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KMID : 1137020220330060074
Journal of Gynecologic Oncology
2022 Volume.33 No. 6 p.74 ~ p.74
Prognostication of early-onset endometrioid endometrial cancer based on genome-wide DNA methylation profiles
Hirano Takuro

Arai Eri
Fujimoto Mao
Nakayama Yuji
Tian Ying
Ito Nanako
Makabe Takeshi
Yamagami Wataru
Susumu Nobuyuki
Aoki Daisuke
Kanai Yae
Abstract
Objective: The aim of this study was to establish criteria that would indicate whether fertility preservation therapy would likely be safe for patients aged 40 years or less with endometrioid endometrial cancer based on their DNA methylation profile.

Methods: Forty-nine fresh-frozen tissue samples from patients with endometrial cancer from an initial cohort and 31 formalin-fixed paraffin-embedded tissue samples from a second cohort were subjected to genome-wide DNA methylation analysis using the Infinium MethylationEPIC BeadChip.

Results: Epigenomic clustering of early-onset endometrial cancer was correlated with the widely used recurrence risk classification. Genes showing differences in DNA methylation levels between the low-recurrence-risk category and intermediate- and high-risk categories were accumulated in pathways related to fibroblast growth factor and nuclear factor-¥êB signaling. DNA hypomethylation and overexpression of ZBTB38 were frequently observed in the low-risk category. Eight hundred thirty-one marker CpG probes showed area under the curve values of >0.7 on the receiver operating characteristic curve for discrimination of patients belonging to the low-risk category. By combining marker CpG sites, seven panels for placing patients into the low-risk category with 91.3% or more sensitivity and specificity in both the initial and second cohorts were established.

Conclusions: DNA methylation diagnostics criteria using up to 6 of 8 CpG sites for LPP, FOXO1, RNF4, EXOC6B, CCPG1, RREB1 and ZBTB38 may be applicable to recurrence risk estimation for patients aged 40 years or less with endometrial cancer, regardless of tumor cell content, even if formalin-fixed paraffin-embedded biopsy or curettage materials are used.
KEYWORD
DNA Methylation, Infinium Array, Endometrioid Carcinoma, Early Onset, Fertility Preservation, ZBTB38
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