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Hypermethylation of MDFI Promoter with NSCLC Is Specific for Females, Non‑Smokers and People Younger Than 65

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Hypermethylation of MDFI Promoter with NSCLC Is Specific for Females, Non‑Smokers and People Younger Than 65 ONCOLOGY LETTERS 15: 9017-9024, 2018 Hypermethylation of MDFI promoter with NSCLC is specific for females, non‑smokers and people younger than 65 HONGYING MA1*, XIAOYING CHEN2*, HAOCHANG HU2*, BIN LI2, XIURU YING2, CONG ZHOU2, JIE ZHONG2, GUOFANG ZHAO3 and SHIWEI DUAN2 1Department of Respiratory Medicine, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang 315020; 2Medical Genetics Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211; 3Department of Thoracic Surgery, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010, P.R. China Received March 11, 2017; Accepted January 25, 2018 DOI: 10.3892/ol.2018.8535 Abstract. Non-small cell lung carcinoma (NSCLC) is a subgroup analysis of the TCGA datasets. The Gene Expression major subtype of lung cancer. Aberrant DNA methylation Omnibus database indicated MDFI expression restoration in has been frequently observed in NSCLC. The aim of the partial lung cancer cell lines (H1299 and Hotz) following present study was to investigate the role of MyoD family demethylation treatment. However, it was identified thatMDFI inhibitor (MDFI) methylation in NSCLC. Formalin-fixed promoter hypermethylation was not significantly associated paraffin‑embedded tumor tissues and adjacent non‑cancerous with prognosis of NSCLC (P>0.05). In conclusion, the present tissues were collected from a total of 111 patients with study indicated that the association of higher methylation of NSCLC. A methylation assay was performed using the the MDFI promoter with NSCLC may be specific to females, quantitative methylation‑specific polymerase chain reaction non‑smokers and people aged ≤65. method. The percentage of methylated reference was used to represent the methylation level of the MDFI promoter. Introduction Data mining of a dataset from The Cancer Genome Atlas (TCGA) demonstrated that MDFI promoter methylation levels Lung cancer is the leading cause of cancer-associated were significantly increased in 830 tumor tissues compared mortality globally (1), with >1 million cases reported annu- with 75 non-tumor tissues (P=0.012). However, the results ally (2). Non-small cell lung cancer (NSCLC) is the dominant on tissues obtained in the present study indicated that the histological subtype, accounting for ~85% of lung cancer (3,4). MDFI promoter methylation levels in tumor tissues were not Other types include lung adenocarcinoma (LUAD), lung squa- significantly different compared with those in the adjacent mous cell carcinoma (LUSC) and large cell carcinoma (5). Due non-tumor tissues (P=0.159). Subsequent breakdown analysis to the nonspecific symptoms at early stages and poor overall identified that higher MDFI promoter methylation levels were survival rates (6,7), association studies for NSCLC biomarkers significantly associated with NSCLC in females (P=0.031), have been investigated globally (8,9). but not in males (P=0.832). Age‑based subgroup analysis The evolution of lung cancer is a complex process demonstrated that higher MDFI promoter methylation levels involving the interaction of genetic, epigenetic and environ- were significantly associated with NSCLC in younger patients mental factors (10). As a common epigenetic modification, (≤65 years; P=0.003), but not in older patients (P=0.327). In DNA methylation serves an important role in human malig- addition, the association of MDFI methylation with NSCLC nant tumor types, including NSCLC (11). Methylation of was significant in non‑smokers (P=0.014), but not in smokers the cytosine-phosphate-guanine (CpG) island affects gene (P=0.832). Similar results also have been determined from silencing (12), and provides a novel insight into lung tumorigen- esis and progression. Currently, there are a number of studies on the potential of DNA methylation biomarkers in NSCLC, including RASSF1 (13), CDKN2A (14), MGMT (14), APC (15), FHIT (16), CDH13 (15) and DAPK (13). Furthermore, a large Correspondence to: Dr Shiwei Duan, Medical Genetics Center, number of tumor‑specific methylated genes have been identi- School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo, fied using genome‑wide CpG island methylation analysis in Zhejiang 315211, P.R. China E-mail: [email protected] NSCLC (17). Since aberrant DNA methylation has been indi- cated as an early stage event during lung carcinogenesis (18), it *Contributed equally is characterized as dynamic and reversible (19). DNA methyla- tion biomarkers may be an ideal tool for early diagnosis and Key words: MyoD family inhibitor, DNA methylation, non-small prognosis due to their non-invasive, high sensitivity, and high cell lung carcinoma, promoter, sex, smoking, age