PO.CL01.18 · 临床研究

表观遗传谱分析利用一种基于靶向甲基化的多癌种早期检测(MCED)血液检测鉴定侵袭性癌症亚型的标志物

Epigenetic profiling identifies markers of aggressive cancer subtype using a targeted methylation-based multi-cancer early detection (MCED) blood test

海报缩略图:表观遗传谱分析利用一种基于靶向甲基化的多癌种早期检测(MCED)血液检测鉴定侵袭性癌症亚型的标志物
编号 1100 展板 10 时间 4/19 02:00–05:00 区域 Section 43 主讲 Yue An, BS;MS
分会场 Early Detection Biomarkers 1
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作者与单位 Authors & Affiliations

Kezhong Chen1, Jian Huang2, Dahong Zhang3, Shu Wang4, Hongxu Liu5, Wenzhao Zhong6, Xiangnan Li7, Qiang Zhang5, Zhigao Li8, Jiaqi Liu9, Ziqing Tian10, Fei Zhou11, Gongsheng Jin12, Xudong Xiang13, Zhigang Li14, Hui Xie15, Ya Wei16, Guochun Zhang17, Guolin Ye18, Ming Cai19, Junfeng Wang8, Yan Zhang20, Chao Cheng21, Hefei Li22, Desong Yang23, Jianhong Lian24, Sheng Huang25, Tao Xu26, Zengjun Wang27, Xi Guo28, Zhuowei Liu29, Minfeng Chen30, Yang Wang31, Yue An31, Yanzhan Yang31, Min Li31, Jing Liu31, Baoliang Zhu31, Yonghui Li31, Xiaohui Wu31, Fan Yang1, Jun Wang1

1Thoracic Oncology Institute and Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China,2The Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,3Urology & Nephrology Center, Department of Urology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, China,4Breast Disease Center, Peking University People's Hospital, Beijing, China,5Liaoning Provincial Cancer Hospital, Shenyang, China,6Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China,7The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,8Harbin Medical University Cancer Hospital, Harbin, China,9Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,10Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,11Shanghai Pulmonary Hospital, Shanghai, China,12The First Affiliated Hospital of Bengbu Medical College, Bengbu, China,13Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, China,14Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of medicine, Shanghai, China,15Department of Breast Cancer Research Center, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China,16Anyang Tumor Hospital, Anyang, China,17Department of Breast Surgery, Guangdong Provincial People's Hospital, Guangzhou, China,18Department of Breast Cancer, The First People's Hospital of Foshan, Foshan, China,19Department of Urology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China,20Department of Oncology, Shijiazhuang People’s Hospital, Shijiazhuang, China,21Department of Thoracic Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China,22Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, China,23Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China,24Department of General Surgery,Shanxi Cancer Hospital, Taiyuan, China,25Department of Breast Surgical Oncology,Yunnan Cancer Hospital, Kunming, China,26Peking University People's Hospital, Beijing, China,27Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,28Department of Urology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, China,29Sun Yat-sen University Cancer Center, Guangzhou, China,30Department of urology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China,31Shanghai Xiaohe Medical Laboratory Co. Ltd., Shanghai, China

