title: IGF-II promoter methylation and ovarian cancer prognosis.
abstract: OBJECTIVE
  The insulin-like growth factor-II (IGF-II) gene has four promoters that produce distinct transcripts which vary by tissue type and developmental stage. Dysregulation of normal promoter usage has been shown to occur in cancer; DNA methylation regulates promoter use. Thus, we sought to examine if DNA methylation varies among IGF-II promoters in ovarian cancer and if methylation patterns are related to clinical features of the disease.
  
  
  METHODS
  Tumor tissue, clinical data, and follow-up information were collected from 215 patients diagnosed with primary epithelial ovarian cancer. DNA extracted from tumor tissues was analyzed for IGF-II promoter methylation with seven methylation specific PCR (MSP) assays: three for promoter 2 (P2) and two assays each for promoters 3 and 4 (P3 and P4).
  
  
  RESULTS
  Methylation was found to vary among the seven assays: 19.3% in P2A, 45.6% in P2B, 50.9% in P2C, 48.4% in P3A, 13.1% in P3B, 5.1% in P4A, and 6.1% in P4B. Methylation in any of the three P2 assays was associated with high tumor grade (P = 0.043), suboptimal debulking (P = 0.036), and disease progression [hazards ratio (HR) = 1.73, 95% confidence interval (CI) 1.09-2.74]. When comparing promoter methylation patterns, differential methylation of P2 and P3 was found to be associated with disease prognosis; patients with P3 but not P2 methylation were less likely to have disease progression (HR = 0.39, 95% CI 0.17-0.91) compared to patients with P2 but not P3 methylation.
  
  
  CONCLUSIONS
  This study shows that methylation varies among three IGF-II promoters in ovarian cancer and that this variation seems to have biologic implications as it relates to clinical features and prognosis of the disease.
authors.affiliation: Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, New Haven, CT, 06520-8034, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Beeghly
authors.forename: D
authors.initials: D
authors.lastname: Katsaros
authors.forename: A L
authors.initials: AL
authors.lastname: Wiley
authors.forename: I A
authors.initials: IA
authors.lastname: Rigault de la Longrais
authors.forename: A T
authors.initials: AT
authors.lastname: Prescott
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Puopolo
authors.forename: T J
authors.initials: TJ
authors.lastname: Rutherford
authors.forename: H
authors.initials: H
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019175:DNA Methylation; D005260:Female; D006801:Humans; D007335:Insulin-Like Growth Factor II / Q000235:genetics*; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011401:Promoter Regions, Genetic / Q000235:genetics*; D016019:Survival Analysis
chemical_list: D007335:Insulin-Like Growth Factor II