Abstract
BackgroundAs biomarkers, DNA methylation is used to detect colorectal cancer (CRC) and make assessment of CRC prognosis. The published findings showed the association between the methylation of SFRP1, SFRP2, and WIF1, located in the Wnt signaling pathway, and the prognosis of CRC were not consistent. Our study aimed to explore the potential possibility of SFRP1, SFRP2, and WIF1 concomitant promoter methylation as prognostic biomarkers of postoperative CRC patients.MethodsAs a total of 307 sporadic postoperative CRC patients were followed up, we detected SFRP1, SFRP2, and WIF1 methylation obtained from tumor tissues and adjacent non-tumor tissues respectively on the basis of methylation-sensitive high resolution melting analysis. Univariate and multivariate Cox regressions were carried out so as to assess the potential possibility of SFRP1, SFRP2, and WIF1 promoter methylation as predictors of prognosis. Confounders in our study were controlled by Propensity Score (PS) analysis.ResultsThe SFRP1, SFRP2, and WIF1 methylation levels in tumor tissues were significantly higher than that in adjacent non-tumor tissues (P < 0.001). SFRP2 hypermethylation was significantly associated with a favorable clinical outcome at the hazard ratio (HR) of 0.343 [95% confidence intervals (CI): 0.164–0.718, P = 0.005] and 0.410 (95% CI: 0.200–0.842, P = 0.015) in multivariate Cox regression and PS analysis, respectively. Co-hypermethylation of SFRP1 and SFRP2 was significantly associated with a favorable clinical outcome at the HR of 0.333 (95% CI: 0.159–0.694, P = 0.003) and 0.398 (95% CI: 0.192–0.821, P = 0.013) in multivariate Cox regression and PS analysis, respectively. Co-hypermethylation of SFRP1, SFRP2 and WIF1 was significantly associated with a favorable clinical outcome at the HR of 0.326 (95% CI: 0.117–0.908, P = 0.032) and 0.401 (95% CI: 0.146–1.106, P = 0.077) in multivariate Cox regression and PS analysis, respectively.ConclusionsSFRP1, SFRP2, and WIF1 were frequently hypermethylated in CRC tumor tissues. It was apparent that the promoter hypermethylation of SFRP2 and co-hypermethylation of SFRP1 and SFRP2 might be considered as independent prognostic predictors for survival advantage of postoperative CRC patients.
Highlights
As biomarkers, DNA methylation is used to detect colorectal cancer (CRC) and make assessment of CRC prognosis
Secreted frizzled-related protein 1 (SFRP1), Secreted frizzled-related protein 2 (SFRP2), and Wnt inhibitory factor 1 (WIF1) methylation in tumor and adjacent non-tumor tissues We had detected the methylation of SFRP1, SFRP2, and WIF1 for 187 adjacent non-tumor tissue specimens and 307 primary tumor tissue specimens
Co-hypermethylation of SFRP1, SFRP2, and WIF1 was significantly associated with a favorable clinical outcome with the hazard ratio (HR) of 0.326 (95%confidence intervals (CI): 0.117–0.908, P = 0.032) in multivariate Cox regression, the results showed that this co-methylation was not associated with prognosis in Propensity Score (PS)-1 analysis, with HR of 0.401 (Table 4)
Summary
DNA methylation is used to detect colorectal cancer (CRC) and make assessment of CRC prognosis. The published findings showed the association between the methylation of SFRP1, SFRP2, and WIF1, located in the Wnt signaling pathway, and the prognosis of CRC were not consistent. Our study aimed to explore the potential possibility of SFRP1, SFRP2, and WIF1 concomitant promoter methylation as prognostic biomarkers of postoperative CRC patients. Colorectal cancer (CRC) has a high estimated death of 881,000 and ranks second in terms of mortality worldwide in 2018 [1]. The global burden of CRC is estimated to reach 1,100,000 cancer deaths by 2030 [2]. More effective prognostic biomarkers might be a key to reduce deaths owing to CRC
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