Possible role of the micronucleus assay in diagnostics and secondary prevention of cervix cancer: A minireview

Recent literature data are presented concerning micronuclei (MN) frequency in exfoliated cells of cervix cancer patients. These data strongly support a positive correlation between the MN level and malignization (changes from pre-malignant stage to cancer). It is suggested that the evaluation of frequency of MN in exfoliated cervical cells may be an additional criterion for establishing cervical cancer risk and the study of MN in cervix smears will increase the sensitivity and specificity of cytology which could impact in diagnostics and secondary prevention of cervical cancer. The text was submitted by the author in English.     

Biomonitoring of the cytogenetic effect of antitumor therapy by means of micronucleus assay in exfoliated epithelial cells

Data are presented concerning the possibility of using the micronuclei (MN) level as a biomarker for cytogenetic effects in exfoliated epithelial cells of cancer patients under therapy. The number of MN in buccal cells of cancer patients under chemotherapy are very contradictory. A significant dose-dependent increment of MN in tumor and normal epithelial cells due to radiotherapy was shown in most investigations. Evaluation of MN induced by radiotherapy in exfoliated tumor cells can potentially identify the radiosensitivity of tumors and the outcome of treatment after the first fractions of irradiation. This technique is almost completely noninvasive and easily done in accessible primary cancers (oral cavity and uterine cervix). The text was submitted by the author in English.     

Micronuclei level in exfoliated buccal mucosa cells of patients with benign and malignant tumors of female reproductive organs and breast

Micronucleus (MN) levels in exfoliated buccal mucosa cells of primary breast, cervix and corpus uteri cancer patients, and patients with benign tumors of uterus (myoma) and breast (fibroadenoma) were studied. Significantly increased number of MN in cells of cancer patients was observed compared to both healthy persons and patients with benign tumors. In patients with benign tumors no increase in MN quantity was observed. The evaluation of MN number in buccal mucosa cells shows genomic instability caused by malignant tumor in somatic cells of humans.     

Use of the micronucleus assay with exfoliated epithelial cells as a biomarker for monitoring individuals at elevated risk of genetic damage and in chemoprevention trials.

This review summarises the current database on the micronucleus (MN) assay with exfoliated cells (MEC assay) and evaluates the predictive value of this model for the detection of human cancer risks. The MEC test is a cost effective, non-invasive method, in which the formation of MN in exfoliated cells from different organs, such as oral and nasal cavity, bladder, cervix, and oesophagus is used as an endpoint to detect endogenous, lifestyle, occupational and environmental exposures to genotoxins as well as chemoprotection of various compounds in intervention studies. The results suggest that the MN assay might be a useful approach to identify antimutagens which are protective in humans. Based on the comparison of the data from MN experiments with results from epidemiological cancer studies, we conclude that the MEC assay is a useful biomarker for the detection of human cancer risk in organs to which the MEC test can be applied. However, the current data base is not sufficient to draw a firm conclusion on the specificity of this approach.     

Dimethylhydrazine: a reliable positive control for the short sampling time in the UDS assay in vivo

Cervical cancer represents the second most common malignant neoplasia in women world-wide. In Mexico, cervical cancer is the most common female malignancy. It has been recently seen an increased frequencies of micronuclei (MN) lymphocytes and cervical epithelial cells of cervical cancer patients. The aim of this hospital-based unmatched case-control study was to investigate the association between progressive stages in development of cervical cancer and frequency of micronucleated cells in the cervical epithelium and peripheral lymphocytes of 40 women, grouped by disease stage. Women at the Obstetrics and Gynecology Hospital of the Instituto Mexicano del Seguro Social (IMSS) in Monterrey, Mexico were diagnosed and classified on the bases of the Papanicolaou (PAP) smear and colposcopy/biopsy into control, low-grade squamous intraepithelial lesions (LGSIL), high-grade squamous intraepithelial lesions (HGSIL), and invasive groups. Analysis of the MN data in both cell types revealed (a) homogeneity among women within each of the four groups with regard to MN frequency, (b) in general, a correlation between MN frequency and grade of cervical lesion, and (c) a positive linear trend between the MN frequency and increased cervical cancer risk. In conclusion, we suggest that MN are a useful biomarker of cancer risk. Nonetheless, these results should be validated by other researchers.     

