Context:Even though the majority of well-differentiated thyroid carcinoma (WDTC) is indolent, a number of cases display an aggressive behavior. Cumulative evidence suggests that the deregulation of DNA methylation has the potential to point out molecular markers associated with worse prognosis.Objective:To identify a prognostic epigenetic signature in thyroid cancer.Design:Genome-wide DNA methylation assays (450k platform, Illumina) were performed in a cohort of 50 nonneoplastic thyroid tissues (NTs), 17 benign thyroid lesions (BTLs), and 74 thyroid carcinomas (60 papillary, 8 follicular, 2 Hürthle cell, 1 poorly differentiated, and 3 anaplastic). A prognostic classifier for WDTC was developed via diagonal linear discriminant analysis. The results were compared with The Cancer Genome Atlas (TCGA) database.Results:A specific epigenetic profile was detected according to each histological subtype. BTLs and follicular carcinomas showed a greater number of methylated CpG in comparison with NTs, whereas hypomethylation was predominant in papillary and undifferentiated carcinomas. A prognostic classifier based on 21 DNA methylation probes was able to predict poor outcome in patients with WDTC (sensitivity 63%, specificity 92% for internal data; sensitivity 64%, specificity 88% for TCGA data). High-risk score based on the classifier was considered an independent factor of poor outcome (Cox regression, P < 0.001).Conclusions:The methylation profile of thyroid lesions exhibited a specific signature according to the histological subtype. A meaningful algorithm composed of 21 probes was capable of predicting the recurrence in WDTC.

BackgroundPapillary thyroid carcinoma (PTC) is a common endocrine neoplasm with a recent increase in incidence in many countries. Although PTC has been explored by gene expression and DNA methylation studies, the regulatory mechanisms of the methylation on the gene expression was poorly clarified. In this study, DNA methylation profile (Illumina HumanMethylation 450K) of 41 PTC paired with non-neoplastic adjacent tissues (NT) was carried out to identify and contribute to the elucidation of the role of novel genic and intergenic regions beyond those described in the promoter and CpG islands (CGI). An integrative and cross-validation analysis were performed aiming to identify molecular drivers and pathways that are PTC-related.ResultsThe comparisons between PTC and NT revealed 4995 methylated probes (88% hypomethylated in PTC) and 1446 differentially expressed transcripts cross-validated by the The Cancer Genome Atlas data. The majority of these probes was found in non-promoters regions, distant from CGI and enriched by enhancers. The integrative analysis between gene expression and DNA methylation revealed 185 and 38 genes (mainly in the promoter and body regions, respectively) with negative and positive correlation, respectively. Genes showing negative correlation underlined FGF and retinoic acid signaling as critical canonical pathways disrupted by DNA methylation in PTC. BRAF mutation was detected in 68% (28 of 41) of the tumors, which presented a higher level of demethylation (95% hypomethylated probes) compared with BRAF wild-type tumors. A similar integrative analysis uncovered 40 of 254 differentially expressed genes, which are potentially regulated by DNA methylation in BRAFV600E-positive tumors. The methylation and expression pattern of six selected genes (ERBB3, FGF1, FGFR2, GABRB2, HMGA2, and RDH5) were confirmed as altered by pyrosequencing and RT-qPCR.ConclusionsDNA methylation loss in non-promoter, poor CGI and enhancer-enriched regions was a significant event in PTC, especially in tumors harboring BRAFV600E. In addition to the promoter region, gene body and 3’UTR methylation have also the potential to influence the gene expression levels (both, repressing and inducing). The integrative analysis revealed genes potentially regulated by DNA methylation pointing out potential drivers and biomarkers related to PTC development.Electronic supplementary materialThe online version of this article (doi:10.1186/s13148-017-0346-2) contains supplementary material, which is available to authorized users.

