Literature DB >> 29440928

Early diagnostic potential of APC hypermethylation in esophageal cancer.

Bujiang Wang1, Haojun Song1, Haizhong Jiang1, Yangbo Fu1, Xiaoyun Ding1, Chongchang Zhou2.   

Abstract

BACKGROUND: The hypermethylation of APC gene is observed in various cancers, including esophageal cancer (EC). However, the association between APC methylation and the initiation and progression of EC is poorly understood. PURPOSE AND METHODS: The current study systematically reviewed studies on abnormal methylation of APC in EC and quantitatively synthesized 18 studies by meta-analysis involving 1008 ECs, 570 Barrett's esophagus (BE), and 782 controls.
RESULTS: Our results showed higher methylation of APC in EC (OR = 23.33, P < 0.001) and BE (OR = 9.34, P < 0.001) than in normal controls. Whereas APC methylation in EC was similar to that in BE (P = 0.052), it was not associated with tumor stage (P = 0.204). Additionally, APC methylation was not significantly associated with overall survival (OS) and relapse-free survival (RFS) in patients with EC. The performance of APC methylation for the detection of EC and BE achieved areas under the receiver operating characteristic curves of 0.94 and 0.88, respectively.
CONCLUSION: Our results imply that APC methylation detection is a potential diagnostic biomarker for EC and BE.

Entities:  

Keywords:  APC; Barrett’s esophagus; esophageal cancer; methylation

Year:  2018        PMID: 29440928      PMCID: PMC5798573          DOI: 10.2147/CMAR.S148677

Source DB:  PubMed          Journal:  Cancer Manag Res        ISSN: 1179-1322            Impact factor:   3.989


Introduction

Cancer poses a major public health burden after cardiovascular diseases, as its global incidence and mortality continue to increase.1 Esophageal cancer (EC) is the leading cause of cancer death; about 16,940 new cases and 15,690 deaths were estimated in the 2017 US statistics.2 Due to a lack of specific symptoms and preventive measures, many EC patients are diagnosed at an advanced stage. Multimodality therapy, consisting of surgery combined with chemotherapy, is the standard treatment for resectable advanced EC.3 In spite of improvements in surgery and chemotherapy, the prognosis for EC patients presenting with advanced stage disease is poor, with the most recent statistics showing 5-year survival rates <50%.4 EC arises from Barrett’s esophagus (BE), which is metaplastic change of the normal squamous mucosa to specialized columnar epithelium. BE ultimately progresses to dysplasia (low-grade dysplasia to high-grade dysplasia) and subsequently to EC. Therefore, early diagnosis of EC and proper endoscopic therapies for BE are key strategies for improving the survival of EC patients. The etiology of EC is multifactorial, including interactions between various environmental, epigenetic, and genetic changes involved in inflammation.5 The relevant environmental factors have been elucidated by several large-scale and well-designed epidemiological studies and include obesity, Helicobacter pylori infection, and tobacco smoking.6–8 Genetic changes such as single-nucleotide polymorphisms involved in multiple cellular pathways may be biomarkers of EC risk.9,10 Recent studies have identified the important role of DNA methylation in esophageal carcinogenesis.11 DNA methylation is one of the important epigenetic modifications involved in the inactivation of numerous tumor suppressor genes (TSGs).12 It is well established that hypermethylation of multiple TSGs in association with the dysfunction of cellular biological pathways characterize human cancers. Additionally, DNA methylation biomarkers are of clinical value for early cancer diagnosis. Adenomatous polyposis coli (APC) is a classical TSG located on chromosomal band 5q21–q22.13 APC was initially uncovered through genetic linkage analysis in colorectal cancer (CRC).13,14 APC protein serves as a negative regulator of the Wnt/beta-catenin pathway.15 Loss of APC expression leads to the stabilization and nuclear accumulation of beta-catenin that could result in the activation of downstream target genes involved in the initiation of tumorigenesis.16,17 In the past decades, the downregulation of APC through promoter hypermethylation has frequently been observed in many cancers, including EC.18–21 However, the diagnostic strength and association of APC methylation with EC progression has been less consistent. The present study aimed at summarizing recent studies on aberrant methylation of APC in EC progression.

