ABSTRACT
BACKGROUND: The early detection of breast cancer (BrC) is associated with improved survival. We describe a blood-based breast cancer detection test based on functional enrichment of breast-adenocarcinoma-associated circulating tumor cells (BrAD-CTCs) and their identification via multiplexed fluorescence immunocytochemistry (ICC) profiling for GCDFP15, GATA3, EpCAM, PanCK, and CD45 status. METHODS: The ability of the test to differentiate BrC cases (N = 548) from healthy women (N = 9632) was evaluated in a case-control clinical study. The ability of the test to differentiate BrC cases from those with benign breast conditions was evaluated in a prospective clinical study of women (N = 141) suspected of BrC. RESULTS: The test accurately detects BrAD-CTCs in breast cancers, irrespective of age, ethnicity, disease stage, grade, or hormone receptor status. Analytical validation established the high accuracy and reliability of the test under intended use conditions. The test detects and differentiates BrC cases from healthy women with 100% specificity and 92.07% overall sensitivity in a case-control study. In a prospective clinical study, the test shows 93.1% specificity and 94.64% overall sensitivity in differentiating breast cancer cases (N = 112) from benign breast conditions (N = 29). CONCLUSION: The findings reported in this manuscript support the clinical potential of this test for blood-based BrC detection.
ABSTRACT
BACKGROUND: Histopathologic examination (HPE) of tumor tissue obtained by invasive biopsy is the standard for cancer diagnosis but is resource-intensive and has been associated with procedural risks. The authors demonstrate that immunocytochemistry (ICC) profiling of circulating ensembles of tumor-associated cells (C-ETACs) can noninvasively provide diagnostic guidance in solid organ cancers. METHODS: The clinical performance of this approach was tested on blood samples from 30,060 individuals, including 9416 individuals with known cancer; 6725 symptomatic individuals with suspected cancer; and 13,919 asymptomatic individuals with no prior diagnosis of cancer. C-ETACs were harvested from peripheral blood and profiled by ICC for organ-specific and subtype-specific markers relevant to the cancer type. ICC profiles were compared with HPE diagnoses to determine concordance. RESULTS: The presence of malignancy was confirmed by the detection of C-ETACs in 91.8% of the 9416 individuals with previously known cancer. Of the 6725 symptomatic individuals, 6025 were diagnosed with cancer, and 700 were diagnosed with benign conditions; C-ETACs were detected in 92.6% of samples from the 6025 individuals with cancer. In a subset of 3509 samples, ICC profiling of C-ETACs for organ-specific and subtype-specific markers was concordant with HPE findings in 93.1% of cases. C-ETACs were undetectable in 95% of samples from the 700 symptomatic individuals who had benign conditions and in 96.3% of samples from the 13,919 asymptomatic individuals. CONCLUSIONS: C-ETACs were ubiquitous (>90%) in various cancers and provided diagnostically relevant information in the majority (>90%) of cases. This is the first comprehensive report on the feasibility of ICC profiling of C-ETACs to provide pan-cancer diagnostic guidance with accuracy comparable to that of HPE.
Subject(s)
Neoplasms/diagnosis , Neoplastic Cells, Circulating/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/metabolism , Female , Humans , Immunohistochemistry , Male , Middle Aged , Neoplasms/metabolism , Neoplasms/pathology , Observational Studies as Topic , Young AdultSubject(s)
Communicable Diseases, Emerging/epidemiology , Encephalitis Virus, Japanese/classification , Encephalitis Virus, Japanese/genetics , Encephalitis, Japanese/epidemiology , Cerebrospinal Fluid/virology , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/virology , Encephalitis Virus, Japanese/isolation & purification , Encephalitis, Japanese/diagnosis , Encephalitis, Japanese/virology , Genotype , Humans , India/epidemiology , Membrane Glycoproteins/genetics , Phylogeny , Reverse Transcriptase Polymerase Chain Reaction , Sequence Analysis, DNA , Viral Envelope Proteins/geneticsABSTRACT
During investigations into the outbreak of encephalitis in 1996 in the Kerala state in India, an arbovirus was isolated from a Culex tritaeniorhynchus mosquito pool. It was characterized as a Japanese encephalitis and West Nile virus cross-reactive arbovirus by complement fixation test. A plaque reduction-neutralization test was performed using hyperimmune sera raised against the plaque-purified arbovirus isolate. The sera did not show reactivity with Japanese encephalitis virus and were weakly reactive with West Nile virus. Complete open reading frame sequence analysis characterized the arbovirus as Bagaza virus (BAGV), with 94.80 % nucleotide identity with African BAGV strain DakAr B209. Sera collected from the encephalitic patients during the acute phase of illness showed 15 % (8/53) positivity for anti-BAGV neutralizing antibodies. This is the first report of the isolation of BAGV from India. The presence of anti-BAGV neutralizing antibodies suggests that the human population has been exposed to BAGV.
Subject(s)
Antibodies, Viral/blood , Culex/virology , Disease Outbreaks , Encephalitis, Viral/epidemiology , Flavivirus Infections/epidemiology , Flavivirus/classification , Animals , Cluster Analysis , Encephalitis Virus, Japanese/immunology , Encephalitis, Viral/immunology , Encephalitis, Viral/virology , Flavivirus/genetics , Flavivirus/immunology , Flavivirus/isolation & purification , Flavivirus Infections/immunology , Flavivirus Infections/virology , Humans , India/epidemiology , Mice , Molecular Sequence Data , Phylogeny , Sequence Analysis, DNA , Sequence Homology , West Nile virus/immunologyABSTRACT
An outbreak of viral encephalitis occurred in northern India in 2006. Attempts to identify an etiologic agent in cerebrospinal fluid by using reverse transcription-PCR showed positivity to enterovirus (EV) in 66 (21.6%) of 306 patients. Sequencing and phylogenetic analyses of PCR products from 59 (89.3%) of 66 specimens showed similarity with EV-89 and EV-76 sequences.
Subject(s)
Cerebrospinal Fluid/virology , Disease Outbreaks , Encephalitis, Viral , Enterovirus , Acute Disease , Adolescent , Animals , Cell Line , Cell Line, Tumor , Child , Child, Preschool , Cricetinae , Encephalitis, Viral/diagnosis , Encephalitis, Viral/epidemiology , Encephalitis, Viral/virology , Enterovirus/classification , Enterovirus/genetics , Enterovirus/isolation & purification , Enterovirus Infections/diagnosis , Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Humans , India/epidemiology , Infant , Infant, Newborn , Phylogeny , RNA, Viral/analysis , RNA, Viral/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction , Sequence Analysis, DNAABSTRACT
Experiments were carried out to demonstrate the susceptibity and transmission potential of Phlebotomus argentipes (Annandale & Brunetti) for Chandipura virus (CHPV). In India, P. argentipes is one of the predominant species found in many areas endemic for CHPV. Although its laboratory colonization is difficult, we have demonstrated that 65% of P. argentipes were susceptible to CHPV infection by the oral route. Transmission experiments were carried out by intrathoracic inoculation because of re-feeding problems with this species. After incubation for 24 hours, efficient transmission of CHPV to mice was observed. The estimated minimum transmission rate among the inoculated flies was 32%. CHPV in sand flies as well as in mice was detected and confirmed by immunofluorescent antibody assay and reverse transcription-polymerase chain reaction, respectively. The susceptibility of P. argentipes to CHPV and its potential to transmit the virus by bite has importance in epidemiology of CHPV.
