New technology for identifying early stage ovarian cancer in uterine and cervical cells could have the potential to one day stem this often deadly disease, according to a recent study in the International Journal of Cancer.
Using equipment that can carry out nanocytology — a technique that identifies cells at the nanoscale, or one billionth of a meter, much smaller than typical microscopy can detect — researchers were able to find ovarian cancerous cells that were invisible using a conventional microscope.
Ovarian cancer is the fifth-leading cause of cancer-related death among women in the United States, according to the Centers for Disease Control and Prevention.
Because prior research has shown that serous ovarian cancer, the deadliest type of the disease, originates in the fallopian tubes, the researchers suspected two contiguous sites might show a precancerous phase of the disease.
Dr. Vadim Backman, professor of biomedical engineering at Northwestern's McCormick School of Engineering and Applied Science, said the method had the potential to eventually predict cancer in patients, though that could be a decade from now.
"The cells are predisposed and some of them may accumulate a sufficient number of mutations to turn into frankly cancerous cells and give rise to tumor," Backman said.
In the study, which was published in the International Journal of Cancer's April issue, the researchers examined endometrial cells from 26 patients (11 with cancer and 15 without) and endocervical cells from 23 patients (10 with cancer and 13 without) prior to hysterectomy. They found an abnormal clumping of chromatin — the DNA and proteins that comprise the nucleus of a cell — in people with cancer that was 50 percent to 100 percent higher than normal.
If the findings are replicated on a larger scale, doctors could brush the cervix and endometrium for cells during a pap smear and only have to use costlier tests, such as a CT scan, to confirm a diagnosis, Backman said.
The researchers' previous studies have shown the same concept at work in lung, colon and pancreatic cancers. Cells from the cheek were used for the lung cancer study, from rectum for the colon study and from the duodenum for the pancreas study.
"In many cancers, including ovarian, even in neighboring cells, cancer can be a fertile field of bad milieu with the same genetic risk factors that led to the cancer changing the linings of neighboring organs," said Dr. Hemant Roy, chief of gastroenterology at the Boston University School of Medicine and the Boston Medical Center. Roy is a co-author of the study.
Roy, who was director of gastroenterology research at NorthShore University HealthSystem when the study was performed, noted there is currently no effective method for screening ovarian cancer.
Dr. Jamie N. Bakkum-Gamez, assistant professor of obstetrics and gynecology at the Mayo Clinic in Rochester, Minn., said the study "is definitely novel."
"It's more widely applicable seemingly than some of the current avenues of study for early detection, such as looking at specific gene mutations or DNA modifications, mainly because it is a fairly generalized way of looking at cell morphology and cell changes," Bakkum-Gamez said.
Bakkum-Gamez said one weakness was a potential test would be limited to the woman with an intact cervix and uterus. But the test would still "potentially improve survival" of many women, she said.
Backman noted cervical cancer was reduced by roughly 90 percent after the pap smear was developed in the 1930s
"It's a really scary diagnosis," Backman said. "We want to help these people."Copyright © 2015, The Baltimore Sun