Materials and methods

Identification of relevant studies

All relevant studies were systematically searched from PubMed, Google Scholar, Web of Science, China National Knowledge Infrastructure, and Wanfang literature databases and updated until June 11, 2017. The search strategies for potential studies applied different combinations of the following terms: adenomatous polyposis coli, APC, methylation, esophagus cancer, and esophagus carcinomas. In addition, a manual search was performed to seek potential studies in the references of retrieved publications. All eligible studies had to have measured APC methylation status in EC patients rather than cancer cell lines. Neither reviews nor abstracts were included in our analysis. Studies without detailed information on APC methylation were excluded.

Data extraction

For the eligible studies, we extracted the first author’s name, year of publication, country of study subjects, methylation assessment methods, and frequency of gene methylation (Table S1). In addition, DNA methylation data of APC in EC were obtained from The Cancer Genome Atlas (TCGA) online database (https://cancergenome.nih.gov/). The methylation status of 186 ECs was analyzed using the human methylation 450K array (HM450). More than 450,000 CpG sites in the human genome were included in the HM450 platform. A total of 20 CpG sites (cg08636638, cg19115695, cg27062904, cg07661636, cg00190738, cg16110711, cg16451027, cg27379240, cg11057897, cg07003745, cg04011030, cg16481008, cg18315896, cg01528425, cg08934600, cg18536802, cg26660754, cg08512345, cg25922032, and cg04226363) in the promoter region of APC were included (Figure S1). We also downloaded clinical stage, gender, age, overall survival (OS), and relapse-free survival (RFS) data of the EC patients (Table S1).

Statistical analysis

The Stata-12.0 software (StataCorp LP, College Station, TX, USA) was used to calculate the pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). The heterogeneity across studies was represented as the I2 statistic with corresponding P-value.22 When there was remarkable heterogeneity (I2>50%, χ2 test with P<0.05) in the meta-analysis, a Dersimonian–Laird (D + L) model was applied to calculate the pooled OR; otherwise, a Mantel–Haenszel (M–H) model was used.23 Besides, the potential source of heterogeneity was identified by meta-regression. For the pooled ORs of studies with unknown heterogeneity source, sensitivity analysis was applied to assess the robustness of the results. The sensitivity analysis estimated the stability of results by excluding single study to estimate the effect of the individual study on the overall pooled OR. Publication bias was estimated by Begg’s and Egger’s linear regression tests. Diagnostic meta-analyses were also performed. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic OR (DOR), and their corresponding 95% CIs were calculated. Summary receiver operating characteristic (SROC) curves with the areas under the receiver operating characteristic curve (AUC) were then generated. Additionally, the failsafe number (Nfs) test was performed using the R software (version 3.3.0) to identify the robustness of our results when significant publication bias among the studies was observed. Cox regression models were used to calculate the adjusted hazard ratios to estimate the relationship between OS and RFS with other covariates (APC methylation level, clinical stage, age, and gender). The survival analysis was performed by SPSS. All P-values are two-sided, and a P-value of <0.05 was deemed statistically significant.

Results

Study characteristics

In order to analyze the relationship between APC methylation and EC progression, we quantitatively synthesized 18 studies including 1008 ECs, 570 BEs, and 782 controls.18,19,24–39 A total of 260 studies were identified using the search strategy described earlier, and 204 studies were excluded after careful filtration, of which 38 were duplicates, 21 were without methylation data, 55 were abstracts or reviews, and 94 were irrelevant. Finally, 18 studies (17 published in English and in Chinese) were included in the meta-analysis. The basic characteristics of all the included studies are shown in Table 1, and the selection process is illustrated in Figure 1.
Table 1

Main characteristics of studies included in the current analyses

First author (reference)YearCountryNormal sourceMethodEC
BE
Control
T1/2
T3/4
Stage I/II
Stage III/IV
N+
N−
M+TotalM+TotalM+TotalM+TotalM+TotalM+TotalM+TotalM+TotalM+Total
Moriichi et al 332009JapanHMSP63881025
Kawakami et al 242000USAHqMSP64841743020
Eads et al 252001USAAqMSP15221619131811711
Brock et al 262003USAAMSP2741341
Brock et al 262003USAHMSP017
Sarbia et al 272004GermanyAqMSP3950150
Schulmann et al 282005USAAqMSP54777592964
Clement et al 292006SwitzerlandHMS-DBA25271525016
Guo et al 302006ChinaHMSP969160017
Ishii et al 312007JapanAMSP15564211056
Ishii et al 312007JapanHMSP442
Kim et al 322009KoreaHMSP235071516358261524
Zare et al 342009IranAMSP2045045
Wang et al 182009USAHMSP20325294017
Li et al 352011ChinaAMSP647247
Wang et al 362011ChinaAMSP3476576116336033531413148328
Hoshimoto et al 372015USAAMSP2111402844517699681246
Fukui et al 382016JapanHMS-HRM91018128
Guilleret et al 192016SwitzerlandHMLM252608
Lei et al 392011ChinaAqMSP9918218182