specificity characteristics (20). MyoD family inhibitor (MDFI) is located in chromosome 6p21.1, encoding a transcription factor that negatively regulates 9018 MA et al: MDFI PROMOTER HYPERMETHYLATION AND NSCLC myogenic family proteins (21). MDFI has been considered as identification that consisted of one cycle of 95˚C for 15 sec, a candidate tumor suppressor gene (21,22) and the domain 58˚C for 1 min and 95˚C for 10 sec (slope 0.11˚C/s, acquisi- protein is involved in transcriptional regulation by affecting tion mode: Continuous). The primer sequences of MDFI were the Wnt signaling pathway (23). Additionally, MDFI gene as follows: Forward, 5'‑AGA GAC GGT GAG GAT TGT‑3' and silencing induced by promoter hypermethylation was observed reverse, 5'‑CGA CTA CTA CAT TCT TAC CTA CTT‑3', and the in pancreatic cancer (24,25); however, the epigenetic role of product length was 80 bp. The primer sequences of β‑actin MDFI methylation in NSCLC pathogenesis remains unclear. were as follows: Forward, 5'‑TGG TGA TGG AGG AGG TTT The present study aimed to establish the association between AGT AAG T‑3' and reverse, 5'‑TGG TGA TGG AGG AGG TTT the MDFI promoter methylation and NSCLC. AGT AAG T‑3', and the product length was 133 bp. Sperm DNA from a healthy individual was methylated with excess SssI Materials and methods methyltransferase (Thermo Fisher Scientific, Inc., Waltham, MA, USA) to serve as a positive control. Water without DNA Sample collection and data source. Formalin-fixed, served as a negative control in each assay. The percentage of paraffin-embedded (FFPE) tumor tissues and adjacent methylated reference (PMR) of the MDFI in each sample was non‑cancerous tissues were collected from 73 male, and calculated using the 2-ΔΔCq method, whereby ΔΔCq was calcu- 38 female patients with NSCLC at Huzhou First People's lated as follows: Sample DNA (Cq target gene-Cq ACTB control)-fully Hospital (Huzhou, Zhejiang, China) between August 2010 and methylated DNA (Cq target gene-Cq ACTB control) (29). All products October 2013. The patient age range was 33 to 82 years old (mean, were confirmed by Sanger sequencing and capillary gel elec- 63.59±10.19 years old). All pathological parameters were defined trophoresis as previously described (30). according to the World Health Organization guidelines and Union for International Cancer Control tumor‑node‑metastasis Statistical analysis. Statistical analysis was performed using classifications (26,27). According to the histological type, there SPSS software 18.0 (SPSS Inc., Chicago, IL, USA). Due to the were 42 patients with LUSC and 69 patients with LUAD. The skewed distribution of methylation data, the non-parametric adjacent non‑cancerous tissues were obtained from ≥5 cm Wilcoxon signed‑rank test and Mann‑Whitney‑U test was outside the edge of tumors. All specimens were sliced at 4-µm used to compare the methylation levels between tumor thickness using a Leica RM2245 Semi-Automated Rotary tissues and non-tumor tissues in the study cohort, and TCGA Microtome (Leica Microsystems GmbH, Wetzlar, Germany). dataset. Data were presented as the median ± interquartile Written informed consent form was signed by all of the range. Fisher exact test or χ2 test was used to determine the participants and the present study was approved by the Ethics associations between the methylation status and the clinical Committee of Huzhou First People's Hospital. characteristics (age, sex, smoking history, histological types DNA methylation profiles (Illumina Human Methylation and clinical stage). Kaplan-Meier curve was implemented to 450K, HM450K; Illumina, Inc., San Diego, CA, USA) assess the prognostic value of MDFI methylation in postopera- and clinical characteristics (age, sex and smoking status) tive patients with NSCLC. P<0.05 was considered to indicate a generated from 830 NSCLC tumor tissues and 75 non‑tumor statistically significant difference. tissues were obtained from The Cancer Genomics Browser of The University of California Santa Cruz database Results (https://genome‑cancer.ucsc.edu/). The browser contains data generated from the Cancer Genome Atlas (TCGA) project In order to assess the methylation level of MDFI promoter (https://cancergenome.nih.gov/). Therefore, larger samples region, a fragment (chr6: 41604618‑41604697) amplified with were used to verify the findings of the study cases. These a suitable primer pair was selected. As there was a high number samples were then used as a control for the study data. of CG sites in the promoter region, a specific primer pair of qMSP method was difficult to design. The primers used were DNA extraction and bisulfite treatment. Genomic DNA from designed to obtain a single melting curve. Furthermore, this tissues was extracted using the E.Z.N.A® FFPE DNA kit fragment was located in the region rich in histone modifications (Omega Bio‑tek, Inc., Norcross, GA,
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