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Tampon as a diagnostic tool for ovarian cancer?

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High-grade serous (epithelial) ovarian cancer accounts for approximately 75% of ovarian malignancies in North America and Europe.  Is is now known to start at the end of a fallopian tube before migrating to its adjacent ovary.  This type of cancer is characterized by mutation (damage, breakdown) of the TP53 gene that is responsible for tumor suppression.

A recently published article (citation below) investigates whether tumor cells could be detected in the vagina through analysis of DNA samples collected by placement of a vaginal tampon.  They instructed diagnosed women who were scheduled for surgery to self-insert a tampon 10-12 hours prior to surgery and to leave it in.  The tampon was removed during surgery and its DNA content was compared with DNA content from the surgically-removed tumor, a process that was repeated for each patient.

Excerpts:

  • Unlike other gynecologic malignancies, epithelial ovarian cancer typically presents at an advance stage.  This is in part a result of the fact that no effective screening methods exist to detect early-stage disease, and patient with advanced-stage usually have nonspecific symptoms at time of diagnosis.
  • Given that intraabdominal cavity communicates with the vagina through the upper genital tract, we speculated that we could detect ovarian cancer cells that exfoliate and descend through the cervical ox and into the vagina.
  • In this pilot study, vaginal tampons were used to collect DNA from women newly diagnosed with advanced serous ovarian cancer.  Deep sequencing (testing) yielded detectable TP53 mutations in 60% of diagnosed patients (excluding those with a history of tubal ligation)… The mutations detected in the tampon samples were identical to the mutations found in the primary metastatic tumor.

The researchers’ vision: “Large studies are needed to validate this method and identify a more precise detection rate.  As methods of DNA extraction and sequencing improve, we are hopeful that this may lay the groundwork for an opportunity to detect ovarian cancer at early or even premalignant stages.”

Amen.

Source: Detection of Somatic TP53 Mutations in Tampons of Patients With High-Grade Serous Ovarian Cancer, Obstetrics & Gynecology: November 2014 – Volume 124 – Issue 5 – p 881–885

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