The authors wish to thank Gr&#225;inne Tierney for editorial assistance.

The protocol follows the guidelines of the IRST Human Research Ethics Committee.
NOTE: This procedure is specifically designed for the detection of a low number of cDNA molecules in human fresh-frozen tissues. The tissue&#160;sections have been cut on dry ice, while still frozen, from previously validated patient-derived gastric tumor or normal tissue samples.
1. RNA Isolation and Purification
<ol>
	<li>RNA extraction 
	Note: RNA isolation is performed under the hood using a specific product (see Table of Materials). However, a variety of isolation kits are commercially available.
	<ol>
		<li>Homogenize 50 - 100 mg of finely cut fresh-frozen tissue sample in a 1.5 mL tube with 1 mL of the RNA isolation reagent and vortex vigorously for 15 s. Incubate the tubes at -80 &#176;C overnight.</li>
		<li>Incubate the tube containing the sample at room temperature for 5 min and mix by vortexing for 15 s.</li>
		<li>Keep the tube on ice, add 200 &#181;L of chloroform, and vortex vigorously for 15 s.</li>
		<li>Incubate the tubes at room temperature for 60 s and centrifuge at 12,000 x g for 15 min at 4 &#176;C.</li>
		<li>Transfer the aqueous phase in a 1.5 mL tube and add 20 &#181;g of glycogen. 
		NOTE: It is important to carefully avoid transferring any of the interphase or organic layer in order to reduce contamination.</li>
		<li>Add 500 &#181;L of isopropanol, inverting the tube to mix, and incubate on ice for 10 min.</li>
		<li>Centrifuge the tube at 12,000 x g for 15 min at 4 &#176;C to precipitate RNA. 
		NOTE: RNA will be present in a gel-like pellet on the side and bottom of the tube, often invisible after centrifugation.</li>
		<li>Remove the supernatant without disturbing the precipitate and wash it with 1 mL of 75% ethanol by pipetting.</li>
		<li>Centrifuge the tube at 7,500 x g for 5 min at 4 &#176;C and remove the supernatant without disturbing the pellet.</li>
		<li>Let the pellet dry until the precipitate becomes transparent and dissolve it in 50 &#181;L of RNase-free water.</li>
		<li>Freeze the samples at -80 &#176;C at least overnight before quantification.</li>
	</ol>
	</li>
	<li>Genomic DNA elimination and RNA purification 
	Note: A DNase digestion step, followed by a column-based RNA purification, is recommended for analyses of low-abundance targets in order to digest contaminating DNA.
	<ol>
		<li>Dissolve the lyophilized DNase I (1,500 Kunitz units) in 550 &#181;L of RNase-free water using a syringe, mix gently by inverting the vial, and divide the reconstituted stock solution into aliquots.</li>
		<li>Transfer in a 1.5 mL tube the calculated volume of sample with 15 &#181;g of RNA, 10 &#181;L of DNase Digestion buffer from the kit (listed in Table of Materials), 2.5 &#181;L of DNase I stock solution, and RNase-free water to 100 &#181;L. Incubate at room temperature for 10 min.</li>
		<li>Add 350 &#181;L of tissue lysis buffer (from the kit, see Table of Materials) and mix by pipetting.</li>
		<li>Add 250 &#181;L of 100% ethanol and mix by pipetting.</li>
		<li>Transfer the entire volume (700 &#181;L) into a new spin column and centrifuge at 12,000 x g for 15 s.</li>
		<li>Transfer the filter into a new collection tube, add 500 &#181;L of 80% ethanol to the column and centrifuge at 12,000 x g for 2 min.</li>