The association between micronucleus,nucleoplasmic bridges,and nuclear buds frequency and the degree of uterine cervical lesions

Background and aim: The loss of genomic stability plays an important role in carcinogenesis. Therefore, it is imperative to use certain biomarkers of DNA damage due to genomic instability in order to predict cancer risk. The aim of this study was the evaluation of genomic instability in patients with cervical lesions.

Materials and methods: We investigated the genetic damages in 80 subjects: 40 patients with high-grade squamous intraepithelial lesions (HSIL), 20 patients with invasive squamous cervical cancer (SCC) and 20 healthy women with a biomarker in two different tissues; the micronucleus (MN) test in peripheral blood lymphocytes (PBL), and in buccal exfoliated cells (BEC). This study also examined the frequency of other nuclear anomalies such as nucleoplasmic bridges (NPBs) and nuclear bunds (NBUDs) in PBL.

Results: The frequency of MN in BEC, MN in PBL, NPB in PBL and NBUD in PBL were significantly higher (p?Conclusion: Although larger studies are needed, our data support the predictive value of MN, NPB and NBUD as biomarkers of genomic instability for evaluation of risk level of cancer diseases.     

Measurement and characterization of micronuclei in exfoliated human cells by fluorescence in situ hybridization with a centromeric probe

The micronucleus (MN) assay in human exfoliated cells has been widely used to detect the genotoxic effects of environmental mutagens, infectious agents and heriditary diseases. Substantial variability characterizes the MN frequencies reported by different research groups. One reason for this may be the restricted resolution power of the Feulgen-Fast-Green staining that is routinely used. Here we describe a new version of the MN assay that employs fluorescent propidium iodide staining along with fluorescence in situ hybridization (FISH) with a centromeric probe. Buccal and urothelial cells were collected from 5 healthy unexposed female volunteers and 55 000 cells analyzed for MN frequency and abnormal nuclear events. The Feulgen-Fast-Green and the new fluorescent staining produced very similar results. The frequency of MN in buccal cells was 0.145±0.118% and in urothelial cells 0.083±0.074%. No correlation was found between the frequencies of MN in the two types of exfoliated cells. FISH with a centrometric probe allowed MN containing whole chromosomes with a centromere to be differentiated from those containing only acentric fragments. The former appear as a result of chromosome lagging in mitosis, while those without a centromere are due to chromosome breakage. In urothelial cells 43% of MN were centromere-negative and in buccal cells — 44%. Fluorescent staining provided more accurate scoring of degenerative cells than standard Feulgen-Fast-Green staining. The combined frequency of pycnotic cells, “broken eggs” and cells with fragmented nuclei did not exceed 2%, while that of karyorrhexis and karyolysis together was as high as 21%. Significant interindividual variability was found in the frequency of cells with karyolysis and karyorrhexis. Thus, the new version of micronucleus assay allows for MN to be scored more precisely, the mechanism of MN formation to be determined and abnormal nuclear events to be readily identified in exfoliated human cells. It is therefore ideal for studying genotoxicity in human populations using exfoliated cells from the mouth, bladder and nose.     

宫颈癌中p53表达和病毒感染的研究

应用PCR对121例宫颈脱落细胞和组织分别检测HPV-16／18和HSV-2DNA。同时应用免疫组化S-P法检测76例宫颈组织中P53过度表达。结果发现,宫颈癌组织中HPV-16／18和HSV-2阳性率分别为61．3％和32．3％,慢性宫颈炎组HPV-16／18和HSV-2阳性率分别为22．5％和20．0％,与正常宫颈组比较均有显著性差异。宫颈癌中HPV-16／18和HSV-2混合感染率为16．1％。p53过度表达率在慢性宫颈炎、宫颈上皮内瘤变(CIN)、宫颈癌组织中呈梯度递增。另外,宫颈癌组织中P53过度表达与HPV-16／18、HSV-2的感染无相关性。提示：宫颈癌的发生与HPV-16／18关系密切,HSV-2可能与HPV-16／18协同作用导致宫颈癌的发生。宫颈组织中p53过度表达率与宫颈癌的进程有关,这在宫颈癌的防治方面有一定的临床意义。     

Micronucleus induction and FISH analysis in buccal cells and lymphocytes of nurses administering antineoplastic drugs

