Clinical Study Of PET/CT-guided Secondary Cytoreductive Surgery In Recurrent Epithelial Ovarian Cancer Promoter Methylation Of DAPK1, RAR-β And MGMT In Cervical Cytology And Its Clinical Application

Objectives The aims of the study were1) to investigate the completeness of secondary cytoreductive surgery and the prognosis in PET/CT-selected patients;2) to investigate the influence of PET/CT on the safety of secondary cytoreductive surgery; and3) to investigate the consistence of PET/CT examination with surgical exploration and pathological examination and its relation to the prognosis.Methods206patients of recurrent epithelial ovarian cancer were reviewed retrospectively. The patients were divided into2groups:103with PET/CT-guided surgery and103without PET/CT. The completeness of the surgery, the prognosis and the safety of the surgery were analyzed in the2groups. The consistence of PET/CT with surgical exploration and pathological examination and its relation to the prognosis were studied in the103patients with PET/CT-guided secondary cytoreductive surgery.Results The proportion of patients undergoing complete cytoreduction (P=0.002), the degree of complete resection (P=0.001) and the quantity of residual lesions (P=0.006) were significantly different between the PET/CT group and non-PET/CT group. Being sensitive to platinum-based chemotherapy (P=0.001), PET/CT-selected patients (P=0.034), more complete resection (P=0.039) and less residual lesions (P=0.004) were associated with longer progression-free survival (PFS) significantly. Being sensitive to platinum-based chemotherapy (P=0.000) and normal CA-125level after2cycles of chemotherapy (P=0.003) were associated with longer overall survival (OS) significantly. There was no significant difference in the safety parameters of the surgery between the two groups with and without PET/CT. There was no significant difference between PET/CT examination and surgical-pathological examination (P=0.144). Less lesions in PET/CT examination was correlated with longer progression-free survival (P=0.023).Conclusions For recurrent epithelial ovarian carcinoma, PET/CT was useful in pre-operative evaluation. Strictly selected patients, who could reach complete resection as evaluated with PET/CT, would benefit from secondary cytoreductive surgery. Background The aims of this study were (1) to assess the correlation of promoter methylation of DAPK1, RAR-β and MGMT with cervical lesions from cytology to histology,(2) to reveal the clinical value of DNA methylation in diagnosis of cervical intraepithelial neoplasia (CIN), and (3) to investigate the feasibility of detecting DNA methylation in liquid-based cervical cytology samples using methylation-specific high-resolution melting (MS-HRM) assay.Methods The MS-HRM assay was used to evaluate promoter methylation of three genes (DAPK1, RAR-β and MGMT) in103biopsy-confirmed liquid-based cervical cytology samples. Methylation levels and high-risk HPV DNA loading (HC2values) detected were analyzed in relation to both cytological and histological diagnosis.Results The methylation level of all three genes showed significant difference among the different cytological groups (p=0.000,0.011, and0.002respectively). The methylation level of DAPK1and RAR-β showed significant difference among the different histological groups (p=0.000and0.021), while there was no significant difference for MGMT. DAPK1methylation levels were significantly different between CIN2+and normal/CIN1groups (p=0.000), but there was no significant difference between CIN2+and normal/CIN1groups for RAR-β and MGMT. The combination of DAPK1/HR-HPV loading showed a sensitivity of0.825and an AUC of0.695as diagnostic methods for detecting CIN2+high-grade precancerous lesions.Conclusions DNA methylation such as DAPK1and RAR-β, in combination with HR-HPV detection, may serve as biomarkers to detect CIN2+high-grade precancerous lesions. Detection of methylated DNA from liquid-based cervical cytology specimens is technically feasible with the MS-HRM assay.