		<li>Open the lid of the spin column and centrifuge at 12,000 x g for 5 min with a new collection tube to dry the filter; then transfer the filter to a 1.5 mL tube.</li>
		<li>Add 14 &#181;L of RNase-free water directly to the filter column and centrifuge at 12,000 x g for 1 min.</li>
		<li>Keep the samples on ice and proceed to quantification using 2 &#181;L of the sample on a bench-top spectrophotometer or store the RNA at -80 &#176;C until use.</li>
	</ol>
	</li>
</ol>
2. cDNA Synthesis
<ol>
	<li>Place 1,000 ng of RNA, 4 &#181;L of master mix, 1 &#181;L of reverse transcriptase, and RNase-free water to a final volume of 20 &#181;L in a sterile PCR tube. Mix gently and spin down.</li>
	<li>Incubate the reaction mix in a thermal cycler, applying the following conditions: 5 min at 25 &#176;C, 30 min at 42 &#176;C, 5 min at 85 &#176;C.</li>
	<li>Centrifuge the tubes briefly and proceed to dPCR analysis or store at -20 &#176;C until needed.</li>
</ol>
3. Digital PCR Reaction Set Up
<ol>
	<li>&#160;dPCR reaction mix and sample preparation
	<ol>
		<li>Thaw the master mix and the assay at room temperature for at least 20 min.</li>
		<li>Dilute the cDNA samples to a concentration of 300 ng in 6 &#181;L of water.</li>
		<li>Gently vortex the master mix and prepare the mix in a sterile tube with 8.7 &#181;L of master mix, 0.87 &#181;L of the CDH1a custom designed assay primer, and 1.83 &#181;L of nuclease-free water for a final volume of 11.4 &#181;L. 
		NOTE: For CDH1a custom designed assay primer details see the Table of Materials.</li>
		<li>Transfer 11.4 &#181;L of the prepared mix to the diluted cDNA sample, mix gently, and briefly centrifuge. 
		NOTE: Volumes include 20% excess to compensate for volume loss from pipetting. Prepare the mix for all samples and a no template control (NTC).</li>
	</ol>
	</li>
	<li>Chip preparation 
	Note: For optimal results load the chips as soon as possible.
	<ol>
		<li>Plug in the chip loader and wait until the indicator light turns green.</li>
		<li>Remove the cap of the immersion fluid syringe by gently pulling back the plunger 1 - 2 mm and releasing it to facilitate this step, and replace it with a tip.</li>
		<li>Take a new chip and take note of the code written on the lid to associate it with the sample.</li>
		<li>Hold the lid carefully by its side, peel away the protective film, and place the lid with the sticky face up in the correct orientation.</li>
		<li>Carefully pick up a chip, taking care not to touch the internal part, and load it onto the chip nest in the correct position by pressing down the lever to open the clamp.</li>
		<li>Load a new loading blade onto the loader and push it gently to ensure that it is firmly in place.</li>
		<li>Transfer 14.5 &#181;L of the dPCR reaction mix onto the loading blade without making air bubbles or deflecting the blade, after which press the black loading button to distribute the volume on the chip.</li>
		<li>Use the immersion fluid syringe to transfer about 20 drops onto the chip surface taking care not to touch the surface with the tip. 
		NOTE: It is important to cover the entire surface without spilling fluid over the edges.</li>
		<li>Rotate the loader arm to make the lid come into contact with the chip and press down for 15 s.</li>
		<li>Press the lid button to release the chip and return the arm to its position.</li>
