Clin Transl Med. 2022 Aug;12(8): e1014
Yibo Gao,
Hengqiang Zhao,
Ke An,
Zongzhi Liu,
Luo Hai,
Renda Li,
Yang Zhou,
Weipeng Zhao,
Yongsheng Jia,
Nan Wu,
Lingyu Li,
Jianming Ying,
Jie Wang,
Binghe Xu,
Zhihong Wu,
Zhongsheng Tong,
Jie He,
Yingli Sun.
BACKGROUND: Cancer cell-specific variation and circulating tumour DNA (ctDNA) methylation are promising biomarkers for non-invasive cancer detection and molecular classification. Nevertheless, the applications of ctDNA to the early detection and screening of cancer remain highly challenging due to the scarcity of cancer cell-specific ctDNA, the low signal-to-noise ratio of DNA variation, and the lack of non-locus-specific DNA methylation technologies.
METHODS: We enrolled three cohorts of breast cancer (BC) patients from two hospitals in China (BC: n = 123; healthy controls: n = 40). We developed a ctDNA whole-genome bisulfite sequencing technology employing robust trace ctDNA capture from up to 200 μL plasma, mini-input (1 ng) library preparation, unbiased genome-wide coverage and comprehensive computational methods.
RESULTS: A diagnostic signature comprising 15 ctDNA methylation markers exhibited high accuracy in the early (area under the curve [AUC] of 0.967) and advanced (AUC of 0.971) BC stages in multicentre patient cohorts. Furthermore, we revealed a ctDNA methylation signature that discriminates estrogen receptor status (Training set: AUC of 0.984 and Test set: AUC of 0.780). Different cancer types, including hepatocellular carcinoma and lung cancer, could also be well distinguished.
CONCLUSIONS: Our study provides a toolset to generate unbiased whole-genome ctDNA methylomes with a minimal amount of plasma to develop highly specific and sensitive biomarkers for the early diagnosis and molecular subtyping of cancer.
Keywords: DNA methylation; cancer early detection; circulating tumour DNA; epigenetic biomarkers; liquid biopsy; whole-genome bisulfite sequencing