BackgroundDNA methylation in miRNA genes has been reported as a mechanism that may cause dysregulation of mature miRNAs and consequently impact the gene expression. This mechanism is largely unstudied in papillary thyroid carcinomas (PTC).MethodsTo identify differentially methylated miRNA-encoding genes, we performed global methylation analysis (Illumina 450 K), integrative analysis (TCGA database), data confirmation (pyrosequencing and RT-qPCR), and functional assays.ResultsMethylation analysis revealed 27 differentially methylated miRNA genes. The integrative analyses pointed out miR-21 and miR-146b as potentially regulated by methylation (hypomethylation and increased expression). DNA methylation and expression patterns of miR-21 and miR-146b were confirmed as altered, as well as seven of 452 mRNAs targets were down-expressed. The combined methylation and expression levels of miR-21 and miR-146b showed potential to discriminate malignant from benign lesions (91–96% sensitivity and 96–97% specificity). An increased expression of miR-146b due to methylation loss was detected in the TPC1 cell line. The miRNA mimic transfection highlighted putative target mRNAs.ConclusionsThe increased expression of miR-21 and miR-146b due to loss of DNA methylation in PTC resulted in the disruption of the transcription machinery and biological pathways. These miRNAs are potential diagnostic biomarkers, and these findings provide support for future development of targeted therapies.Electronic supplementary materialThe online version of this article (10.1186/s13148-018-0579-8) contains supplementary material, which is available to authorized users.

Despite the low mortality rates, well-differentiated thyroid carcinomas (WDTC) frequently relapse. BRAF and TERT mutations have been extensively related to prognosis in thyroid cancer. In this study, the methylation levels of selected CpGs (5-cytosine-phosphate-guanine-3) comprising a classifier, previously reported by our group, were assessed in combination with BRAF and TERT mutations. We evaluated 121 WDTC, three poorly-differentiated/anaplastic thyroid carcinomas (PDTC/ATC), 22 benign thyroid lesions (BTL), and 13 non-neoplastic thyroid (NT) tissues. BRAF (V600E) and TERT promoter (C228T and C250T) mutations were tested by pyrosequencing and Sanger sequencing, respectively. Three CpGs mapped in PFKFB2, ATP6V0C, and CXXC5 were evaluated by bisulfite pyrosequencing. ATP6V0C hypermethylation and PFKFB2 hypomethylation were detected in poor-prognosis (PDTC/ATC and relapsed WDTC) compared with good-prognosis (no relapsed WDTC) and non-malignant cases (NT/BTL). CXXC5 was hypomethylated in both poor and good-prognosis cases. Shorter disease-free survival was observed in WDTC patients presenting lower PFKFB2 methylation levels (p = 0.004). No association was observed on comparing BRAF (60.7%) and TERT (3.4%) mutations and prognosis. Lower PFKFB2 methylation levels was an independent factor of high relapse risk (Hazard Ratio = 3.2; CI95% = 1.1–9.5). PFKFB2 promoter methylation analysis has potential applicability to better stratify WDTC patients according to the recurrence risk, independently of BRAF and TERT mutations.

Background: The differential diagnosis of thyroid nodules using fine-needle aspiration biopsy (FNAB) is challenging due to the inherent limitation of the cytology tests. The use of molecular markers has potential to complement the FNAB-based diagnosis and avoid unnecessary surgeries. In this study, we aimed to identify DNA methylation biomarkers and to develop a diagnostic tool useful for thyroid lesions. Methods: Genome-wide DNA methylation profiles (Illumina 450k) of papillary (PTC= 60) and follicular (FTC= 10) thyroid cancers were compared with non-neoplastic tissue samples