		<li>Hold the assembled chip at a 45&#176; angle and carefully dispense the immersion fluid with the syringe through the fill port, rotate the chip slightly to make sure there are no air bubbles, and remove any excess fluid with a sterile wipe.</li>
		<li>Seal the chip case by gently peeling away the label on top of the chip lid and press over the fill port for at least 5 s.</li>
		<li>Store the chip in the dark until ready to load in the thermal cycler. 
		NOTE: Prepared chips should be used within 2 h.</li>
	</ol>
	</li>
	<li>dPCR reaction
	<ol>
		<li>Open the lid and install the adapters to both blocks, even when a single block is used.</li>
		<li>Place the chips on the sample block in the correct position. 
		NOTE: The fill port must be oriented towards the front of the thermal cycler in an elevated position to allow any air bubbles to float to the top without disturbing the window of the chip. Use empty chips to balance the two blocks.</li>
		<li>Lay the thermal pad on the sample block to completely cover the chips.</li>
		<li>Close the lid and start the PCR run, applying the following conditions: hold at 96 &#176;C for 10 min; 45 cycles of 60 &#176;C for 2 min and 98 &#176;C for 30 s; hold at 60 &#176;C for 2 min; hold at 4 &#176;C. Turn off the thermal cycler and thaw the chips at room temperature for at least 10 min. 
		NOTE: Chip analysis must be performed within one hour.</li>
	</ol>
	</li>
	<li>Chip analysis
	<ol>
		<li>Open the lid of the instrument and remove the thermal pads, then remove the chips from the adapters. 
		NOTE: Store the chips in a dark, clean location until analysis.</li>
		<li>Clean the chip surface with isopropanol and a sterile wipe. 
		NOTE: Inspect each chip for leaks or potential problems.</li>
		<li>Insert the USB into the detector system to save the data.</li>
		<li>Open the chip tray of the detector system, load the chip face-up in the correct position and then close the tray.</li>
		<li>Wait 30 s for processing, then remove the chip and insert the next one.</li>
		<li>Wait for the analysis to be completed for all the processed chips then insert the USB into a computer to transfer the files. 
		NOTE: The total time for analysis is around 2 to 3 min/chip.</li>
	</ol>
	</li>
</ol>
4. Data Analysis and Interpretation
<ol>
	<li>Connect to the cloud-based software platform required to carry out all the downstream analyses.</li>
	<li>Create a project and import all data files of the chips of interest.</li>
	<li>Enter the sample name; select the dye and assay used in the &#34;Define Chips&#34; tab.</li>
	<li>Determine if the chip is acceptable by visualizing it in the &#34;Review Data&#34; tab, checking how thoroughly the sample was loaded onto the chip and how many data points are evaluable. 
	NOTE: Reject chips with less than 13,000 evaluable&#160;data points.</li>
	<li>Move on to the scatter plot of the selected chip on the right side of the screen; apply a threshold of 6,000 for the fluorescein amidite (FAM) reporter dye signals (Y-axis) to all the chips. 
	NOTE: The threshold set up may vary on the basis of the assays used.</li>
	<li>Remove any dubious positive signals to prevent false positive results by selecting the relative spot on the scatter plot using the lasso tool and pressing on &#34;undetermined&#34;. All remaining positive spots indicate the presence of cDNA copies of the rare target analyzed.</li>
</ol>

