Department of Epidemiology, School of Public Health, Medical College of Soochow University , Suzhou, China.
Department of General Surgery, Harrison International Peace Hospital , Hengshui, China.
Cancer Biol Ther. 2020 Dec 1;21(12):1119-1127. doi: 10.1080/15384047.2020.1833811. Epub 2020 Nov 5.
Muscle-invasive bladder urothelial carcinoma (MIBC) is a highly invasive cancer, which leads to prevalent recurrence and poor prognosis. Exploring the association of DNA methylation and the prognosis of MIBC will thus be of important value in clinical management and treatment. Bumphunter method and adaptive lasso regression were used to explore the relationship between different methylation regions (DMRs) and the prognosis of MIBC. Next, we constructed a risk prognosis model and validated this model. Moreover, the performance of this risk model was examined by using time-dependent receiver operating characteristic curve (ROC). We identified 58,449 different methylation sites and 490 different methylation regions. Among them, 11 DMRs were associated with the prognosis of MIBC through rigorous screening. Through the linear combination of 11 DMRs, a putative marker was developed, which can distinguish the survival risk in both the training dataset (HR = 2.58, 95% CI = (1.64, 4.05)) and the verification dataset (HR = 2.77, 95% CI = (1.25, 6.15)). Relatively high predictive values were observed from this model for training dataset (AUC = 0.791) and verification dataset (AUC = 0.668). Stratified analysis showed that the association was independent of gender. A nomogram was additionally generated to predict 5-year survival probability containing risk score and pathological stage. Its performance was evaluated by applying calibration curve. The methylation signature risk model based on 11 DMRs may be a reliable prognostic signature for MIBC, which provides new insights into development of individualized therapy for MIBC.
肌肉浸润性膀胱癌(MIBC)是一种高度侵袭性癌症,导致普遍复发和预后不良。因此,探索 DNA 甲基化与 MIBC 预后的关系在临床管理和治疗中具有重要价值。Bumphunter 方法和自适应套索回归用于探索不同甲基化区域(DMR)与 MIBC 预后之间的关系。接下来,我们构建了风险预后模型并对其进行了验证。此外,还通过时间依赖性接受者操作特征曲线(ROC)来检验该风险模型的性能。我们鉴定了 58449 个不同的甲基化位点和 490 个不同的甲基化区域。其中,通过严格筛选,有 11 个 DMR 与 MIBC 的预后相关。通过 11 个 DMR 的线性组合,开发了一个潜在的标志物,可以区分训练数据集(HR=2.58,95%CI=(1.64,4.05))和验证数据集(HR=2.77,95%CI=(1.25,6.15))中的生存风险。该模型在训练数据集(AUC=0.791)和验证数据集(AUC=0.668)中均表现出较高的预测值。分层分析表明,这种相关性独立于性别。此外,还生成了一个包含风险评分和病理分期的诺模图来预测 5 年生存率。通过校准曲线评估了其性能。基于 11 个 DMR 的甲基化特征风险模型可能是 MIBC 的一种可靠预后标志物,为 MIBC 的个体化治疗提供了新的见解。