DNA Ploidy Cytometry Testing for Cervical Cancer Screening in China (DNACIC Trial): a Prospective Randomized, Controlled Trial

Tong, Hua; Shen, Rong; Wang, ZhuMing; Kan, YanJing; Wang, Yiquan; Li, FengShan; Yang, Jie; Guo, Xirong

doi:10.1158/1078-0432.ccr-09-1689

Cited by 28 publications

(48 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study is the first to apply fully automated ICM to measure DNA ploidy in effusion cytology specimens and to determine its value in the diagnosis of effusion. Automated DNA ICM technology has been recently proven in some studies to increase the sensitivity of cytologic detection of dysplastic and malignant cells in several types of cancers [5,6,28]. Because it uses automation and digital slide scanning technology, ICM is simple and easy to use, requiring minimal training and experience.…”

Section: Discussionmentioning

confidence: 99%

“…Automated quantitative image analysis of DNA aneuploidy of cells has recently been shown to be a simple, practical and effective method for application of the biomarker in cytologic diagnosis [5][6][7]. DNA aneuploidy is a hall marker of cancer, resulting from genetic and chromosome instability of cancer cells, a common event in caner carcinogenesis [8].…”

Section: Z Meng Et Al / Automated Quantification Of Dna Aneuploidy mentioning

confidence: 99%

“…It was shown to be a predictive marker for progression of dysplasia in cervical cancer [9], transformation from dysplasia to malignancy in esophageal adenocarcinoma [10], and requirement of aggressive treatment in breast [11], ovarian [12] and endometrial cancers [13] as it is associated with adverse prognosis in those and other cancers [14]. Several recent studies have shown the value of automated quantitative analysis of DNA aneuploidy by image cytometry (ICM) in the cytologic diagnosis and screening of cervical, esophageal and oral cancer [5][6][7]15], among others.…”

Section: Z Meng Et Al / Automated Quantification Of Dna Aneuploidy mentioning

confidence: 99%

See 2 more Smart Citations

Automated Quantification of DNA Aneuploidy by Image Cytometry as an Adjunct for the Cytologic Diagnosis of Malignant Effusion

Meng

Shi

Zhu³

et al. 2013

Analytical Cellular Pathology

View full text Add to dashboard Cite

Abstract. DNA aneuploidy is a cancer biomarker, which may have a potential diagnostic value in body effusion specimen. DNA aneuploidy is determined by measuring the DNA content of tested cells and comparing them with diploid cells (2c). In order to assess the value of automated DNA image cytometry (DNA-ICM) in the cytologic diagnosis of effusion, we measured DNA ploidy using an automated DNA-ICM analysis system in 126 consecutive effusion specimens and followed the cases for histologic diagnosis. Half of each effusion specimen was used to prepare cytologic smears for conventional cytologic diagnosis, while the other half was used to prepare a monolayer slide stained by Feulgen stain for automated ICM. By using Youden index, we found that 4 cells exceeding 2.5c is the optimal cut off value for aneuploidy, which has a sensitivity of 88.3% and specificity of 100% for diagnosis of malignant effusion. We also found that the DNA aneuploidy thresholds used for other types of cytologic specimens cannot be used in the diagnosis of effusion specimens. Our study demonstrated that automated DNA image cytometry is a simple, practical and cost-effective method for adjunct diagnosis of malignant effusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Z Meng Et Al / Automated Quantification Of Dna Aneuploidy mentioning

confidence: 99%

Section: Z Meng Et Al / Automated Quantification Of Dna Aneuploidy mentioning

confidence: 99%

See 1 more Smart Citation

Automated Quantification of DNA Aneuploidy by Image Cytometry as an Adjunct for the Cytologic Diagnosis of Malignant Effusion

Meng

Shi

Zhu³

et al. 2013

Analytical Cellular Pathology

View full text Add to dashboard Cite

show abstract

“…Garner, Guillaud, and MacAulay in our work and thank them for their critical comments on our recent publication (1). Early detection of cancerous lesions is a pivotal step for reducing cervical cancer-associated mortality.…”

mentioning

confidence: 89%

DNA Cytometry Testing for Cervical Cancer Screening – Response

Tong¹,

Shen²,

Kan³

et al. 2010

Clinical Cancer Research

Self Cite

View full text Add to dashboard Cite

We appreciate the interest of Drs. Garner, Guillaud, and MacAulay in our work and thank them for their critical comments on our recent publication (1). Early detection of cancerous lesions is a pivotal step for reducing cervical cancer-associated mortality. Finding a method which possesses high sensitivity and specificity in screening of mass populations has been difficult for cancer researchers. False negatives are a major problem for cervical cancer testing using conventional cytologic methods and frequent retesting is required (2). Previous studies have reported that DNA ploidy testing could increase the positive prediction of precancerous and cancerous lesions of uterine cervix compared with cytology (3-5). However, there has been little data on DNA ploidy cytometry testing as a single detection method in low-resource countries where it might be used for large population screening. This was the basis for performing the randomized study under discussion. Our goal was to test the hypothesis that DNA ploidy cytometry testing would be superior to conventional cytologic screening to detect early precancerous or cancerous cervical lesions.First, we need to clarify the design of our study as to whether it was a randomized controlled trial or not. Garner et al. critically said that our study was not a randomized trial because the data analyzed in our study were pooled together from both arms. In fact, we did perform both DNA cytometry and the cytologic evaluation on all patients' specimens. This was done for ethical reasons because performing a single test on each arm would not have been approved by our institutional review boards. In Table 2 from our article, the results we reported included crossover screening. We apologize for not making this clear. However, all study processes were conducted in a randomized manner, i.e., patient's eligibility screening, randomization, blindness concealment and uncovering, intention-to-treat, and per protocol analyses. Such analyses, at first, gave an overall understanding as to the two testing methods' capability to detect possible cervical lesions. Furthermore, presenting the data in this manner did not influence the study design because this table only provided partial information about the whole study. We also performed analyses for the two separate groups (see Table 1). We felt we had made these points clear in the Materials and Methods and Results sections, but perhaps should have commented further in the Discussion.As mentioned above, the data in our article was presented inconsistently between Table 2 and in the text, which resulted in our readers' difficulty in understanding our design and data analyses. As Garner et al. pointed out, we stated that 54 cases of cancer were detected in the Results section, whereas Table 2 showed a total of 64 cases of cancer. As noted above, this is because Table 2 presented the results of crossover testing. The 54 cases stated in the Results section were the number of total cases detected by cytometry and cytology without crossover testi...

show abstract

“…Flow cytometry DNA content analysis on minced biopsy specimens (Melsheimer et al 2004) or smear (Tong et al, 2009) allow the association between aneuploidy and dysplasia degree. lrHPV types tend to be associated with polyclonal lesions whereas hrHPV types are associated with monoclonal lesions (Park et al, 1996).…”

Section: Proliferation Markersmentioning

confidence: 99%