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The authors report no conflicts of interest for this work.

dPCR was originally developed for DNA molecular measurements10,11,12,13 and in time this technology was adapted for the quantification of microRNAs and RNA transcripts5,14,15. In this protocol we have extended the list of applications to include detection of rare transcripts derived from fresh-frozen t...

The CDH1 gene encodes for E-cadherin, a key factor involved in the maintenance of the normal gastric epithelium through the regulation of cell adhesion, survival, proliferation, and migration1. Loss of E-cadherin protein as a result of deleterious germline or somatic alterations of CDH1 has been associated with the development of GC2,3. Non-canonical transcripts arising from intron 2 of the gene have also been hypothesized to play a role in gastric carcinogenesis4,5. In particular, one such transcript, CDH1a, has been shown to be expressed in GC cell lines but is absent from the normal stomach4. We recently detected CDH1a in GC tissue samples from GC patients using chip-based dPCR5. dPCR was used to evaluate, for the first time, the presence of the CDH1a gene transcript in intestinal GC and in normal tissue.
The gold standard method to determine gene expression is Real-Time quantitative PCR (qPCR). However, the resulting data can sometimes be variable and of poor quality, especially when the level of target in the sample is low. This variability can be caused by contaminants, which inhibit polymerase activity and primer annealing, leading to non-specific amplification and competitive side reactions6.
Although the basic biochemical principles of dPCR are similar to those of qPCR, dPCR shows some advantages, allowing for very precise measurements of genomic DNA (gDNA)/complementary DNA (cDNA) molecules. Indeed, dPCR is an end-point reaction that relies on the calibrated partitioning of a sample into thousands of wells, so that each well contains zero or a single target molecule. Amplification then occurs only in the wells containing a copy of the target and is indicated by a fluorescent signal. The absolute number of target molecules in the original sample can then be calculated by determining the ratio of positive to total partitions using binomial Poisson statistics7.
In addition, the dPCR technique eliminates the need for running a standard curve and, hence, the associated bias and variability, allowing for a direct quantification of targets8,9; it produces more precise and reproducible results independently of contaminants and efficiency due to its high tolerance to inhibitors10; it is more sensitive and specific than qPCR, and is thus a reliable method for the detection of a rare target. Finally, the partitioning of the sample into multiple reactions reduces the competition with background molecules and improves the limit of target detection, making amplification possible and facilitating the detection of single molecules of gDNA/cDNA6. The detection and quantification of nucleic acids by chip-based dPCR has been increasingly applied to copy number variation, quantification of DNA fragments, and mutation analyses11,12,13, given the precision and low material input requirement of the method. In addition, dPCR has recently been integrated into the analysis of both microRNAs14 and gene transcripts5,15.

<table><tbody><tr><td>TRIazol Reagent</td><td>Thermo Fisher Scientific</td><td>15596018</td><td></td></tr><tr><td>Glycogen 20 mg/ml</td><td>ROCHE</td><td>10901393001</td><td></td></tr><tr><td>RNeasy MinElute Cleanup kit</td><td>QIAGEN</td><td>74204</td><td></td></tr><tr><td>iScript cDNA Synthesis kit</td><td>BioRad</td><td>1708891</td><td></td></tr><tr><td>QuantStudio 3D Digital PCR Master Mix v2</td><td>Thermo Fisher Scientific</td><td>A26358</td><td></td></tr><tr><td>CDH1a IDT custom designed assay</td><td>Integrated DNA Technologies (IDT)</td><td>NA</td><td>F) GCTGCAGTTTCACTTTTAGTG&lt;br/&gt; (R) ACTTTGAATCGGGTGTCGAG&lt;br/&gt; (P)/FAM/CGGTCGACAAAGGACAGCCTATT/TAMRA/&lt;br/&gt; [dPCR optimized assay concentrations: 900 nM (F),&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp; 900 nM (R), 250 nM (P)]</td></tr><tr><td>QuantStudio 3D Digital PCR 20K Chip Kit v2</td><td>Thermo Fisher Scientific</td><td>A26316</td><td></td></tr><tr><td>Heraeus Biofuge Fresco</td><td>Thermo&amp;nbsp; Scientific</td><td>75002402</td><td></td></tr><tr><td>Thermocycler (Labcycler)</td><td>Sensoquest</td><td>011-103</td><td></td></tr><tr><td>GeneAmp PCR System 9700</td><td>Thermo Fisher Scientific</td><td>N805-0200</td><td></td></tr><tr><td>Dual Flat Block Sample Module</td><td>Thermo Fisher Scientific</td><td>4425757</td><td></td></tr><tr><td>QuantStudio 3D Tilt Base for Dual Flat Block GeneAmp PCR System 9700</td><td>Thermo Fisher Scientific</td><td>4486414</td><td></td></tr><tr><td>QuantStudio 3D Digital PCR Chip Adapter Kit for Flat Block Thermal Cycler</td><td>Thermo Fisher Scientific</td><td>4485513</td><td></td></tr><tr><td>QuantStudio 3D Digital PCR Chip Loader</td><td>Thermo Fisher Scientific</td><td>4482592</td><td></td></tr><tr><td>QuantStudio 3D Digital PCR Instrument with power cord</td><td>Thermo Fisher Scientific</td><td>4489084</td><td></td></tr></tbody></table>

detection of a cdh1 rare transcript variant in fresh-frozen gastric cancer tissues by chip-based digital pcr