Notes: A, autologous (control sample from the same patients); H, heterogeneous (control samples from other individuals); M+, positive for APC methylation; N+, positive for lymph node metastasis; N−, negative for lymph node metastasis.

Abbreviations: BE, Barrett’s esophagus; EC, esophageal cancer; MLM, methylation ligation-dependent macroarray; MSP, methylation-specific polymerase chain reaction; MD-DBA, methylation-sensitive dot-blot assay; MS-HRM, methylation-sensitive high-resolution melting; qMSP, quantitative methylation-specific polymerase chain reaction.

Figure 1

Flow diagram of the search strategy for this meta-analysis.

Association of APC methylation with EC progression

First, we performed a meta-analysis of 17 studies including 948 EC patients and 757 normal controls to ascertain if there were any APC methylation differences between the two groups. Considering the presence of significant heterogeneity across the studies (I2=68.3%, P<0.01, Table 2), a meta-regression was performed to assess the potential resource of heterogeneity. The results showed that the two studies from Japan might be responsible for the significant heterogeneity. Other parameters such as year of publication, methylation detection method, and normal controls contributed little to the heterogeneity (Table 3). Therefore, we compared the pooled ORs as well as the heterogeneity value before and after removal of these two studies. Our results showed a significant decrease in heterogeneity with exclusion of the two studies (I2=45.1%, P=0.03, Table 2). The pooled ORs therefore showed that APC methylation was associated with an increased risk of EC (OR = 23.33; range, 12.72–42.78; Table 2; Figure S2). The Begg’s test showed an absence of publication bias (P=0.175; Figure 2A), whereas the Egger’s test implied the presence of publication bias (P<0.001; Figure 2B). Therefore, we applied the Nfs test and sensitivity analysis to assess the efficacy of the meta-analysis. Both the Nfs test (Nfs0.05=1127 and Nfs0.01=878) and sensitivity analysis supported the robustness of our results (Table 4).
Table 2

Summary of pooled OR of APC methylation during the carcinogenesis of EC

CharacteristicsNM–H model
D + L model
Test of heterogeneity
OR95% CIPOR95% CIPI2P
EC vs control1712.959.57–17.52<0.00117.648.90–34.95<0.00168.30%<0.001
EC vs controla1518.7913.24–26.670.0323.3312.72–42.78<0.00145.10%0.03
EC vs BE81.911.36–2.70<0.0012.580.99–6.700.05281.20%<0.001
BE vs control99.36.04–14.34<0.0019.342.92–29.83<0.00176.50%<0.001
T3/4 vs T1/242.561.35–4.890.042.250.64–7.870.20463.90%0.04

Note:

The pooled OR of APC methylation was computed after removal of two studies from Japan, which might be responsible for the significant heterogeneity in EC vs control.

Abbreviations: BE, Barrett’s esophagus; CI, confidence interval; EC, esophageal cancer; OR, odds ratio.

Table 3

Meta-regression analysis of APC promoter methylation in EC vs control

CharacteristicsCoefficientP95% CI
LowerUpper
Year–0.0940.333–0.2960.107
Country
China–2.010.2–5.251.231
Germany0.8650.641–3.1014.831
Japan–3.5070.039–6.804–0.208
Switzerland1.4550.449–2.6255.534
USA–1.1620.451–4.4342.109
IranDropped
Method
MLM–0.1520.956–5.9795.675
MSP–3.6130.082–7.750.523
qMSP–2.3990.241–6.6121.815
MS–DBADropped
Normal source
Autologous–0.8940.303–2.6810.892
HeterogeneousDropped

Abbreviations: CI, confidence interval; EC, esophageal cancer; MLM, methylation ligation-dependent macroarray; MSP, methylation-specific polymerase chain reaction; qMSP, quantitative methylation-specific polymerase chain reaction; MD-DBA, methylation-sensitive dot-blot assay; MS-HRM, methylation-sensitive high-resolution melting.

