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Identification of a Novel Renal Metastasis Associated CpG-Based DNA Methylation Signature (RMAMS)
oleh: Jürgen Serth, Inga Peters, Olga Katzendorn, Tu N. Dang, Joana Moog, Zarife Balli, Christel Reese, Jörg Hennenlotter, Alexander Grote, Marcel Lafos, Hossein Tezval, Markus A. Kuczyk
Format: | Article |
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Diterbitkan: | MDPI AG 2022-09-01 |
Deskripsi
Approximately 21% of patients with renal cell cancer (RCC) present with synchronous metastatic disease at the time of diagnosis, and metachronous metastatic disease occurs in 20–50% of cases within 5 years. Recent advances in adjuvant treatment of aggressive RCC following surgery suggest that biomarker-based prediction of risk for distant metastasis could improve patient selection. Biometrical analysis of TCGA-KIRC data identified candidate loci in the NK6 homeobox 2 gene (<i>NKX6-2</i>) that are hypermethylated in primary metastatic RCC. Analyses of <i>NKX6-2</i> DNA methylation in three gene regions including a total of 16 CpG sites in 154 tumor-adjacent normal tissue, 189 RCC, and 194 metastatic tissue samples from 95 metastasized RCC patients revealed highly significant tumor-specific, primary metastatic-specific, and metastatic tissue-specific hypermethylation of <i>NKX6-2</i>. Combined CpG site methylation data for <i>NKX6-2</i> and metastasis-associated genes (<i>INA</i>, <i>NHLH2</i>, and <i>THBS4</i>) demonstrated similarity between metastatic tissues and metastatic primary RCC tissues. The random forest method and evaluation of an unknown test cohort of tissues using receiver operator characteristic curve analysis revealed that metastatic tissues can be differentiated by a median area under the curve of 0.86 (<i>p</i> = 1.7 × 10<sup>−8</sup>–7.5 × 10<sup>−3</sup>) in 1000 random runs. Analysis of variable importance demonstrated an above median contribution for decision-making of at least one CpG site in each of the genes, suggesting superior informativity for sites annotated to <i>NHLH2</i> and <i>NKX6</i>-2. Thus, DNA methylation of <i>NKX6-2</i> is associated with the metastatic state of RCC tissues and contributes to a four-gene-based statistical predictor of tumoral and metastatic renal tissues.