CDH1a, a non-canonical transcript of the CDH1 gene, has been found to be expressed in some gastric cancer (GC) cell lines, whereas it is absent in normal gastric mucosa. Recently, we detected CDH1a transcript variant in fresh-frozen tumor tissues obtained from patients with GC. The expression of this variant in tissue samples was investigated by the chip-based digital PCR (dPCR) approach presented here. dPCR offers the potential for an accurate, robust, and highly sensitive measurement of nucleic acids and is increasingly utilized for many applications in different fields. dPCR is capable of detecting rare targets; in addition, dPCR offers the possibility for absolute and precise quantification of nucleic acids without the need for calibrators and standard curves. In fact, the reaction partitioning enriches the target from the background, which improves amplification efficiency and tolerance to inhibitors. Such characteristics make dPCR an optimal tool for the detection of the CDH1a rare transcript.

Using the procedure presented here, we checked for the expression of the rare transcript variant CDH1a in gastric fresh-frozen tissues. The analysis by dPCR was performed on 21-paired normal and cancer tissue samples and in 11 additional tumor samples. CDH1a was detectable in 15 out of 32 (47%) tumors, whereas no normal tissue samples showed the presence of this rare transcript5. In our analysis, chips with less than 13,000 data points were reject...

Watch this Scientific Journal Video about Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR at JoVE.com

Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR

The manuscript describes a chip-based digital PCR assay to detect a rare CDH1 transcript variant (CDH1a) in fresh-frozen normal and tumor tissues obtained from patients with gastric cancer.

Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR

CDH1a, a non-canonical transcript of the CDH1 gene, has been found to be expressed in some gastric cancer (GC) cell lines, whereas it is absent in normal ...

detection-cdh1-rare-transcript-variant-fresh-frozen-gastric-cancer

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Cancer Research

6.1K Views.  Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS. The manuscript describes a chip-based digital PCR assay to detect a rare CDH1 transcript variant (CDH1a) in fresh-frozen normal and tumor tissues obtained from patients with gastric cancer.

Video: Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

The crosstalk between tumor cells and bone cells in the bone microenvironment is crucial to understanding the mechanism of bone metastasis formation. We developed an in vitro fully human preclinical model of a co-culture of breast cancer cells and monocytes undergoing differentiation towards osteoclasts. We optimized a model of osteoclastogenesis starting from a sample of peripheral blood collected from healthy donors. Peripheral blood mononuclear cells (PBMCs) were first separated by density gradient centrifugation, seeded at a high density and induced to differentiate by adding two growth factors (GFs): receptor activator of nuclear factor-&#954;B ligand (RANKL) and macrophage colony-stimulating factor (MCSF). The cells were left in culture for 14 days and then fixed and analyzed by downstream analysis. In osteolytic bone metastases, one of the effects of cancer cell arrival in bone is the induction of osteoclastogenesis. We thus challenged our model with co-cultures of breast cancer cells to study the differentiation power of cancer cells with respect to GFs. A straightforward way of studying cancer cell-osteoclast interaction is to perform indirect co-cultures based on the use of conditioned medium collected from breast cancer cell cultures and mixed with fresh medium. This mixture is then used to induce osteoclast differentiation. We also optimized a method of direct co-culture in which cancer cells and monocytes undergoing differentiation share the medium and exchange secreted factors. This is a significant improvement over the original indirect co-culture method as researchers can observe the reciprocal interactions of the two cell types and perform downstream analyses for both cancer cells and osteoclasts. This method enables us to study the effect of drugs on the metastatic bone microenvironment and to seed cell lines other than those derived from breast cancer. The model can also be used to study other diseases such as osteoporosis or other bone conditions.

This protocol describes development of an in vitro human preclinical model of osteoclastogenesis from peripheral blood monocytes cultured with breast cancer cell lines to mimic the cancer cell-osteoclast interaction. The model could be used to further our understanding of bone metastasis formation and improve therapeutic options.