Figure 2

Begg’s funnel and Egger’s plots of publication bias for APC methylation during esophageal carcinogenesis.

Notes: (A and B) Cancer vs controls. (C and D) Cancer vs BE. (E and F) BE lesions vs control. (G and H) T3/4 vs T1/2.

Abbreviations: BE, Barrett’s esophagus; EC, esophageal cancer; OR, odds ratio; SE, standard error.

Table 4

Sensitivity analysis of APC methylation in EC vs control

Study omittedEstimate95% CI
LowerUpper
Kawakami et al (2000)2421.50911.76939.309
Eads et al (2001)2521.95911.78440.922
Brock et al (2003)2624.02212.33446.784
Brock et al (2003)2622.51412.10341.883
Sarbia et al (2004)2719.23210.94533.794
Schulmann et al (2005)2826.94513.24954.801
Clement et al (2006)2920.52111.50936.590
Guo et al (2006)3024.96613.31746.804
Zare et al (2009)3422.33612.04141.434
Wang et al (2009)1822.72012.17842.387
Li et al (2011)3526.48814.50548.373
Wang et al (2011)3627.02113.58853.736
Hoshimoto et al (2015)3724.37312.90846.021
Guilleret et al (2016)1921.08111.68338.041
Lei et al (2011)3928.04513.98456.244
Combined23.32812.72242.776

Abbreviations: CI, confidence interval; EC, esophageal cancer.

Second, a meta-analysis was performed on eight studies involving 377 EC and 482 BE patients. The difference in APC methylation level between the two groups was slight with no statistical significance (OR = 2.58; range, 0.99–6.70; Table 2; Figure S2). The D + L model was used to compute OR because of the presence of significant heterogeneity (I2=81.2%, P<0.001, Table 2). However, meta-regression failed to identify any potential resource of heterogeneity (Table 5). The Begg’s and Egger’s tests for publication bias were not statistically significant (P=0.174 and 0.204, respectively; Figure 2C and D).
Table 5

Meta-regression analysis of APC promoter methylation in EC vs BE

CharacteristicsCoefficientP95% CI
LowerUpper
Year0.1360.258–0.1260.398
Country
China0.0600.981–5.9696.089
USA–1.7860.348–6.2202.647
Japan–0.1740.932–5.1804.832
SwitzerlandDropped
Method
MS–DBA–1.8870.389–7.0293.254
MSP–3.2210.110–7.4821.040
qMSP–3.6870.072–7.8510.477
MLMDropped

Abbreviations: BE, Barrett’s esophagus; CI, confidence interval; EC, esophageal cancer; MLM, methylation ligation-dependent macroarray; MSP, methylation-specific polymerase chain reaction; qMSP, quantitative methylation-specific polymerase chain reaction; MD-DBA, methylation-sensitive dot-blot assay; MS-HRM, methylation-sensitive high-resolution melting.

Third, the association between methylated APC and progression of BE was analyzed in nine studies, including 442 BEs and 288 controls. The pooled OR was computed by the D + L model, as significant heterogeneity was observed (I2=76.5%, P<0.001, Table 2). Our results demonstrated that methylation of APC was associated with an increased risk for developing BE (OR =9.34; range, 2.92–29.82). The pooled OR was not significantly transformed by the M–H model (Table 2), indicating that our results were robust. The sensitivity analysis also confirmed the stability and credibility of our results (Table 6). No potential source of heterogeneity was identified by meta-regression (Table 7). No publication bias was observed by Begg’s test (P=0.917; Figure 2E) and Egger’s test (P=0.222; Figure 2F).
Table 6

Sensitivity analysis of APC methylation in BE vs control

Study omittedEstimate95% CI
LowerUpper
Moriichi et al (2009)3311.2552.78445.504
Kawakami et al (2000)248.5182.47629.298
Eads et al (2001)256.7142.13221.142
Schulmann et al (2005)287.6862.18427.048
Clement et al (2006)298.0732.38527.320
Guo et al (2006)3011.2503.36037.672
Ishii et al (2007)3113.0164.09341.395
Ishii et al (2007)3111.6983.24342.193
Wang et al (2009)188.1262.39527.565
Combined9.3392.92329.834

Abbreviations: BE, Barrett’s esophagus; CI, confidence interval.

