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A New Two-gene Test to Discern Similar Gastrointestinal Cancers

Researchers have devised a powerful two-gene test that can distinguish between a pair of nearly identical gastrointestinal// cancers that require radically different courses of treatment.

Their report is published this week in the online Early Edition of the Proceedings of the National Academy of Sciences.

"This simple and accurate test has the potential to be relatively quickly implemented in the clinic to benefit patients by guiding appropriate treatment," says senior author Wei Zhang, Ph.D., professor in the Department of Pathology at The University of Texas M. D. Anderson Cancer Center.

The analytical technique employed to tell gastrointestinal stromal tumor (GIST) from leiomyosarcoma (LMS) with near perfect accuracy will have wider application in more individualized diagnosis and treatment of other types of cancer, study co-authors from M. D. Anderson and the Institute for Systems Biology in Seattle conclude.

GIST was once thought to be a type of leiomyosarcoma because both originate in the smooth muscle cells of the gastrointestinal tract. However, GIST is treatable with the targeted medication known as Gleevec and is relatively unresponsive to chemotherapy. The opposite is true of LMS. An existing test distinguishes among the two cancers with about 87 percent accuracy, but intensive and time-consuming additional analyses are required for uncertain cases, Zhang says.

The researchers used common whole genome microarrays to measure gene expression in 68 GIST or LMS tumors, but then applied an analytical twist. Rather than identifying multiple genes that might distinguish each type of cancer, the researchers instead analyzed every possible pair of genes, says first author Nathan Price, Ph.D., research scientist at the Institute for Systems Biology, a process called Top Scoring Pair analysis.

The result was a cancer classifier based on the expression ratio of two genes. If the gene OBSCN expr
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