The crosstalk between tumor cells and bone cells in the bone microenvironment is crucial to understanding the mechanism of bone metastasis formation. We ...

Digital Polymerase Chain Reaction Assay for the Genetic Variation in a Sporadic Familial Adenomatous Polyposis Patient Using the Chip-in-a-tube Format

The quantitative analysis of human genetic variation is crucial for understanding the molecular characteristics of serious medical conditions, such as tumors. Because digital polymerase chain reactions (PCR) enable the precise quantification of DNA copy number variants, they are becoming an essential tool for detecting rare genetic variations, such as drug-resistant mutations. It is expected that molecular diagnoses using digital PCR (dPCR) will be available in clinical practice in the near future; thus, how to efficiently conduct dPCR with human genetic material is a hot topic. Here, we introduce a method to detect Adenomatous polyposis coli (APC) somatic mosaicism using dPCR with the chip-in-a-tube format, which allows eight dPCR reactions to be simultaneously conducted. Care should be taken when filling and sealing the reaction mixture on the chips. This article demonstrates how to avoid the over- and underestimation of positive partitions. Furthermore, we present a simple procedure for collecting the dPCR product from the partitions on the chips, which can then be used to confirm the specific amplification. We hope that this methods report will help promote the dPCR with the chip-in-a-tube method in genetic research.

Digital polymerase chain reaction (PCR) is a useful tool for the high-sensitivity detection of single nucleotide variants and DNA copy number variants. Here, we demonstrate key considerations for measuring rare variants in the human genome using digital PCR with the chip-in-a-tube format.

The quantitative analysis of human genetic variation is crucial for understanding the molecular characteristics of serious medical conditions, such as ...

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids

Complications associated with upfront and repeat surgical tissue sampling present the need for minimally invasive platforms capable of molecular sub-classification and temporal monitoring of tumor response to therapy. Here, we describe our dPCR-based method for the detection of tumor somatic mutations in cell free DNA (cfDNA), readily available in&#160;patient biofluids. Although limited in the number of mutations that can be tested for in each assay, this method provides a high level of sensitivity and specificity. Monitoring of mutation abundance, as calculated by MAF, allows for the evaluation of tumor response to therapy, thereby providing a much-needed supplement to radiographic imaging.

Here, we present a protocol to detect tumor somatic mutations in circulating DNA present in patient biological fluids (biofluids). Our droplet digital polymerase chain reaction (dPCR)-based method enables quantification of the tumor mutation allelic frequency (MAF), facilitating a minimally invasive complement to diagnosis and temporal monitoring of tumor response.

Complications associated with upfront and repeat surgical tissue sampling present the need for minimally invasive platforms capable of molecular ...

Genome-Wide Analysis of DNA Methylation in Gastrointestinal Cancer

DNA methylation is an important epigenetic change that is biologically meaningful and a frequent focus of cancer research. Genome-wide DNA methylation is a useful measure to provide an accurate analysis of the methylation status of gastrointestinal (GI) malignancies. Given the multiple potential translational uses of DNA methylation analysis, practicing clinicians and others new to DNA methylation studies need to be able to understand step by step how these genome-wide analyses are performed. The goal of this protocol is to provide a detailed description of how this method is used for the biomarker identification in GI malignancies. Importantly, we describe three critical steps that are needed to obtain accurate results during genome-wide analysis. Clearly and concisely written, these three methods are often lacking and not noticeable to those new to epigenetic studies. We used 48 samples of a GI malignancy (gastric cancer) to highlight practically how genome-wide DNA methylation analysis can be performed for GI malignancies.

Herein, we describe a procedure for genome-wide analysis of DNA methylation in gastrointestinal cancers. The procedure is of relevance to studies that investigate relationships between methylation patterns of genes and factors contributing to carcinogenesis in gastrointestinal cancers.

DNA methylation is an important epigenetic change that is biologically meaningful and a frequent focus of cancer research. Genome-wide DNA methylation is ...

