MR Metabolic Biomarkers for Cervical Cancer
Condition: Uterine Cervical Neoplasms
MeSH terms: Uterine Cervical Neoplasms
Study type: Observational

Summary: 
      The purposes of this study are: (1) to develop magnetic resonance (MR) imaging and
      spectroscopy as surrogate biomarkers for altered cancer metabolism in cervical cancer; (2) to
      understand the function of human papillomavirus (HPV) infection and autophagy (a cellular
      catabolic degradation response to stress) in the metabolic alterations in cervical cancer.
    

Detailed description: 
      In the first part of this project, we aim to identify the differences in cancer metabolism
      between normal and cervical cancer. Conventional MR study plus magnetic resonance
      spectroscopy (MRS) and diffusion weighted imaging (DWI) sequences will be carried out on 30
      eligible surgical candidates for pretreatment clinical assessment. Metabolites in cancer
      tissue will be collected during operation and analyzed using high resolution MRS, and
      compared with control group comprising 30 patients with normal cervical tissue. The primary
      endpoint of this part is to identify different MRS profiles between normal and cancer
      subjects. We will investigate the underlying biological mechanism between these two groups by
      evaluating status of HPV infection and autophagy. In the second part, we aim to understand
      cancer metabolism in cervical cancers infected by different types of HPV. We plan to enroll
      another 30 surgical candidates and complete the data regarding clinical MRS/DWI and tissue
      high resolution MRS. Together with the 30 cancer subjects in part one there will be in total
      60 cancer subjects for analysis. The primary endpoint of this part is to compare MRS profiles
      from cancer tissue infected with different HPV genotypes, particularly HPV type 16 and HPV
      type 18. The secondary endpoint is to correlate the tissue MRS profiles with the in vivo
      MRS/DWI measured by clinical MR scanner. In the third part of this project, we aim to
      investigate cancer metabolism under combined chemoradiation therapy (CCRT). We plan to enroll
      60 patients primarily treated with CCRT and collect the data using clinical MR and tissue
      high-resolution MRS. Tissue MRS profiles will be correlated with the HPV, E6/E7 and
      autophagy.

      The advance in knowledge of this project is to unwire the complex relationship among cancer
      metabolism, HPV infection and autophagy in cervical cancer. The clinical impact is the
      development of MR biomarkers for cancer metabolism and autophagy, both play important roles
      in the resistance to cancer therapy. The inherited non-invasiveness and non-radiation nature
      makes MR technique an ideal platform for clinical usage.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients in a tertiary referral center.
      
Biospecimen description: 
      Tumor tissue will be collected during the operation or biopsy and will be store in liquid
      nitrogen within 5 minutes removal from body. Standard dual phase tissue extraction will be
      performed for tumor and cell samples for high resolution MRS analysis.
    
Keywords: Autophagy; Cancer metabolism; Cervical cancer; Diffusion weighted imaging; Human papillomavirus; Magnetic resonance spectroscopy.