Background: Papillary thyroid cancer (PTC) is the most common thyroid malignancy. DNA methylation associated with microRNAs (miRNA) regulation is an effective epigenetic mechanism for controlling gene expression. This mechanism is poorly explored in PTC. Patients and Methods: To investigate miRNAs genes regulated by methylation, global DNA methylation (Infinium® Human Methylation450 BeadChip, Illumina) analysis was performed in 50 matched PTC and normal tissues (NT) and compared with those deposited in The Cancer Genome Atlas (TCGA) (515 PTC and 56 NT). An integrative analysis was performed in 510 cases evaluated by whole methylation and miRNA expression analysis (TCGA). Using these findings, three miRNAs were investigated by RT-qPCR and pyrosequencing in PTC (N=103), normal thyroid tissues (NT, N=40) and benign thyroid lesions (BTL, N=32). In addition, seven target genes of these miRNAs were evaluated by RT-qPCR (44PTC, 30BTL and 28NT). Functional assays using three PTC cell lines (TPC1, K1 and BCPAP) were used to investigate the role of methylation in the miRNAs expression. Results: We found 50 differentially methylated probes of which 42 (27 microRNA genes) were confirmed in the TCGA database. The miRNA expression data from TCGA presented 67 differentially expressed miRNAs in PTC. The integrative analysis revealed three miRNAs (hsa-miR-146b-5p, hsa-miR-146b-3p and hsa-miR-21-5p) as candidates to be regulated by methylation. A significant hypomethylation pattern in PTC compared to NT and BTL (thyroid benign lesions) was found for these three miRNAs. Increased expression levels of hsa-miR-21-5p and hsa-miR-146b-5p were detected in PTC compared to NT and BTL. Combining these two miRNAs expression values, 45/47 PTC were distinguished from 66/67 non-malignant tissues (96% sensitivity and 99% specificity). Similarly, the association of methylation and expression data distinguished 41/45 PTC from 55/60 non-malignant tissues (91% sensitivity and 92% specificity) for MIR21 gene and 45/47 PTC from 61/61 NT/BTL (96% sensitivity and 100% specificity) for MIR146B gene. Seven target genes (MPPED2, STXBP5L, MRO, FHL1, FLRT1, DOK6 and MOB3B) of these miRNAs were significantly down regulated in PTC compared to NT and BTL. The BRAFV600E mutation was significantly associated to hypomethylation and overexpression of hsa-miR-21-5p and hsa-miR-146b-5p. Methylation and expression data in these three cell lines revealed that MIR146B is putatively regulated by methylation. Conclusion: We provide evidences that MIR21 and MIR146B genes are regulated by methylation having control in the expression of target genes associated with PTC. These miRNAs have a strong potential to be used as diagnostic markers in the clinical practice. Citation Format: Isabella Maria D. Ortiz, Mateus de Camargo Barros-Filho, Mariana B. dos Reis, Caroline Moraes Beltrami, Fabio Albuquerque Marchi, Hellen Kuasne, Clovis Pinto, Luiz Kowalski, Silvia Rogatto. MiRNAs genes are regulated by methylation in papillary thyroid carcinomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4416.

Background: Although the incidence rates of rectal cancer (ReCa) have been increasing, the mechanisms or mutations involved in the development of the disease are poorly explored, especially in younger patients. To date, rectal tumors from young patients show molecular, clinical and pathological differences compared with colorectal cancer from older patients. Few studies have reported the presence of a hereditary factor involved in the risk of developing ReCa in a set of patients even in the absence of family history of cancer. Patients and Method: Twenty-seven ReCa younger patients (&lt;40 years old) were screened for germline alterations in DNA from blood samples. The family history and clinical-pathological findings were assessed from the medical records from all subjects. DNA library was performed from SureSelectQXT Library Prep kit (Agilent, Santa Clara, CA) and next-generation sequencing was applied using a multigenic panel with 105 cancer-related genes (SureSelectXT Custom Panel; Agilent, Santa Clara). The generated sequences were aligned to human genome (hg19) and reported as pathogenic, likely pathogenic, variant of uncertain significance (VUS), benign and likely benign according to the American College of Medical Genetics and Genomics guidelines. Sanger sequencing was used to confirm the pathogenic variants. Results: Two patients carried out high penetrance genes associated with colorectal cancer, MUTYH biallelic and BMPR1A. MTHFR and MUTYH variants were found in two patients. POT1 (melanoma predisposition), MEN1 (high penetrance) and ATM (moderate penetrance) variants were found in three additional ReCa patients. Three patients carried out likely pathogenic varaints (BMPR1A, CHEK2 and RAD51D genes). Four of ten patients with pathogenic variants had no family history of cancer. Conclusion: Pathogenic (7/27) and likely pathogenic (3/27) variants were found in 37% of ReCa patients younger than 40 years old affecting genes with high or moderate penetrance. Our data suggest that genetic testing using a multigene panel and genetic counseling should be offered for younger patients with rectal cancer. Citation Format: Caroline Beltrami, Luisa Matos Alvim, Bruna Elisa Kupper, Annabeth Petersen, Mads Jørgensen, Samuel Aguiar Junior, Silvia Regina Rogatto. Germline cancer predisposition gene mutations among patients with early onset rectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1414.