A Blood-based Test for the Detection of ROS1 and RET Fusion Transcripts from Circulating Ribonucleic Acid Using Digital Polymerase Chain Reaction

We have developed novel methods for the isolation and characterization of tumor-derived circulating ribonucleic acid (cRNA) for blood-based liquid biopsy. Robust detection of cRNA recovered from blood represents a solution to a critical unmet need in clinical diagnostics. The test begins with the collection of whole blood into blood collection tubes containing preservatives that stabilize cRNA. Cell-free, exosomal, and platelet-associated RNA is isolated from plasma in this test system. The cRNA is reverse transcribed to complementary DNA (cDNA) and amplified using digital polymerase chain reaction (dPCR). Samples are evaluated for both the target biomarker as well as a control gene. Test validation included limit of detection, accuracy, and robustness studies with analytic samples. The method developed as a result of these studies reproducibly detect multiple fusion variants for ROS1 (C-Ros proto-oncogene 1; 8 variants) and RET (rearranged during transfection proto-oncogene; 8 variants). The sample processing workflow has been optimized so that test results can consistently be generated within 72 hours of sample receipt.

Detection of circulating ribonucleic acid (cRNA) from blood is an unmet need in clinical diagnostics. Here we describe methods that characterize cRNA from non-small cell lung cancer patients using sensitive and specific digital polymerase chain reaction. The tests meet design requirements to detect fusion variants within 72 hours.

We have developed novel methods for the isolation and characterization of tumor-derived circulating ribonucleic acid (cRNA) for blood-based liquid biopsy. ...

Medicine

Robotic Vagus-Sparing Total Gastrectomy for CDH1 Gene Mutation Treatment

Hereditary diffuse gastric cancer (HDGC) caused by the CDH1 gene mutation is an inherited cancer syndrome that increases the risk of diffuse gastric cancer and is nearly impossible to detect by screening gastroscopy. The recommended preventative treatment is a total gastrectomy. Robotic surgery facilitates the use of minimally invasive surgical (MIS) techniques for anastomoses and posterior vagus preservation to potentially reduce adverse functional outcomes. An asymptomatic 24 year old male with the CDH1 gene mutation proven by genetic testing and a family history of a brother having a total gastrectomy for HDGC was treated with this technique. This video case report demonstrates the techniques and pitfalls of robotic surgery in terms of the patient positioning and port placement, posterior vagus-preserving dissection, sutured esophagojejunostomy, jejunal pouch formation, and Roux-en-Y reconstruction with a staple-stapled jejunojejunostomy. While these techniques are demonstrated in the case of prophylactic gastrectomy, many of them can be applied to other benign and bariatric foregut and general surgery types.Robotic surgery can facilitate the foregut MIS technique, as described in this case of a vagus-sparing total gastrectomy.

This article focuses on robotic vagus-sparing total gastrectomy. The techniques and pitfalls of vagus preservation, sutured esophagojejunostomy, jejunal pouch formation, and Roux-en-Y reconstruction with a staple-stapled jejunojejunostomy are discussed.

Hereditary diffuse gastric cancer (HDGC) caused by the CDH1 gene mutation is an inherited cancer syndrome that increases the risk of diffuse gastric ...

SNP-Guided 5-FU Therapy in Gastric Cancer Using Ion Torrent Sequencing

Multi-Gene Single Nucleotide Polymorphism Detection in Gastric Cancer Based on Ion Semiconductor Sequencing Platform