Table 7

Meta-regression analysis of APC promoter methylation in BE vs control

CharacteristicsCoefficientP95% CI
LowerUpper
Year–0.3910.091–0.8660.084
Country
China–4.0110.165–10.5722.550
Japan–3.0800.142–7.7611.601
USA–0.0680.970–4.7394.603
SwitzerlandDropped
Method
qMSP–0.0570.977–4.9284.814
MSP–2.8730.130–5.3220.424
MS-DBADropped

Abbreviations: BE, Barrett’s esophagus; CI, confidence interval; MSP, methylationspecific polymerase chain reaction; qMSP, quantitative methylation-specific polymerase chain reaction; MD-DBA, methylation-sensitive dot-blot assay; MS-HRM, methylation-sensitive high-resolution melting.

Finally, in order to examine the association between APC methylation and the progression of EC, we quantitatively analyzed the association between APC methylation and tumor stage. A total of three studies including 76 patients classified as stage T1 or T2 and 164 patients classified as stage T3 or T4 were analyzed. Due to remarkable heterogeneity across the studies, a D + L model was applied and results showed no statistical significance (OR = 2.25; range, 0.64–7.87; Table 2; Figure S2). The results of Begg’s (P=0.734) and Egger’s (P=0.686) tests illustrated no publication bias among these three studies (Figure 2G and H).

The diagnostic accuracy of methylated APC for EC and BE

The diagnostic accuracy of methylated APC for EC was analyzed from 17 studies involving 948 EC patients and 757 controls. The summary specificity and sensitivity of methylated APC for distinguishing EC from controls were 0.96 (95% CI: 0.92–0.98) and 0.55 (95% CI: 0.39–0.69), respectively (Figure 3). The SROC based on the specificity and sensitivity is shown in Figure 3, and the AUC was 0.94 (95% CI: 0.91–0.95). The summary diagnostic OR was 30 (95% CI: 10–88). The PLR and NLR were 14.0 (95% CI: 5.9–32.8) and 0.47 (95% CI: 0.33–0.67), respectively. As indicated by the PLR, EC patients hadã14 times higher chance of having methylated APC than normal controls. Also, as indicated by the NLR, normal controls had a twofold greater chance (the reciprocal of the value of NLR) of having unmethylated APC than EC patients. As shown in Figure 4, the Fagan plot analyses based on the PLR and NLR demonstrated that the probability of a patient being diagnosed with EC was, respectively, 82% and 93% following a positive methylated APC result, whereas the pretest probability of being diagnosed with EC was 25% and 50%, respectively. However, the probability of an exclusion diagnosis of EC was 14 and 32% following a negative methylated APC result. Besides, the Deek’s funnel plot test indicated no publication bias across the studies included in the diagnostic analysis (Figure 5).
Figure 3

SROC plots of methylated APC for the diagnosis of EC and BE.

Notes: (A) Cancer vs control: specificity, 0.96 (95% CI: 0.92–0.98); sensitivity, 0.55 (95% CI: 0.39–0.69); AUC, 0.94 (95% CI: 0.91–0.95). (B) BE vs control: specificity, 0.96 (95% CI: 0.79–0.99); sensitivity, 0.48 (95% CI: 0.22–0.74); AUC, 0.88 (95% CI: 0.85–0.91).

Abbreviations: AUC, area under the receiver operating characteristic curve; BE, Barrett’s esophagus; CI, confidence interval; EC, esophageal cancer; SROC, summary of receiver operating characteristic; SENS, sensitivity; SPEC, specificity.

Figure 4

Fagan plot analysis to evaluate the clinical applicability of screening for methylated APC in EC diagnosis.

Notes: (A) The post-test probability of EC was 93% at a pretest probability of 50%. (B) The post-test probability of EC was 82% at a pretest probability of 25%. (C) The post-test probability of BE was 93% at a pretest probability of 50%. (D) The post-test probability of BE was 81% at a pretest probability of 25%.

Abbreviations: BE, Barrett’s esophagus; EC, esophageal cancer; LR, likelihood ratio.

Figure 5

Deek’s funnel plot test of publication bias across studies included in the diagnostic analysis.

Notes: (A) Cancer vs control. (B) BE vs control.

Abbreviations: BE, Barrett’s esophagus; ESS, effective sample size.

