Abstract

BackgroundThe analysis of aberrant DNA methylations is used for the diagnosis of cancer as significant changes in the gene methylation pattern are often detected during early carcinogenesis. In this study, we evaluated the performance of a two-step method that combines pre-amplification with ddPCR technique.ResultsBy using ddPCR, the dependence of amplification efficiency for methylated and unmethylated DNA fragments on the relevant MgCl2 concentration and the annealing temperature was established in addition to the primer design. We found that the efficiency can be adjusted toward methylated sequences by using primers covering one to four CpG sites under appropriately selected MgCl2 concentration and annealing temperature. Applying a PCR bias between 85% and 95%, five copies of methylated tumor DNA fragments were detected against a background of 700,000 copies of unmethylated DNA fragments with a high signal-to-noise ratio. The analysis of serum samples from patients with prostate cancer showed a significantly improved performance of the new method in comparison with the MS-HRM technique, ddPCR alone, or ddPCR in combination with an unbiased pre-amplification using methylation-independent primers.ConclusionsWe define this method as an optimized bias-based pre-amplification-digital droplet PCR (OBBPA-ddPCR) technique. This novel method is recommended for the early detection of cancer-specific DNA methylation biomarkers in the form of a liquid biopsy.

Highlights

  • Malignant disease prognosis strongly depends on the stage at which the disease is diagnosed and the presence of metastases

  • By using ddPCR, the dependence of amplification efficiency for methylated and unmethylated DNA fragments on the relevant MgCl2 concentration and the annealing temperature was established in addition to the primer design

  • Applying a PCR bias between 85% and 95%, five copies of methylated tumor DNA fragments were detected against a background of 700,000 copies of unmethylated DNA fragments with a high signal-to-noise ratio

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Summary

Introduction

Malignant disease prognosis strongly depends on the stage at which the disease is diagnosed and the presence of metastases. The detection of malignancy at the early stage increases the chances of a positive prognosis. There is a need to find early cancer biomarkers as well as diagnostic methods allowing their detection with high sensitivity and specificity. Epigenetic mechanisms such as DNA methylation play an important role in many physiological and pathophysiological processes including carcinogenesis [1,2,3,4,5]. The suggested methods, with the exception of the methylation-sensitive restriction enzyme analysis (MSRE-PCR), use bisulfite-modified genomic DNA. The analysis of aberrant DNA methylation is used for the diagnosis of cancer as significant changes in the gene methylation pattern are often detected during early carcinogenesis. We evaluated the performance of a twostep method that combines pre-amplification with ddPCR technique

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