BACKGROUND: Thyroid cancer (TC) is the most frequent endocrine neoplasia composed essentially by well-differentiated tumors (90%). These tumors generally are indolent and the patients show a favorable outcome. However, a set of TC patients presents aggressive outcome. Global deregulation of DNA methylation has been described as involved in thyroid cancer (TC) development. In this study, DNA methylation profile was performed aiming to identify a prognostic signature in TC. PATIENTS AND METHODS: The methylation profile of 50 non-neoplastic thyroid tissues (NT), 17 benign thyroid lesions and 74 TC (60 papillary, 8 follicular, 2 Hürthle cell, 1 poorly differentiated and 3 anaplastic thyroid carcinomas) were investigated using the Methylation 450 Human Infinium®BeadChip platform (Illumina). The data were normalized and analyzed using SVA, wateRmelon and LIMMA packages. The threshold delta beta of 0.2 and adjusted p-value &lt;0.05 were used to identify differentially methylated probes among the histological subtypes. The delta beta of 0.1 and adjusted p-value &lt;0.05 were used in the prognostic features analysis in WDTC (well differentiated thyroid cancer) cases. An epigenetic classifier according to WDTC was identified using diagonal linear discriminant analysis. The results were compared with The Cancer Genome Atlas (TCGA) database. RESULTS: Methylation analyses revealed a specific epigenetic profile according to the histological subtypes. A global hypermethylation was observed in benign lesions and follicular carcinomas, while papillary and undifferentiated carcinomas were widely hypomethylated compared with NT. An epigenetic signature comprising 21 probes differentially methylated (delta beta 0.1) was able to predict poor outcome in WDTC patients. This classifier reveled 63% of sensitivity and 92% of specificity, which was confirmed by TCGA database (64% of sensitivity and 88% of specificity). Using the established signature, we were able to confirm the involvement of poor prognosis markers with high-risk scores (multivariable analysis; P&lt;0.001). CONCLUSION: Thyroid tumors showed different methylation profile according to the histological subtypes. Genes regulated by methylation in TC and associated with the tumor development were identified and confirmed by TCGA. In addition, a meaningful algorithm was designed and confirmed as capable to predict recurrence in WDTC. FINANCIAL SUPPORT: FAPESP (2015/20548-5) and National Institute of Science and Technology in Oncogenomics (FAPESP 2008/57887-9 and CNPq 573589/08-9), CNPq (302606/2011-4). Note: This abstract was not presented at the meeting. Citation Format: Mariana Bisarro dos Reis, Caroline Moraes Beltrami, Mateus Camargo Barros-Filho, Fabio Albuquerque Marchi, Hellen Kuasne, Skirant Ambatipudi, Zdenko Herceg, Luiz Paulo Kowalski, Silvia Regina Rogatto. Epigenetic signatures associated with patient outcome in thyroid carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3358. doi:10.1158/1538-7445.AM2017-3358