title: A 7 gene expression score predicts for radiation response in cancer cervix.
abstract: BACKGROUND
  Cervical cancer is the most common cancer among Indian women. The current recommendations are to treat the stage IIB, IIIA, IIIB and IVA with radical radiotherapy and weekly cisplatin based chemotherapy. However, Radiotherapy alone can help cure more than 60% of stage IIB and up to 40% of stage IIIB patients.
  
  
  METHODS
  Archival RNA samples from 15 patients who had achieved complete remission and stayed disease free for more than 36 months (No Evidence of Disease or NED group) and 10 patients who had failed radical radiotherapy (Failed group) were included in the study. The RNA were amplified, labelled and hybridized to Stanford microarray chips and analyzed using BRB Array Tools software and Significance Analysis of Microarray (SAM) analysis. 20 genes were selected for further validation using Relative Quantitation (RQ) Taqman assay in a Taqman Low-Density Array (TLDA) format. The RQ value was calculated, using each of the NED sample once as a calibrator. A scoring system was developed based on the RQ value for the genes.
  
  
  RESULTS
  Using a seven gene based scoring system, it was possible to distinguish between the tumours which were likely to respond to the radiotherapy and those likely to fail. The mean score +/- 2 SE (standard error of mean) was used and at a cut-off score of greater than 5.60, the sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) were 0.64, 1.0, 1.0, 0.67, respectively, for the low risk group.
  
  
  CONCLUSIONS
  We have identified a 7 gene signature which could help identify patients with cervical cancer who can be treated with radiotherapy alone. However, this needs to be validated in a larger patient population.
authors.affiliation: Department of Molecular Oncology, Cancer Institute (WIA), Chennai, India. drtrajkumar@gmail.com
authors.forename: Thangarajan
authors.initials: T
authors.lastname: Rajkumar
authors.forename: Neelakantan
authors.initials: N
authors.lastname: Vijayalakshmi
authors.forename: Kesavan
authors.initials: K
authors.lastname: Sabitha
authors.forename: Sundersingh
authors.initials: S
authors.lastname: Shirley
authors.forename: Ganesharaja
authors.initials: G
authors.lastname: Selvaluxmy
authors.forename: Mayil Vahanan
authors.initials: MV
authors.lastname: Bose
authors.forename: Lavanya
authors.initials: L
authors.lastname: Nambaru
mesh_terms: D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000235:genetics* / Q000473:pathology / Q000532:radiotherapy*