A genotoxic effect for antineoplastic drugs, in particular micronucleus induction, has been shown in several studies. The aim of our study was to assess genotoxic effects in nurses administering different mixtures of antineoplastic drugs in an oncology hospital by evaluating the frequency of micronuclei in exfoliated buccal cells and blood lymphocytes by use of the standard micronucleus (MN) test and by identifying, by means of FISH analysis with centromeric probes, the mechanism of micronucleus induction (clastogenic or aneugenic). The study group comprised 23 nurses, 10 of whom worked in the day-care hospital and 13 in the ward. Twenty healthy subjects were selected as controls. Pan-centromeric FISH analysis was performed on lymphocytes from a selected group of nurses (12/23 subjects) characterized by higher MN frequencies as observed by standard Giemsa staining. A significant increase of micronucleus frequency compared with controls was found in exfoliated buccal cells of both groups of nurses: day-care hospital nurses 0.92 versus 0.45 (p=0.034) and ward nurses 0.94 versus 0.45 (p=0.051). An increase, although not statistically significant, of mean MN frequency was also found by the MN standard test on lymphocytes of the day-care hospital nurses (10.9 versus 7.5; p=0.056), while no differences were found in ward nurses (8.15 versus 7.5; p=0.56). We found that the administration of antineoplastic drugs by nurses in ward units induced a higher frequency of FISH MN+ (43% of subjects) than in the day-care hospital (20%). This was associated with the micronucleus size percentage. This finding could be correlated with the different compositions of administered mixtures of antineoplastic drugs: in ward units the mixtures contained drugs, such as vinorelbine, that were absent in the mixtures administered in the day-care hospital. Our results show genetic damage induced by administration of antineoplastic drugs, particularly in exfoliated buccal cells. This result suggests the useful application of this non-invasive sampling to evaluate genotoxic effects of occupational exposure to mixtures of inhalable chemicals at low doses.     

宫颈脱落细胞中HCCR的表达及意义

目的研究人宫颈癌基因(HCCR)在宫颈脱落细胞中的表达情况,探讨其对宫颈癌及癌前病变诊断的意义。方法采用Western blot及免疫组化SP法对79例宫颈脱落细胞中HCCR蛋白进行检测,其中正常宫颈上皮脱落细胞11例、宫颈上皮内瘤样病变(CIN)53例、宫颈癌(CCa)15例。所有标本均来自中国医科大学附属第一医院。结果HCCR基因在正常宫颈脱落细胞中不表达或阳性率较低,在宫颈上皮内瘤变及宫颈癌中表达阳性率随病变加重而逐级升高。结论HCCR与宫颈上皮内瘤变及宫颈癌的发生密切相关,检测宫颈脱落细胞中HCCR蛋白的水平对宫颈癌的筛查和诊断可能具有重要意义。     

免疫印记法检测宫颈脱落细胞中HPV16/18 E6蛋白的意义

目的用免疫印记法检测宫颈脱落细胞中人乳头瘤病毒（HPV）16/18型E6蛋白的表达,从而为探求一种简捷、无创的诊断宫颈癌及其癌前病变的新方法提供理论依据。方法采用免疫印记法（Western blot）检测112例宫颈脱落细胞标本中HPV16/18 E6蛋白的表达,并以导流杂交检测标本中HPV DNA作为对照。结果在宫颈癌组和CINII/Ⅲ组,HPV16/18 E6蛋白的表达水平（75%、67.5%）明显高于正常对照组（5%）,P（0.05;而CINI组（31.5%）与正常对照组比较,HPV16/18 E6蛋白表达的差异无统计学意义,P=0.05。结论宫颈脱落细胞中HPV16/18 E6蛋白的过度表达与宫颈癌及CINII/Ⅲ的发生密切相关;利用免疫印记法检测脱落细胞中HPV16/18 E6蛋白对宫颈鳞癌及CINII/Ⅲ的诊断及无创性筛查具有重大意义。     