The diagnostic accuracy of APC methylation for BE was analyzed in nine studies involving 442 BEs and 288 controls. The pooled specificity and sensitivity were 0.96 (95% CI: 0.79–0.99) and 0.48 (95% CI: 0.22–0.74), respectively (Figure 3). The area under the SROC was 0.88 (95% CI: 0.85–0.91). The summary diagnostic OR was 24 (95% CI: 3–163). The PLR and NLR were 12.8 (95% CI: 2.2–74.7) and 0.54 (95% CI: 0.32–0.93), respectively. As indicated by the PLR, BE patients had a ~13 times higher chance of having methylated APC than normal controls. Similarly, as indicated by the NLR, normal controls had a 1.9-fold greater chance (the reciprocal of the value of NLR) of having unmethylated APC than BE patients. The Fagan plot analyses based on the PLR and NLR demonstrated that the probability of a patient being diagnosed with BE was, respectively, 81 and 93% following a positive methylated APC result, whereas the pretest probability of being diagnosed with BE was 25% and 50%, respectively (Figure 4). However, the probability of an exclusion diagnosis of BE was 15% and 35%, following a negative methylated APC result. There was no publication bias observed by the Deek’s funnel plot test (Figure 5).

Association between methylation of APC and prognosis of EC

In the current study, we analyzed 11 different probes located in the promoter region of APC including the transcription start site (chr 5:112043265-112043265) and CpG island (chr 5:112043080-112043917). The association between APC methylation and RFS was analyzed using 144 EC patients from TCGA. Analysis of the relationship between APC methylation and OS was conducted using data from 186 patients. Cox proportional-hazards regression models were applied to adjust multiple variables to estimate the OS and RFS. As we speculated, no statistically significant difference was found between APC methylation and the examined clinical parameters (Table 8).
Table 8

Survival analysis of 11 CpG island probes located in the promoter region of APC applying TCGA cohort

IDRFS
OS
HR95% CI
PHR95% CI
P
LowerUpperLowerUpper
cg110578970.01110.0000731.6849890.0790.1010.0043152.3732520.16
cg040110300.0000004983.71E-19691,601.8780.310.008761.47E-10529,992.66720.6
cg164810081,900,0007.62E-144.43E+250.533,380,000,0000.0003413.29935E+220.15
cg183158965.04E-181.94E-381410.2652560.0970.1455.12E-143.89619E+110.89
cg015284252.54E-163.84E-3618,725.355780.1214,050.571.04E-091.87534E+170.54
cg0893460038.878.27E-081,856,960,9420.720.01671.38E-1120,103,936.740.7
cg185368029608.55.82E-101.57E+170.5527,382.190.0005071.43E+120.26
cg266607549.43E-086.74E-17129.9487810.134229.440.00045836,992,750,1390.31
cg085123458.73E-271.48E-61547,656,291.10.141.79E-084.69E-327.28E+150.52
cg259220326.64E-403.12E-851,424,872.330.094.29E-203.05E-495,826,722,5630.19
cg042263632.83E-241.16E-56801,341,200.20.154.09E-153.49E-35456,874.55930.16

Abbreviations: CI, confidence interval; HR, hazard ratio; OS, overall survival; RFS, relapse-free survival.

