Response to the letter "DNA microarrays will be instrumental in the future diagnosis of cervical dysplasia and neoplasia", by P. K. Wright (doi:10.1093/annonc/mdi109): prospective and controlled trials are required to evaluate the relevance of DNA microarrays with regard to diagnosis and therapy of cervical neoplasia

C. Dannecker*

Department of Obstetrics and Gynecology, University of Munich–Großhadern, Marchioninistrasse 15, D-81377 Munich, Germany

* Email: christian.dannecker{at}med.uni-muenchen.de

We thank Paul Wright for his comment [1Go]. We are also convinced that the use of biochips will open up new dimensions in diagnostic and therapeutic practice in the future [2Go]. The DNA microarray technique holds the promise of revolutionizing future medicine unlike any other technology that was available in the past [3Go]. The possibility of monitoring simultaneously the expression of thousands of genes or proteins in one experiment will hopefully give us a global insight into cancer biology on a molecular basis. There are already several promising applications of the microarray technique in clinical medicine [4Go–6Go]. With regard to therapy of cervical cancer, gene expression profiling by DNA microarray may be used for further molecular classification of disease stages and prediction of treatment response [7Go, 8Go]. However, the microarray technique is still a topic of research, and with regard to clinical medicine it is still in its infancy. Many well designed prospective and controlled trials will be necessary to evaluate the relevance of this new and promising technique. As long as we do not have the published data from such studies, it is imperative to improve the diagnostic and therapeutic options in small steps. Both techniques, self-sampling of HPV DNA (which improves cervical cancer screening) and the sentinel node procedure (which reduces surgery-related morbidity), are good examples of such small, but important, steps [9Go, 10Go].


    References
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 References
 
1. Wright PK. DNA microarrays will be instrumental in the future diagnosis of cervical dysplasia and neoplasia. doi:10.1093/annonc/mdi109.

2. Chittur SV. DNA microarrays: tools for the 21st century. Comb Chem High Throughput Screen 2004; 7: 531–537.[ISI][Medline]

3. Choudhuri S. Microarrays in biology and medicine. J Biochem Mol Toxicol 2004; 18: 171.[CrossRef][Medline]

4. Kunz M, Ibrahim SM, Koczan D et al. DNA microarray technology and its applications in dermatology. Exp Dermatol 2004; 13: 593–606.[CrossRef][ISI][Medline]

5. Selvanayagam ZE, Cheung TH, Wei N et al. Prediction of chemotherapeutic response in ovarian cancer with DNA microarray expression profiling. Cancer Genet Cytogenet 2004; 154: 63–66.[CrossRef][ISI][Medline]

6. Mischel PS, Cloughesy TF, Nelson SF. DNA-microarray analysis of brain cancer: molecular classification for therapy. Nat Rev Neurosci 2004; 5: 782–792.[CrossRef][ISI][Medline]

7. Wong YF, Selvanayagam ZE, Wei N et al. Expression genomics of cervical cancer: molecular classification and prediction of radiotherapy response by DNA microarray. Clin Cancer Res 2003; 9: 5486–5492.[Abstract/Free Full Text]

8. Snyder AR, Morgan WF. Gene expression profiling after irradiation: clues to understanding acute and persistent responses? Cancer Metastasis Rev 2004; 23: 259–268.[CrossRef][ISI][Medline]

9. Barranger E, Cortez A, Commo F et al. Histopathological validation of the sentinel node concept in cervical cancer. Ann Oncol 2004; 15: 870–874.[Abstract/Free Full Text]

10. Dannecker C, Siebert U, Thaler CJ et al. Primary cervical cancer screening by self-sampling of human papillomavirus DNA in internal medicine outpatient clinics. Ann Oncol 2004; 15: 863–869.[Abstract/Free Full Text]





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