There are multiple forms of cervical cancer, and each is associated with different outcomes from treatment. Squamous cell carcinoma (SCC), adenocarcinoma (AC), and adenosquamous carcinoma (ASC) are the three most prevalent forms of cervical cancer. While these can be differentiated through histological techniques, histology requires a tissue sample. A research team from Leiden University Medical Center in The Netherlands conducted a study that suggests testing for somatic mutations in DNA may be used as a tumor-specific, less invasive way of classifying tumors and generating a quick prognosis.
“Precise classification of cervical carcinomas in combination with mutation profiling is valuable for predicting disease outcome and may guide the development and selection of tumor-specific treatment approaches,” wrote Dr. Vivian M. Spaans, lead author of the research published in PLOS One, entitled, “Precise Classification of Cervical Carcinomas Combined with Somatic Mutation Profiling Contributes to Predicting Disease Outcome.” By conducting this study, the research team identified 123 different types of mutations that can occur in cervical cancer, providing a plethora of mutations to be aware of during prognosis.
To begin, the researchers collected 301 cervical tumors and classified them into SCC, AC, and ASC. From there, the team looked for “hot-spot” mutations in 13 genes previously associated with cervical cancer. Out of all the tumors, approximately one-third displayed somatic mutations, with 4% of the tumors displaying multiple mutations.
While there was no difference in the prevalence of somatic mutations between cervical cancer types, there was a difference in the kind of mutation observed in the cervical cancer tumors. More PIK3CA mutations were found in SCC than in AC, while KRAS mutations were found more in AC than in SCC. Related to survival, there seemed to be no difference between mutation types.
“Undoubtedly, in the near future additional mutations will be detected by the ongoing international exome- and full-genome sequencing consortia that could be added to panel of histology-specific genes crucial in cervical cancer development and prognosis,” wrote Dr. Spaans. Clinicians may be able to put these findings to use when figuring out a diagnosis and prognosis for cervical cancer patients. As an example, patients with AC generally have smaller, less invasive tumors. If patients display mutations associated with AC, they may be advised to go a less intense treatment regimen, as there was a lower rate of adjuvant radiotherapy used in AC patients in this research cohort.