Oncosuppressor-Mutated Cell-Based Diagnostic Platform for Liquid Biopsy Diagnoses Benign Head and Neck Masses and Predicts Malignancy in Thyroid Nodules: Results from a Consecutive Cohort of Patients

Abstract

Background: We reported that a novel oncosuppressor-mutated cell (OMC)-based platform has the potential for early cancer detection in healthy individuals and for identification of cancer patients at risk of developing metachronous metastases.

Objective: Herein, we sought to determine the diagnostic accuracy of this novel OMC-based platform in a consecutive cohort of patients operated for suspicious head and neck masses.

Methods: OMCs (BRCA1-deficient fibroblasts) were exposed to blood serum from patients with head and neck nodules before surgical removal. These cells were analyzed for their proliferation and survival. Treated OMCs were inoculated subcutaneously in NOD/SCID mice, and tumor growth was monitored over time.

Results: OMCs exposed to serum from patients with malignant lesions displayed increased proliferation compared to those exposed to serum from patients with benign lesions. Only OMCs exposed to serum from patients diagnosed with malignant thyroid neoplasia generated a cancerous mass. The sensitivity of the test was 92%, with only 1 false negative out of 34 patients. Immunohistochemical staining showed that the cancerous masses were poorly differentiated adenocarcinomas with high proliferative index.

Conclusions: These data show that liquid biopsy combined with an OMC-based in vivo platform has the potential to diagnose benign head and neck masses and predict whether a thyroid nodule is malignant. These results strengthen the concept that OMCs can be used to detect circulating malignant factors in cancer patients.

Keywords: Cancer screening; Head and neck lesions; Liquid biopsy; Metastatic And Transforming Elements Released Discovery; Oncosuppressor-mutated cells; Thyroid cancer.

Fig. 1

Thyroid cancer patients' serum increased the proliferation of Fibro-BKO cells during in vitro treatment. Fibro-BKO cells were cultured for 3 weeks in the serum from patients with thyroid carcinoma or benign lesions. a, b Cell growth was analyzed by counting the number of viable cells at every passage. Line graph shows the population doublings capability (a); column graph represents cumulative population doublings at the end of the in vitro treatment periods (b). c Cell viability was calculated as the percentage of viable cells over total counted cells using Trypan blue exclusion dye. Data are presented as mean ± SD. p values were given, and differences were considered statistically significant at p ˂ 0.05.

Fig. 2

Thyroid cancer patients' serum induced the transformation of Fibro-BKO. a, b Fibro-BKO cells treated as described in Figure 1 were injected subcutaneously in NOD/SCID mice, and tumor growth was monitored for 4 weeks. a Once tumors were palpable, their diameters were measured to determine the time course of the xenotransplant growth. b At euthanasia, mean volumes of tumors obtained with cells exposed to sera from the 2 cohorts of patients were calculated. Values are mean ± SD (n = 4 xenotransplants per treatment [2 mice per treatment injected at 2 sites]). c Formalin-fixed paraffin-embedded xenotransplant samples were processed for H&E staining and immunolabeled with antibodies for cell proliferation or specific to cancer markers. Representative pictures are shown. Scale bar, 50 μm.