title: Quantitative DNA methylation analysis of candidate genes in cervical cancer.
abstract: Aberrant DNA methylation has been observed in cervical cancer; however, most studies have used non-quantitative approaches to measure DNA methylation. The objective of this study was to quantify methylation within a select panel of genes previously identified as targets for epigenetic silencing in cervical cancer and to identify genes with elevated methylation that can distinguish cancer from normal cervical tissues. We identified 49 women with invasive squamous cell cancer of the cervix and 22 women with normal cytology specimens. Bisulfite-modified genomic DNA was amplified and quantitative pyrosequencing completed for 10 genes (APC, CCNA, CDH1, CDH13, WIF1, TIMP3, DAPK1, RARB, FHIT, and SLIT2). A Methylation Index was calculated as the mean percent methylation across all CpG sites analyzed per gene (~4-9 CpG site) per sequence. A binary cut-point was defined at >15% methylation. Sensitivity, specificity and area under ROC curve (AUC) of methylation in individual genes or a panel was examined. The median methylation index was significantly higher in cases compared to controls in 8 genes, whereas there was no difference in median methylation for 2 genes. Compared to HPV and age, the combination of DNA methylation level of DAPK1, SLIT2, WIF1 and RARB with HPV and age significantly improved the AUC from 0.79 to 0.99 (95% CI: 0.97-1.00, p-value = 0.003). Pyrosequencing analysis confirmed that several genes are common targets for aberrant methylation in cervical cancer and DNA methylation level of four genes appears to increase specificity to identify cancer compared to HPV detection alone. Alterations in DNA methylation of specific genes in cervical cancers, such as DAPK1, RARB, WIF1, and SLIT2, may also occur early in cervical carcinogenesis and should be evaluated.
authors.affiliation: Department of Cancer Epidemiology, Division of Population Sciences, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States of America.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.affiliation: Department of Cancer Epidemiology, Division of Population Sciences, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States of America.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Riggs
authors.affiliation: Department of Biochemistry and Molecular Biology and UF-Shands Cancer Center, University of Florida College of Medicine, 1200 Newell Drive, Academic Research Building, R3-234, Gainesville, FL 32610, United States of America.
authors.forename: Amber L
authors.initials: AL
authors.lastname: Delmas
authors.affiliation: Department of Cancer Epidemiology, Division of Population Sciences, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States of America.
authors.forename: Abby
authors.initials: A
authors.lastname: Koch
authors.affiliation: Department of Anatomic Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, United States of America.
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Hakam
authors.affiliation: Department of Biochemistry and Molecular Biology and UF-Shands Cancer Center, University of Florida College of Medicine, 1200 Newell Drive, Academic Research Building, R3-234, Gainesville, FL 32610, United States of America.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Brown
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000235:genetics*; D016022:Case-Control Studies; D019175:DNA Methylation; D005260:Female; D006801:Humans; D008875:Middle Aged; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000235:genetics*
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