay with PCR, reaching 100% sensitivity for both genotypes, 81.82% specificity for HPV 16 and 94.12% specificity for HPV 18. Proposed assay could be a straightforward, simple, rapid and sensitive alternative for early diagnostics of precancerous cervical lesions.

The role of miR-409-3p in regulation of HPV16/18-E6 mRNA in human cervical high-grade squamous intraepithelial lesions.

Cervical cancer is one of the most common malignancies in women. MicroRNAs (miRNAs) are involved in a variety of fundamental cellular processes, including carcinogenesis. The potential utilization of aberrantly expressed miRNAs as novel biomarkers in cervical cancer diagnostics is growing. We investigated miRNA expression profiles during the progression of dysplasia in cervical epithelium to identify aberrantly expressed miRNAs. High-throughput miRNA profiling of high-grade precancerous lesions identified 79 miRNAs showing significant difference in expression values compared to normal cervical epithelium. Ten selected miRNAs were subsequently measured in an independent group of samples to validate them as promising biomarkers of cervical carcinogenesis. MicroRNAs miR-10b-5p, miR-34c-5p, miR-409-3p and miR-411-5p were confirmed as downregulated, while miR-10a-5p, miR-132-3p, miR-141-5p were significantly upregulated in dysplastic cervical tissues. Further investigation revealed an inverse correlation of miR-409-3p with E6 mRNA levels in precancerous cervical lesions. Subsequent in vitro analyses showed a direct involvement of this miRNA in the regulation of E6 oncogene levels, thus confirming a potential tumor suppressor function of miR-409-3p in cervical malignancies. Hence, miR-409-3p may represent a useful early marker and a potential therapeutic target for cervical cancer.

Genomagnetic LAMP-based electrochemical test for determination of high-risk HPV16 and HPV18 in clinical samples.

Major cause of cervical cancer is a persistent infection with high-risk types of human papillomaviruses (HPV). For that reason, HPV testing is now becoming an important addition to standard cytological screening of cervical malignancies in women (known as Pap test). New methods are sought which could offer rapid and inexpensive detection schemes, such as those based on electrochemical (EC) readout. Here, we developed an assay for parallel detection of two most oncogenic high-risk HPV types, HPV16 and HPV18, by combining loop-mediated amplification (LAMP) of template DNA, its separation using magnetic beads and detection with amperometry at carbon-based electrode chips. Our EC-LAMP test enabled us to successfully discriminate both HPV types not only in cancer cell lines, but also using clinical material obtained from HPV-positive patient samples.

Struma ovarii - ultrasound features of a rare tumor mimicking ovarian cancer.

AIMS: To describe the ultrasound features of benign struma ovarii that often mimic ovarian cancer in the background of complex clinical and histopathological pictures. MATERIAL AND METHODS: We retrospectively identified patients with histologically confirmed benign struma ovarii, treated in our institution between 2003-2016 with complete imaging, clinical, nd histopathological data available. Ultrasound findings were drawn from images, and reports using terms and definitions of the International Ovarian Tumor Analysis group and pattern recognition description was applied. RESULTS: In all, 19 patients were identified; 10 with pure and 9 with impure struma. Median age was 47 (range 24-69); 10 (53%) were premenopausal. Only four (21%) patients presented with pain, others were asymptomatic. Using pattern recognition, 74% strumas (14/19) were uni-/multilocular solid or solid tumors. The solid components were roundish with smooth contours. Six struma pearls were detected. The subjective color score was moderate or abundant in the majority of solid components. Only 5 (26%) tumors were purely cystic. CONCLUSIONS: The ultrasound characteristics differ widely from typical mature ovarian teratoma. Features such as, solid roundish components with smooth contours, struma pearls, acoustic shadowing and occasionally signs of dermoid are clues and may help preoperatively to differentiate benign struma from malignant adnexal lesions.

Expression and Functional Characterization of miR-34c in Cervical Cancer.

BACKGROUND: Cervical cancer is the fourth most common cancer in women and is usually associated with human papillomavirus infection. Viral infections are usually characterized by morphological changes of epithelial cells; however, it is difficult to determine using recently available screening methods whether the changes are caused by productive infection or by malignant disease. Thus, new efforts are required to find novel diagnostic biomarkers of cervical cancer, such as miRNAs, which are small non-coding RNAs involved in the regulation of gene expression. MATERIALS AND METHODS: miR-34c levels in cervical cancer cell lines were determined by the droplet-digital polymerase chain reaction. Changes in miR-34c expression in vitro were achieved by transient transfection with a specific miRNA mimic and inhibitor oligonucleotides. Cell proliferation was analyzed by crystal violet staining followed by spectrophotometric measurements. The effect on migratory properties was studied using a „scratch“ assay. Western blotting analysis was used to determine the expression of selected proteins. RESULTS: The downregulation of miR-34c expression was associated with a slight increase in cellular proliferation and a significant increase in cell migration. The analysis of miR-34c expression performed on a set of 39 dysplastic tissues and 35 samples of healthy controls subsequently revealed a significant difference (p < 0.01) in the level of this miRNA. CONCLUSION: Comparative expression analysis revealed lower expression of miR-34c in cervical precanceroses than in normal untransformed epithelium. in vitro modulation of miR-34c expression revealed its tumor suppressor role in cervical  malignancies. Key words: cervical cancer - HPV - miRNA - HSIL - hsa-miR-34c - precancerosis This work was supported by the projects MEYS - NPS I - LO1413, P206/12/G151 and MH CZ - DRO (MMCI, 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.  The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Accepted: 16. 7. 2018.

Electrochemical chip-based genomagnetic assay for detection of high-risk human papillomavirus DNA.

Cervical cancer, being the fourth leading cause of cancer death in women worldwide, predominantly originates from a persistent infection with a high-risk human papillomavirus (HPV). Detection of DNA sequences from these high-risk strains, mostly HPV-16 and HPV-18, represents promising strategy for early screening, which would help to identify women with higher risk of cervical cancer. In developing countries, inadequate screening options lead to disproportionately high mortality rates, making a fast and inexpensive detection schemes highly important. Electrochemical sensors and assays offer an alternative to current methods of detection. We developed an electrochemical-chip based assay, in which target HPV DNA is captured via magnetic bead-modified DNA probes, followed by an antidigoxigenin-peroxidase detection system at screen-printed carbon electrode chips, enabling parallel measurements of eight samples simultaneously. We show sensitive detection in attomoles of HPV DNA, selective discrimination between HPV-16 and HPV-18 and good reproducibility. Most importantly, we show application of the assay into both cancer cell lines and cervical smears from patients. The electrochemical results correlated well with standard methods, making this assay potentially applicable in clinical practice.