Genetic polymorphisms and micronucleus formation: a review of the literature

The formation of micronuclei (MN) is extensively used in molecular epidemiology as a biomarker of chromosomal damage, genome instability, and eventually of cancer risk. The occurrence of MN represents an integrated response to chromosome-instability phenotypes and altered cellular viabilities caused by genetic defects and/or exogenous exposures to genotoxic agents. The present article reviews human population studies addressing the relationship between genetic polymorphisms and MN formation, and provides insight into how genetic variants could modulate the effect of environmental exposures to genotoxic agents, host factors (gender, age), lifestyle characteristics (smoking, alcohol, folate), and diseases (coronary artery disease, cancer). Seventy-two studies measuring MN frequency either in peripheral blood lymphocytes or exfoliated cells were retrieved after an extensive search of the MedLine/PubMed database. The effect of genetic polymorphisms on MN formation is complex, influenced to a different extent by several polymorphisms of proteins or enzymes involved in xenobiotic metabolism, DNA repair proteins, and folate-metabolism enzymes. This heterogeneity reflects the presence of multiple external and internal exposures, and the large number of chromosomal alterations eventually resulting in MN formation. Polymorphisms of EPHX, GSTT1, and GSTM1 are of special importance in modulating the frequency of chromosomal damage in individuals exposed to genotoxic agents and in unexposed populations. Variants of ALDH2 genes are consistently associated with MN formation induced by alcohol drinking. Carriers of BRCA1 and BRCA2 mutations (with or without breast cancer) show enhanced sensitivity to clastogens. Some evidence further suggests that DNA repair (XRCC1 and XRCC3) and folate-metabolism genes (MTHFR) also influence MN formation. As some of the findings are based on relatively small numbers of subjects, larger scale studies are required that include scoring of additional endpoints (e.g., MN in combination with fluorescent in situ hybridization, analysis of nucleoplasmic bridges and nuclear buds), and address gene-gene interactions.     

Synergistic Effect of Betel Quid,Tobacco, and Alcohol in Cigarette Smoking Induced Micronuclei in a Population of Arunachal Pradesh,India

Genotoxicity is one of the important endpoints for risk assessment of various lifestyle factors. The present study examined the synergistic effect of tobacco, betel quid, and alcohol in cigarette smoking induced micronuclei (MN) in the buccal epithelia of exposed individuals. Analysis of MN frequency and nuclear abnormalities (binucleated, karyorrhectic, karyolitic, and pyknotic cells) was performed in the exfoliated buccal cells of 110 habituates and compared to a control group matched for gender, age, and habit. A significant increase in the frequency of MN was found in smokers and alcohol, betel quid, and tobacco users compared to the control group. Tobacco, alcohol, and betel quid seem to potentiate the effect of cigarette smoking induced MN formation in the buccal epithelium. Smoking alone significantly increased the number of karyorrhexis cells in the buccal epithelium and combined exposure of all four test substances significantly increased the number of karyorrhexis and pycnotic cells. The findings indicate a synergistic effect between smoking, betel quid, tobacco, and alcohol in MN induction and cell death in buccal cells of exposed individuals.     

Validation of micronuclei frequency in peripheral blood lymphocytes as early cancer risk biomarker in a nested case-control study

Aim of this work was to assess the predictive value of micronuclei (MN) frequency in peripheral blood lymphocytes (PBL) for the risk of cancer death in disease-free individuals. Blood samples from 1650 subjects selected from the general population of Pisa, Italy, were collected between June 1991 and November 1993. The follow-up until January 2005 recorded a total of 111 deaths (52 for cancer). MN frequency was assessed for 49 cancer cases and 101 matched controls. A significantly higher MN frequency was found in cancer cases (4.7+/-3.4 MN/1000 BN cells) versus controls (1.5+/-1.7; p<0.0001). Donors were stratified in two classes and multivariate logistic regression analysis confirmed that individuals with high MN frequency (>2.5 MN/1000 BN cells) had a significantly increased risk of cancer death (OR=10.7; 95% CI=4.6-24.9; p<0.0001) when compared to individuals with low MN frequency (相似文献   

The micronucleus assay in human exfoliated cells of the nose and mouth: application to occupational exposures to chromic acid and ethylene oxide

We have applied the micronucleus (MN) assay to exfoliated cells of buccal and nasal cavities to monitor the genotoxic risk in a group of workers exposed to chromic acid and in another group exposed to ethylene oxide (EtO). The first group comprised 16 subjects working in a 'hard' type chrome-plating factory showing increased chromium absorption and chromium-induced rhinopathy. The second group comprised 9 subjects working in a sterilization unit, exposed to EtO concentrations lower than 0.38 ppm as timed weighted average (TWA) for a working shift; 3 of them were involved in a acute exposure too. The frequency of MN in buccal mucosa was within the norm for exposure both to chromium and to EtO. The MN frequency in nasal mucosa was not altered in chromium platers, whereas a significant increase (p less than 0.01) in MN was found in 2 out of 3 subjects involved in the accidental EtO leakage and a non-significant increase in MN was found in the group chronically exposed to EtO.     

