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Title: Urine cell-based DNA methylation classifier for monitoring bladder cancer
Author: Heijden, Antoine G. van der
Mengual Brichs, Lourdes
Ingelmo-Torres, Mercedes
Lozano Salvatella, Juan José
Rijt-van de Westerlo, Cindy C. M. van
Baixauli, Montserrat
Geavlete, Bogdan
Moldoveanud, Cristian
Ene, Cosmin
Dinney, Colin P.
Czerniak, Bogdan
Schalken, Jack A.
Kiemeney, Lambertus A. L. M.
Ribal, María José
Witjes, J. Alfred
Alcaraz Asensio, Antonio
Keywords: Càncer de bufeta
Expressió gènica
Bladder cancer
Gene expression
Issue Date: 30-May-2018
Publisher: BioMed Central
Abstract: Background: Current standard methods used to detect and monitor bladder cancer (BC) are invasive or have low sensitivity. This study aimed to develop a urine methylation biomarker classifier for BC monitoring and validate this classifier in patients in follow-up for bladder cancer (PFBC). Methods: Voided urine samples (N = 725) from BC patients, controls, and PFBC were prospectively collected in four centers. Finally, 626 urine samples were available for analysis. DNA was extracted from the urinary cells and bisulfite modificated, and methylation status was analyzed using pyrosequencing. Cytology was available from a subset of patients (N = 399). In the discovery phase, seven selected genes from the literature (CDH13, CFTR, NID2, SALL3, TMEFF2, TWIST1, and VIM2) were studied in 111 BC and 57 control samples. This training set was used to develop a gene classifier by logistic regression and was validated in 458 PFBC samples (173 with recurrence). Results: A three-gene methylation classifier containing CFTR, SALL3, and TWIST1 was developed in the training set (AUC 0.874). The classifier achieved an AUC of 0.741 in the validation series. Cytology results were available for 308 samples from the validation set. Cytology achieved AUC 0.696 whereas the classifier in this subset of patients reached an AUC 0.768. Combining the methylation classifier with cytology results achieved an AUC 0.86 in the validation set, with a sensitivity of 96%, a specificity of 40%, and a positive and negative predictive value of 56 and 92%, respectively. Conclusions: The combination of the three-gene methylation classifier and cytology results has high sensitivity and high negative predictive value in a real clinical scenario (PFBC). The proposed classifier is a useful test for predicting BC recurrence and decrease the number of cystoscopies in the follow-up of BC patients. If only patients with a positive combined classifier result would be cystoscopied, 36% of all cystoscopies can be prevented.
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It is part of: Clinical Epigenetics, 2018, vol. 10, p. 71
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ISSN: 1868-7075
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
Articles publicats en revistes (Biomedicina)

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