title: Detection of somatic TP53 mutations in tampons of patients with high-grade serous ovarian cancer.
abstract: OBJECTIVE
  To investigate whether tumor cells could be detected in the vagina of women with serous ovarian cancer through TP53 analysis of DNA samples collected by placement of a vaginal tampon.
  
  
  METHODS
  Women undergoing surgery for a pelvic mass were identified in the gynecologic oncology clinic. They placed a vaginal tampon before surgery, which was removed in the operating room. Cells were isolated and DNA was extracted from both the cells trapped within the tampon and the primary tumor. In patients with serous carcinoma, the DNA was interrogated for the presence of TP53 mutations using a method capable of detecting rare mutant alleles in a mixture of mutant and wild-type DNA.
  
  
  RESULTS
  Thirty-three patients were enrolled. Eight patients with advanced serous ovarian cancer were included for analysis. Three had a prior tubal ligation. TP53 mutations were identified in all eight tumor samples. Analysis of the DNA from the tampons revealed mutations in three of the five patients with intact tubes (sensitivity 60%) and in none of the three patients with tubal ligation. In all three participants with mutation detected in the tampon specimen, the tumor and the vaginal DNA harbored the exact same TP53 mutation. The fraction of DNA derived from exfoliated tumor cells ranged from 0.01% to 0.07%.
  
  
  CONCLUSIONS
  In this pilot study, DNA derived from tumor was detected in the vaginas of 60% of patients with ovarian cancer with intact fallopian tubes. With further development, this approach may hold promise for the early detection of this deadly disease.
authors.affiliation: Departments of Obstetrics and Gynecology and Pathology, University of Alabama at Birmingham, Birmingham, Alabama; the Ludwig Center of Cancer Genetics and Therapeutics and the Swim Across America Laboratory at Johns Hopkins University, Baltimore, Maryland; and the Departments of Obstetrics and Gynecology and Pathology, University of Virginia, Charlottesville, Virginia.
authors.forename: Britt K
authors.initials: BK
authors.lastname: Erickson
authors.forename: Isaac
authors.initials: I
authors.lastname: Kinde
authors.forename: Zachary C
authors.initials: ZC
authors.lastname: Dobbin
authors.forename: Yuxuan
authors.initials: Y
authors.lastname: Wang
authors.forename: Jovana Y
authors.initials: JY
authors.lastname: Martin
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Alvarez
authors.forename: Michael G
authors.initials: MG
authors.lastname: Conner
authors.forename: Warner K
authors.initials: WK
authors.lastname: Huh
authors.forename: Richard B S
authors.initials: RBS
authors.lastname: Roden
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Kinzler
authors.forename: Nickolas
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: Bert
authors.initials: B
authors.lastname: Vogelstein
authors.forename: Luis A
authors.initials: LA
authors.lastname: Diaz
authors.forename: Charles N
authors.initials: CN
authors.lastname: Landen
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D004252:DNA Mutational Analysis; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D052576:Menstrual Hygiene Products; D008875:Middle Aged; D060787:Neoplasm Grading; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D010865:Pilot Projects; D011237:Predictive Value of Tests; D016159:Tumor Suppressor Protein p53 / Q000032:analysis* / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53