Discussion

Esophageal carcinoma is thought to develop from BE following accumulation of genetic and epigenetic abnormalities leading to the activation of oncogenes and/or inactivation of TSGs.40–42 These aberrant genetic and epigenetic changes result in the failure to maintain the equilibrium of multiple biological pathways. The Wnt/beta-catenin pathway is a main regulator of development through impacting the cell cycle at various points.43 Dysfunction of the Wnt/beta-catenin pathway components underlies multiple growth-related pathologies and human cancers.43 Genomic studies have identified various epigenetically silenced genes such as SFRP5, SOX17, WIF1, and APC involved in the Wnt/beta-catenin pathway.43 The APC protein is the core constituent of the Wnt pathway that was first identified in CRC.44 A direct correlation between APC methylation and loss of expression has been observed in ~70–80% of CRC.44–46 As the third deadly malignancy of the digestive system, the effect of APC hypermethylation on the progression of EC remains inconsistent and inconclusive. The study by Kawakami et al24 identified APC methylation in ~40% of BE and 80% of EC patients compared with normal controls. However, other study30 reported that 3% of their patients with low-grade esophageal dysplasia harbored high frequency of APC methylation, with none observed in patients with high-grade dysplasia and healthy normal controls. Considering the distribution of subjects in the study by Guo et al30 (39 patients with low-grade dysplasia and only nine patients with high-grade dysplasia), it is necessary to analyze the association between APC methylation and esophageal carcinogenesis using a large sample. The current study systematically reviewed all relevant evidences and synthesized data from 18 studies inclusive of 1008 ECs, 570 BEs, and 782 normal controls using meta-analysis. The main finding of this study was the significant association between APC promoter methylation and increased risk of BE and EC. In particular, the APC methylation was 23 and 10 times more likely to predict EC and BE, respectively, although the effects came from heterogeneous sources. Whereas the frequency of APC hypermethylation was similar between EC and BE, and these results are consistent with previous studies.25,28 Besides, our analysis of tumor stage appears consistent with a previous study32 in terms of the slight effect of APC methylation on EC progression. These findings suggest that APC promoter hypermethylation is an early event in esophageal carcinogenesis. Field cancerization was first proposed for oral cancer with the description of occult multifocal precancerous lesions in the epithelium of normal appearing oral mucosa.47 These lesions can now be detected by molecular analyses for genetic or epigenetic alterations associated with tumorigenesis and could precede morphological tumor formation.48 An emerging indication that alterations in epigenetic marks could be used as biomarkers (especially DNA methylation) was provided by analyses of hypermethylation of O-6-methyl-guanine-DNA methyltransferase (MGMT)49 in gliomas and glutathione S-transferase pi 1 (GSTP1) in prostate cancer.50 These hypermethylation events have been shown to be effective in the diagnosis of cancers. The detection of epigenetic alterations is therefore a promising auxiliary cancer diagnostic tool. APC promoter methylation seems an ideal cancer biomarker because previous study demonstrates this to be an early event in a number of different malignancies.51 However, the diagnostic power of APC hypermethylation in EC has been less investigated. Therefore, we performed a pooled analysis of 18 studies, including 2360 samples. Our results showed that the pooled AUC of APC methylation in distinguishing EC from normal control was 0.94, with 96% specificity and 55% sensitivity, and the pooled AUC for differentiating BE from normal controls was 0.88, with 96% specificity and 48% sensitivity. Besides, we mapped Fagan plots to analyze the clinical utility of APC methylation as an auxiliary diagnostic biomarker of EC and BE. The Fagan plot indicated that the probability of EC or BE diagnosis was remarkably increased with the detection of significant APC hypermethylation frequency even in people with low risks of developing EC or BE based on other clinical parameters. These findings suggest that the hypermethylation of APC has a potential in the diagnosis of EC and BE.

Conclusion

The notable findings of the current study are the significant association between APC methylation and increased risk of EC and BE and its potential role as an early diagnostic biomarker of EC. However, further studies regarding the role of APC methylation in EC progression are required. All the CpG island probes located in the APC. Pooled forest plot of APC methylation status during the carcinogenesis of EC. Note: (A) Cancer vs. control: OR = 23.33; 95% CI, 12.72 – 42.78. (B) Cancer vs. BE: OR = 2.58; 95% CI, 0.99–6.70. (C) BE vs. control: OR = 9.34; 95% CI, 2.92 – 29.82. (D) T3/4 vs. T1/2: OR = 2.25; 95% CI, 0.64 – 7.87. Abbreviations: BE, Barrett’s esophagus; EC, esophageal cancer. Methylation data of APC and survival data of all EC patients from TCGA Abbreviations: EC, esophageal cancer; TCGA, The Cancer Genome Atlas.
Table S1