摘要 Abstract

中文摘要
背景:既往MCED研究显示不同侵袭性癌症亚型间的检测性能存在差异。然而,不同侵袭性亚型间的甲基化谱和ctDNA释放模式尚未得到分析。我们系统性地比较了三种癌症中不同侵袭性亚型间的游离DNA(cfDNA)肿瘤分数和甲基化谱,以鉴定区分肿瘤侵袭性的表观遗传生物标志物。 方法:使用一种基于靶向甲基化的MCED检测,分析了一项病例对照研究(NCT06217900)中包括757例癌症病例的血样。我们比较了各侵袭性亚型间的cfDNA肿瘤分数和甲基化谱,包括分期匹配的小细胞肺癌(SCLC)(n=137)对比(vs)非小细胞肺癌(NSCLC)(n=137)、I期浸润性肺腺癌(IAC)(n=81)vs微浸润性腺癌(MIA)(n=81)、三阴性乳腺癌(TNBC)(n=151)vs非TNBC(n=151),以及中/高级别前列腺癌(Gleason分级组[GG]2-5)(n=14)vs低级别前列腺癌(GG1)(n=6)。基于甲基化信号的分布,使用零膨胀负二项模型估计肿瘤分数,并通过计算不同侵袭性亚型间的甲基化/非甲基化(M/U)比值评估甲基化谱。标志物比较采用Mann-Whitney U检验并进行多重检验校正。 结果:更具侵袭性的亚型敏感性更高(肺癌93.73% vs SCLC 99.27%;乳腺癌70.76% vs TNBC 81.46%;前列腺癌40% vs 中高级别前列腺癌42.86%)。在肺癌中,SCLC表现出显著高于NSCLC的cfDNA肿瘤分数(Wilcoxon p = 2.24×10⁻²⁴),有41,136个标志物(79.18%为低甲基化)显示M/U比值升高。在I期肺腺癌中,IAC较MIA表现出更高的cfDNA肿瘤分数(Wilcoxon p = 2.55×10⁻⁶)和系统性甲基化差异。在乳腺癌中,TNBC的cfDNA肿瘤分数显著高于非TNBC(Wilcoxon p = 2.55×10⁻⁶),有25,717个标志物(80.32%为低甲基化)显示M/U比值升高。在相同分期的前列腺癌中,GG2-5病例较GG1表现出更高的cfDNA肿瘤分数(Wilcoxon p = 0.038)和系统性甲基化改变。 结论:侵袭性肿瘤亚型持续表现出升高的cfDNA肿瘤分数和以M/U比值增加为特征的特征性甲基化谱。这些发现提示cfDNA甲基化模式是区分肿瘤侵袭性的有前景的表观遗传生物标志物,有可能提高癌症筛查的精确性并减少过度诊断。
查看英文原文 English abstract
Background: Previous MCED studies have shown differences in detection performance across different aggressiveness cancer subtypes. However, the methylation profiles and ctDNA shedding patterns across different aggressiveness subtypes have not been analyzed. We systematically compared cell-free DNA (cfDNA) tumor fraction and methylation profiles across aggressiveness subtypes in three cancers to identify epigenetic biomarkers that differentiate tumor aggressiveness. Methods: Blood samples from a case-control study (NCT06217900) including 757 cancer cases were analyzed using a targeted methylation-based MCED test. We compared cfDNA tumor fraction and methylation profiles between aggressiveness subtypes, stage-matched small cell lung cancer (SCLC) (n=137) versus (vs) non-small cell lung cancer (NSCLC) (n=137), stage I invasive lung adenocarcinoma (IAC) (n=81) vs minimally invasive adenocarcinoma (MIA) (n=81), triple-negative breast cancer (TNBC) (n=151) vs non-TNBC (n=151), and intermediate/high-grade prostate cancer (Gleason Grade Group[GG] 2-5)(n=14) vs low-grade prostate cancer(GG1)(n=6). Tumor fraction was estimated using zero-inflated Negative Binomial model based on the distribution of methylation signals, and methylation profiles were assessed by calculating methylated/unmethylated (M/U) ratios between different aggressiveness subtypes. Marker comparisons were conducted using the Mann-Whitney U test with multiple testing corrections. Results: The sensitivity is higher in more aggressive subtypes (lung cancer 93.73% vs SCLC 99.27%; breast cancer 70.76% vs TNBC 81.46%; prostate cancer 40% vs intermediate and high-grad prostate cancer 42.86%). In lung cancer, SCLC exhibited a significantly higher cfDNA tumor fraction than NSCLC (Wilcoxon p = 2.24×10⁻²⁴), with 41,136 markers (79.18% hypomethylated) showing elevated M/U ratios. In stage I lung adenocarcinoma, IAC demonstrated a higher cfDNA tumor fraction (Wilcoxon p = 2.55×10⁻⁶) and systematic methylation differences compared to MIA. In breast cancer, TNBC had a significantly higher cfDNA tumor fraction than non-TNBC (Wilcoxon p = 2.55×10⁻⁶), with 25,717 markers (80.32% hypomethylated) displaying increased M/U ratios. Among prostate cancers of the same stage, GG2-5 cases exhibited higher cfDNA tumor fraction (Wilcoxon p = 0.038) and systematic methylation alterations compared to GG1. Conclusion: Aggressive tumor subtypes consistently display elevated cfDNA tumor fraction and characteristic methylation profiles marked by increased M/U ratios. These findings suggest cfDNA methylation patterns are promising epigenetic biomarkers for distinguishing tumor aggressiveness, potentially improving cancer screening precision and reducing overdiagnosis.
利益披露 Disclosure
K. Chen, None.. J. Huang, None.. D. Zhang, None.. S. Wang, None.. H. Liu, None.. W. Zhong, None.. X. Li, None.. Q. Zhang, None.. Z. Li, None.. J. Liu, None.. Z. Tian, None.. F. Zhou, None.. G. Jin, None.. X. Xiang, None.. Z. Li, None.. H. Xie, None.. Y. Wei, None.. G. Zhang, None.. G. Ye, None.. M. Cai, None.. J. Wang, None.. Y. Zhang, None.. C. Cheng, None.. H. Li, None.. D. Yang, None.. J. Lian, None.. S. Huang, None.. T. Xu, None.. Z. Wang, None.. X. Guo, None.. Z. Liu, None.. M. Chen, None. Y. Wang, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. Y. An, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. Y. Yang, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. M. Li, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. J. Liu, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. B. Zhu, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. Y. Li, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. X. Wu, Shanghai Xiaohe Medical Laboratory Co. Ltd. Employment. F. Yang, None.. J. Wang, None.

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