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A comprehensive methylation signature identifies lymph node metastasis in esophageal squamous cell carcinoma
Author(s) -
Roy Roshni,
Kandimalla Raju,
Sonohara Fuminori,
Koike Masahiko,
Kodera Yasuhiro,
Takahashi Naoki,
Yamada Yasuhide,
Goel Ajay
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31755
Subject(s) - pathology , metastasis , methylation , carcinoma , medicine , esophageal squamous cell carcinoma , lymph node metastasis , basal cell , oncology , cancer research , biology , cancer , gene , biochemistry
Treatment modalities in esophageal squamous cell carcinoma (ESCC) depend largely on lymph node metastasis (LNM) status. With suboptimal detection sensitivity of existing imaging techniques, we propose a methylation signature which identifies patients with LNM with greater accuracy. This would allow precise stratification of high‐risk patients requiring more aggressive treatment from low‐risk ESCC patients who can forego radical surgery. An unbiased genome‐wide methylation signature for LNM detection was established from an initial in silico discovery phase. The signature was tested in independent clinical cohorts comprising of 249 ESCC patients. The prognostic potential of the methylation signature was compared to clinical variables including LNM status. A 10‐probe LNM associated signature (LNAS) was developed using stringent bioinformatics analyses. The area under the curve values for LNAS risk scores were 0.81 and 0.88 in the training and validation cohorts respectively, in association with lymphatic vessel invasion and tumor stage. High LNAS risk‐score was also associated with worse overall survival [HR (95% CI) 3 (1.8–4.8), p < 0.0001 training and 3.9 (1.5–10.2), p = 0.001 validation cohort]. In conclusion, our novel methylation signature is a powerful biomarker that identifies LNM status robustly and is also associated with worse prognosis in ESCC patients.