MYC quantitation in cell-free plasma DNA by real-time PCR for gastric cancer diagnosis.

BACKGROUND Detection of tumor-associated genetic alterations in plasma of cancer patients has recently been suggested to be an accurate method for detecting early or recurrent cancer. METHODS We performed quantitative real-time PCR for MYC and GAPDH in tissue and plasma samples of 57 patients with gastric cancer and in plasma of 79 cancer-free individuals. We also performed two-color MYC fluorescence in situ hybridization (FISH) in tissue from the 57 patients with gastric cancer. RESULTS The tissue MYC/GAPDH ratio by real-time PCR was significantly correlated with MYC status by FISH (p<0.001). The mean ratio of plasma MYC/GAPDH was 5.226+/-3.578 (range: 1.25-18.35) in gastric cancer patients, and 2.436+/-0.881 (range: 1.00-5.00) in the healthy volunteers (p<0.001). We used receiver-operating characteristics (ROC) curve analysis to select two optimal plasma MYC/GAPDH cut-offs of 2.725 and 5.225. The sensitivity and specificity were 75.4% and 76.9% at 2.725, 38.6% and 100% at 5.225, respectively. The plasma MYC/GAPDH ratio from cancer patients was significantly correlated with the tissue MYC/GAPDH ratio (p=0.009), and tissue MYC status by FISH (p=0.024). CONCLUSIONS These findings suggest that the plasma MYC/GAPDH ratio, as determined by real-time PCR, may be an alternative non-invasive approach for detecting gastric cancer.