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01.12.2018 | Research | Ausgabe 1/2018 Open Access

Journal of Experimental & Clinical Cancer Research 1/2018

Serum DNA integrity index as a potential molecular biomarker in endometrial cancer

Journal of Experimental & Clinical Cancer Research > Ausgabe 1/2018
Enrico Vizza, Giacomo Corrado, Martina De Angeli, Mariantonia Carosi, Emanuela Mancini, Ermelinda Baiocco, Benito Chiofalo, Lodovico Patrizi, Ashanti Zampa, Giulia Piaggio, Lucia Cicchillitti
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:https://​doi.​org/​10.​1186/​s13046-018-0688-4) contains supplementary material, which is available to authorized users.
A correction to this article is available online at https://​doi.​org/​10.​1186/​s13046-018-0708-4.



Circulating cell-free DNA (cfDNA) and its integrity index may represent a rapid and noninvasive “liquid biopsy” biomarker, which gives important complementary information for diagnosis, prognosis, and treatment stratification in cancer patients. The aim of our study was to evaluate the possible role of cfDNA and its integrity index as a complementary tool for endometrial cancer (EC) management.


Alu-quantitative real-time PCR (qPCR) analysis wasprformed on 60 serum samples from preoperative EC patients randomly recruited. Both cfDNA content and DNA integrity index were measured by qPCR-Alu115 (representing total cfDNA) and qPCR-Alu247 (corresponding to high molecular weight DNA) and correlated with clinicopathologic characteristics. Lymphovascular space invasion (LVSI) was detected by hematoxylin and eosin staining. In case of doubt, LVSI status was further evaluate by immunohistochemistry using anti-CD31 and anti-CD34 antibodies.


Total cfDNA content significantly increases in high grade EC. A significant decrease of DNA integrity index was detected in the subset of hypertensive and obese high grade EC. Serum DNA integrity was higher in samples with LVSI. The ordinal regression analysis predicted a significant correlation between decreased integrity index values and hypertension specifically in tumors presenting LVSI.


Our study supports the utility of serum DNA integrity index as a noninvasive molecular biomarker in EC. We show that a correlation analysis between cfDNA quantitative and qualitative content and clinicopathologic features, such as blood pressure level, body mass index (BMI) and LVSI status, could represent a potential predictive signature to help stratification approaches in EC.
Additional file 1: Table S1. CfDNA content and EC staging. Measurement of median cfDNA values obtained by qPCR-Alu115, qPCR-Alu247, and pPCR-Alu247/qPCR-Alu115 (DNA integrity index) in different EC stages. (DOCX 15 kb)
Additional file 2: Table S2. Receiver operative characteristics (ROC) analysis and optimal cut-offs values for cfDNA evaluated by qPCR-Alu115, qPCR-Alu247 and qPCR-Alu247/qPCR-Alu115 in G2 and G3 EC versus G1 EC serum samples. (DOCX 11 kb)
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