On the difference of micronucleus frequencies in peripheral blood lymphocytes between breast cancer patients and controls.

Sporadic breast cancer patients as well as mutation carriers of the BRCA genes have a reduced DNA repair capacity compared to controls when assessed by the G0 micronucleus test (G(0)MNT) or by induced chromosomal aberrations. Since the individual MN frequencies vary widely and overlap between cases and controls it remained unclear which percentage of the cases should be considered to exhibit an increased radiosensitivity. We performed a similar case-control study and found a highly significant difference (P < 0.0001) between all breast cancer cases (N = 91) and female controls (N = 96) using descriptive statistics and ANOVA with adjustment for age. This difference also holds for baseline MN frequencies (P = 0.0006) and for subgroups of the patients similar to those without treatment (P < 0.0001). These results were confirmed in a second sample acquired at a different hospital. Since we are dealing in this analysis with two predefined groups (patients and controls), we calculated odds ratios (ORs) in order to assess the discriminative power of the G0 MNT. These amounted to OR = 4.9 (P < 0.0001) for MN frequencies obtained by visual counting and ranged from OR = 11 (P < 0.0011) to OR = 22 (P < 0.0001) using automated counting. In order to overcome the problem of choosing a cut-off point inherent in ORs, receiver operating characteristic curves were calculated, which visualize specificity and sensitivity over the entire range of values and which characterize the discriminative power of a test by the area under the curve (AUC) (visual counting, baseline: AUC = 0.67; induced AUC = 0.75; automated counting: AUC > 0.88; evaluation sample: AUC > 0.73). We conclude that the G0 MNT may be a useful tool to substitute the phenotype breast cancer in association and linkage studies and that it may be possible to develop a test useful in the diagnosis or risk assessment for breast cancer.

Scoring variability of micronuclei in binucleated human lymphocytes in a case-control study.

The micronucleus test in binucleated lymphocytes is a sensitive standard assay for biomonitoring, mutagenicity testing and to assess radiosensitivity of blood donors. The results vary between laboratories and scorers which led to the definition of international scoring criteria. We used these criteria in a case-control study, but nevertheless observed large differences between the seven scorers on the level of descriptive analysis. Therefore, we used the repeat measurements (267 in 98 blood donors) from this dataset (354 measurements in 185 blood donors) to analyse scoring variability in the setting of a case-control study. The variability was assessed by analysis of variance, which revealed the storage time of the blood samples, the blood donors including their disease status, and the scorers as sources of variation in the entire dataset. In addition, the coefficient of variation (CV) of the measurements was determined (overall: CV = 24.3%). After stepwise removal of biological and experimental variation by normalizations, the CV dropped to 6.8% on average, which may reflect the 'pure counting error'. The scorer-specific CVs were between 5.5 and 9.5%. The differences between the scorers suggested by the raw data were neither related to the scorer-specific CV nor to their experience. Instead, we observed a general decline of the micronuclei frequencies towards the end of the study for all scorers. This could not be related to a change in experimental conditions or in the defined scoring criteria. An explanation could be an unintended and unrecognized change of scoring criteria. Since the change in the results did not occur in automated counting we suggest to use either reference slides in longer-lasting studies or automated counting by image analysis.