Abstract
As peripheral blood contains fluctuated levels of circulating cell-free mitochondrial DNA (ccf mtDNA), we aimed to evaluate ccf mtDNA as a biomarker for diagnosis and prognosis of epithelial ovarian cancer (EOC). In the present study, we recruited 165 EOC patients and 60 healthy women. Quantitative RT-PCR was applied to amplify 79-bp and 230-bp fragments of the mitochondrial 16 s RNA gene in sera of these participants. MtDNA integrity was defined as the ratio of long to short mtDNA fragments. We observed that the levels of mtDNA79 and mtDNA230 were significantly increased (P = .0001), whereas the mtDNA integrity (P = .0001) was decreased in EOC patients compared with those in healthy controls. MtDNA79 showed a sensitivity of 90.3% and a specificity of 81.7% (AUC = 0.900) to discriminate EOC from healthy controls. Moreover, the amounts of mtDNA79 (P = .0001, P = .012, P = .039) and mtDNA230 (P = .0001, P = .042) continuously raised from healthy controls over FIGO I-II to FIGO III and IV, with highest levels of mtDNA79 (P = .0001) and mtDNA230 (P = .0001) in FIGO III and IV. Increasing levels of mtDNA79 (P = .003, P = .0001) and mtDNA230 (P = .041, P = .0001) were also associated with lymph node metastasis and CA125 values. The higher levels of mtDNA79 (P = .0001; HR 3.2, 95%CI:1.6-6.3) and mtDNA230 (borderline P = .048, HR 0.9, 95%CI:0.9-1.0) also correlated with poor patients' overall survival, of which mtDNA79 could act as an independent factor for overall survival. Our data show a significant association of increasing levels of ccf mtDNA with EOC progress and poor prognosis.