机构:[1]Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China研究所北京市神经外科研究所首都医科大学附属天坛医院[2]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[3]Chinese Glioma Genome Atlas, Beijing, China
The methylation status of the promoter of MGMT gene is a crucial factor influencing clinical decision-making in patients with gliomas. MGMT pyrosequencing results are often dichotomized by a cut-off value based on an average of several tested CpGs. However, this method frequently results in a "gray zone", representing a dilemma for physicians. We therefore propose a novel analytical model for MGMT methylation pyrosequencing. MGMT CpG heterogeneity was investigated in 213 glioma patients in two tested cohorts: cohort A in which CpGs 75-82 were tested and cohort B in which CpGs 72-78 were tested. The predictive performances of the novel and traditional averaging models were compared in 135 patients who received temozolomide using receiver operating characteristic curves and Kaplan-Meier curves, and in patients stratified according to isocitrate dehydrogenase gene mutation status. The results were validated in an independent cohort of 65 consecutive patients with high-grade gliomas from the Chinese Glioma Genome Atlas database. Heterogeneity of MGMT promoter CpG methylation level was observed in most gliomas. The optimal cut-off value for each individual CpG varied from 4-16%. The current analysis defined MGMT promoter methylation as occurring when at least three CpGs exceeded their respective cut-off values. This novel analysis could accurately predict the prognosis of patients in the methylation "gray zone" according to the standard averaging method, and improved the area under the curves from 0.67, 0.76, and 0.67 to 0.70, 0.84, and 0.72 in cohorts A, B, and the validation cohort, respectively, demonstrating superiority of this analytical method in all three cohorts. Furthermore, the advantages of the novel analysis were retained regardless of WHO grade and isocitrate dehydrogenase gene mutation status. In conclusion, this novel analytical model offers an improved clinical predictive performance for MGMT pyrosequencing results and is suitable for clinical use in patients with gliomas.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81773208, 81402052]; Beijing Nova ProgramBeijing Municipal Science & Technology Commission [Z16110004916082]; National Key Research and Development Plan [2016YFC0902500]; Beijing Scienceand Technology Plan [Z131100006113018, Z141100000214009]; Capital Medical Development Research Fund [2016-1-1072]
第一作者机构:[1]Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China[2]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China[2]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China[3]Chinese Glioma Genome Atlas, Beijing, China
推荐引用方式(GB/T 7714):
Chai Rui-Chao,Liu Yu-Qing,Zhang Ke-Nan,et al.A novel analytical model of MGMT methylation pyrosequencing offers improved predictive performance in patients with gliomas[J].MODERN PATHOLOGY.2019,32(1):4-15.doi:10.1038/s41379-018-0143-2.
APA:
Chai, Rui-Chao,Liu, Yu-Qing,Zhang, Ke-Nan,Wu, Fan,Zhao, Zheng...&Wang, Yong-Zhi.(2019).A novel analytical model of MGMT methylation pyrosequencing offers improved predictive performance in patients with gliomas.MODERN PATHOLOGY,32,(1)
MLA:
Chai, Rui-Chao,et al."A novel analytical model of MGMT methylation pyrosequencing offers improved predictive performance in patients with gliomas".MODERN PATHOLOGY 32..1(2019):4-15