Gastric cancer is a common heterogeneous tumor. Most patients have advanced gastric cancer at the time of diagnosis and often need chemotherapy. Although 5-fluorouracil (5-FU) is widely used for treatment, its therapeutic sensitivity and drug tolerance still need to be determined, which emphasizes the importance of individualized administration. Pharmacogenetics can guide the clinical implementation of individualized treatment. Single nucleotide polymorphisms (SNPs), as a genetic marker, contribute to the selection of appropriate chemotherapy regimens and dosages. Some SNPs are associated with folate metabolism, the therapeutic target of 5-FU. Methylenetetrahydrofolate reductase (MTHFR) rs1801131 and rs1801133, dihydrofolate reductase (DHFR) rs1650697 and rs442767, methionine synthase (MTR) rs1805087, gamma-glutamyl hydrolase (GGH) rs11545078 and solute carrier family 19 member 1 (SLC19A1) rs1051298 have been investigated in different kinds of cancers and antifolate antitumor drugs, which have potential forecasting and guiding significance for application of 5-FU. The ion torrent next-generation semiconductor sequencing technology can rapidly detect gastric cancer-related SNPs. Each time a base is extended in a DNA chain, an H+ will be released, causing local pH changes. The ionic sensor detects pH changes and converts chemical signals into digital signals, achieving sequencing by synthesis. This technique has low sample requirement, simple operation, low cost, and fast sequencing speed, which is beneficial for guiding individualized chemotherapy by SNPs.

Author Spotlight: Genetic Profiling for Fluorouracil Response in Gastric Cancer

This protocol proposes holistic laboratory procedures required to detect single nucleotide polymorphisms in gastric cancer samples based on an ion semiconductor sequencing platform. The target sequences, ligating adapters, library amplification and purification, and quality control criteria are also described in detail.

Gastric cancer is a common heterogeneous tumor. Most patients have advanced gastric cancer at the time of diagnosis and often need chemotherapy. Although ...

Chip-Based Digital PCR to Detect Rare Transcript Variants Using a Nanofluidic Chip

Source: Molinari, C., et al. <a href="https://app.jove.com/v/57066">Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR.</a> J. Vis. Exp. (2018).
This video demonstrates chip-based digital PCR &#8212; a variation of the digital PCR technique that is useful in detecting rare transcript variants. The PCR reaction is partitioned into the chambers of a nanofluidic chip, each of which acts as an independent reaction. The detection of fluorescence signals from the chambers with amplified targets confirms the presence of rare transcript variants in the sample.

Source: Molinari, C., et al. Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR. J. Vis. Exp. ...

JoVE Encyclopedia of Experiments

Biological Techniques

PCR Techniques

Chip-in-a-Tube-Based Digital PCR for Quantification of Single Nucleotide Variants

Source: Kahyo, T., et al. <a href="https://app.jove.com/v/58199">Digital Polymerase Chain Reaction Assay for the Genetic Variation in a Sporadic Familial Adenomatous Polyposis Patient Using the Chip-in-a-tube Format.</a> J. Vis. Exp. (2018).
This video demonstrates the utility of digital PCR in a chip-in-a-tube format for the detection of single nucleotide variations in DNA samples. A single PCR reaction is partitioned into chambers that act as independent PCR reactions, and the detection of fluorescence signals from the amplified targets in the chambers is used to compute the frequency of the variant allele in the sample.

Source: Kahyo, T., et al. Digital Polymerase Chain Reaction Assay for the Genetic Variation in a Sporadic Familial Adenomatous Polyposis Patient Using the ...

Detection of a CDH1 Rare Transcript Variant in Fresh-frozen Gastric Cancer Tissues by Chip-based Digital PCR

Summary

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Chapters in this video

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

Digital Polymerase Chain Reaction Assay for the Genetic Variation in a Sporadic Familial Adenomatous Polyposis Patient Using the Chip-in-a-tube Format

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids

Genome-Wide Analysis of DNA Methylation in Gastrointestinal Cancer

A Blood-based Test for the Detection of ROS1 and RET Fusion Transcripts from Circulating Ribonucleic Acid Using Digital Polymerase Chain Reaction

Robotic Vagus-Sparing Total Gastrectomy for CDH1 Gene Mutation Treatment

Multi-Gene Single Nucleotide Polymorphism Detection in Gastric Cancer Based on Ion Semiconductor Sequencing Platform

Chip-Based Digital PCR to Detect Rare Transcript Variants Using a Nanofluidic Chip

Chip-in-a-Tube-Based Digital PCR for Quantification of Single Nucleotide Variants