Measurement of subvisual changes in cervical squamous metaplastic cells for detecting abnormality.

Quantitative measures of visually normal squamous metaplastic cells exfoliated from the uterine cervix were obtained to test the hypothesis that these cells, like intermediate squamous and endocervical columnar cells, show subvisual evidence of atypia in cases of bonafide squamous intraepithelial neoplasia. The cells identified as squamous metaplastic were obtained from 14 abnormal (dysplastic) and 9 diagnostically negative cases. Although the cell populations so grouped showed no statistically significant differences in overall cell size, nuclear area or nuclear/cytoplasmic ratios, there were significant differences in nuclear and cytoplasmic densitometric features and in nuclear texture features. A combination of three features (nuclear density, texture and cytoplasmic density) permitted 76% of the cells to be categorized correctly as originating in normal versus abnormal slides. It is concluded that selected quantitative features of exfoliated metaplastic cell populations may contribute to improved diagnostic accuracy in automated screening for cervical abnormalities.     

Malignant melanoma of the cervix. Report of a case

A malignant melanoma of the cervix, a rare neoplasm, was found to have an unusual cytologic pattern, similar to that of a leiomyosarcoma. A biopsy sample was diagnosed as cervical malignant melanoma of the spindle cell type. Some neoplastic cells in the tissue contained melanin pigment, whereas none of the abnormal cells in the cervical scrapes, except for an abnormal giant cell, had visible cytoplasmic pigment. The abnormal cells in the cervical scrape specimen were spindle-shaped, as were their nuclei, which is why the cytologic pattern was interpreted as that of a leiomyosarcoma. Evidence from this and previously reported cases shows that malignant melanoma must be considered as a possible source of exfoliated abnormal nonpigmented spindle-shaped cells in a cervicovaginal cell sample.     

Effect of hyperthermia on the frequency of sister-chromatid exchanges in patients with cancer of cervix uteri

The frequencies of sister-chromatid exchanges (SCE) were studied in patients with cancer of the cervix uteri and normal controls at 37 degrees C and 40 degrees C. At 37 degrees C the mean frequency of SCE was found to be 8.26 +/- 1.91 in untreated patients with cervical cancer and 7.91 +/- 1.68 in cancer patients treated with radiotherapy; these values were significantly higher than the control value of 5.34 +/- 1.28 exchanges. Increase of the growth temperature to 40 degrees C elevated the SCE frequency to 11.95 +/- 2.12 in patients without radiotherapy treatment, 13.37 +/- 2.17 in patients with radiotherapy treatment and 7.82 +/- 1.84 in normal controls. These data indicate that there is a differential induction of SCEs by hyperthermia in the lymphocytes of control women and patients with cancer of the cervix uteri.     

The micronucleus assay in exfoliated buccal cells: application to occupational exposure to polycyclic aromatic hydrocarbons.

Many polycyclic aromatic hydrocarbons (PAHs) have been identified as cancer-inducing chemicals for animals and/or humans. Also, there is sufficient evidence that exposures in the occupational settings are carcinogenic or probably carcinogenic to human. Engine exhaust and used engine oils are major PAH sources in engine repair workshops and traffic. Analysis of micronucleus (MN) in exfoliated buccal cells is a sensitive method for monitoring genetic damage in human populations. In our study, we used three different occupational groups (Group 1; engine repair workers, Group 2; taxi drivers, Group 3; traffic police) and two controls (Control I for Group 1 and Control II for Group 2 and Group 3) for the exposed groups. We analysed MN frequencies in exfoliated buccal cells and compared the exposed groups (Group 1; n=34, Group 2; n=17, Group 3; n=15) and subjects not occupationally exposed to PAH (Control I; n=28, Control II; n=20). The mean (+/-S.D.) MN (%) frequencies in exfoliated buccal cells from Group 1 and Control I were 0.07+/-0.05 and 0. 05+/-0.04, respectively (p>0.05; Table 2). The mean (+/-S.D.) MN (%) frequencies in exfoliated buccal cells from Group 2, 3 and Control II were 0.12+/-0.05, 0.10+/-0.05 and 0.03+/-0.03, respectively (p<0. 0001, p<0.05; Table 2) Smokers and nonsmokers do not differ with respect to the incidence of MN in all groups.