Methylation data of APC and survival data of all EC patients from TCGA

sampleRFS daysRFS statusOS daysOS statuscg25673075cg07710833cg08636638cg19115695cg27062904cg07661636cg00190738cg16110711cg16451027cg27379240cg11057897cg07003745cg04011030cg16481008cg18315896cg01528425cg08934600cg18536802cg26660754cg08512345cg25922032cg04226363cg11479000cg23497707cg25645338cg00577935cg08571859cg14511739cg22035501cg11613015cg14479889cg16970232cg03667968cg20311501cg23938220cg02511809cg21634602cg12534150cg24332422cg15020645cg01240931cg16106903cg07863043
TCGA-R6-A6L6-01214other wise214death/0.7396////////0.1803/0.0620.05580.02820.05010.02820.05570.08190.02260.02540.02860.4270.803/0.15770.20720.18070.1870.11210.24650.25910.14330.33410.27760.43320.31620.06390.20240.1620.4214//
TCGA-R6-A6DN-01199other wise243death/0.5852////////0.1083/0.04640.04430.03480.04670.03820.04370.05140.0160.0150.01910.35130.8433/0.8150.77970.87080.87920.73790.8310.8740.92160.82570.73810.7720.92970.87090.64760.76840.8194//
TCGA-R6-A6KZ-01154other wise154death/0.7996////////0.1571/0.05680.03750.04630.04270.02670.04590.06260.01640.01570.02560.22680.6776/0.48810.4390.5290.62490.43880.62020.62030.70340.62880.62130.71330.80640.53630.50930.49530.5162//
TCGA-V5-A7RC-06104other wise104death/0.861////////0.2098/0.04660.04080.04550.05260.03370.09610.15170.01280.01470.03110.4290.6627/0.03240.04880.0320.03930.04810.03560.04460.03010.07790.03740.18170.0590.0270.06380.02930.2265//
TCGA-V5-A7RC-01104other wise104death/0.8414////////0.257/0.04720.04990.04570.04710.03010.03820.07080.01640.01810.02250.25080.7325/0.03590.03710.03580.0490.04830.02540.03960.03470.06580.01780.11270.05740.03160.03540.01930.1523//
TCGA-IG-A51D-01518other wise518censor/0.8635////////0.2247/0.05020.04060.04310.04420.02640.04920.07920.01870.01660.02610.65470.8295/0.02670.0240.02570.02960.03370.03840.02890.02160.06190.01430.08870.04490.01920.03810.01990.2311//
TCGA-VR-AA7D-01//279death/0.8072////////0.4361/0.0520.04960.0420.0490.03670.05360.08520.01820.01520.03230.73530.8351/0.03120.03430.02790.0350.04180.02460.0340.02240.05790.01660.16160.04070.02780.03870.0240.4049//
TCGA-VR-AA7B-01//342censor/0.8886////////0.1536/0.05120.04370.04360.06110.03840.06520.08470.02020.01990.02930.28920.752/0.02830.0260.02450.04080.03210.03180.03260.02270.05450.01440.14540.05590.02690.05450.01810.2923//
TCGA-VR-A8EP-01824other wise824censor/0.8387////////0.2289/0.04660.0330.04620.04970.03140.04060.08980.02720.02120.02750.61230.5997/0.02840.03070.03140.03820.03350.02940.03690.02570.0720.01580.13470.05160.02430.05250.02720.2925//
TCGA-VR-A8EZ-01//553death/0.8628////////0.1594/0.07150.03840.04260.04950.03280.06030.05670.01840.01860.03390.4280.7159/0.03990.05380.04630.05530.06130.040.05940.04980.11980.02020.12570.11080.03490.07510.04710.3249//
TCGA-VR-A8EY-011025other wise1025censor/0.7792////////0.4462/0.05890.03460.02850.05130.03320.04870.05210.01580.01840.03120.47830.8577/0.03370.03170.03460.07840.04570.03810.04930.03240.10320.01380.06160.10980.02520.04160.03040.0947//
TCGA-VR-A8ET-0147other wise47death/0.7944////////0.2608/0.0550.04530.04520.05380.03360.05470.08180.0160.01690.02660.65080.7627/0.24370.28670.31690.36250.31860.36750.38510.35050.4210.41740.52450.35910.20550.2830.25580.4088//
TCGA-L7-A56G-01270new tumor330death/0.8841////////0.1561/0.0440.03570.03570.03430.03610.03930.05530.01780.01480.02270.71350.7817/0.02080.02630.02080.02840.04460.03890.03250.02210.06480.01020.05960.05740.0190.02790.01780.5353//
TCGA-VR-AA4D-011405other wise1405death/0.6214////////0.1291/0.05320.04490.04770.05570.03910.0360.06640.01560.01510.03140.74030.855/0.52870.73250.81080.87940.71280.81970.82930.88530.76810.71260.7520.92290.81470.65010.70420.7819//
TCGA-V5-AASX-01273new tumor273censor/0.6749////////0.2309/0.04990.03610.03630.04650.03740.04410.05520.0150.0160.02730.50050.8457/0.06460.04940.0370.06770.07350.05150.07590.05870.1250.01080.08180.53280.03090.05070.06350.6175//
TCGA-VR-A8EW-01//247death/0.9043////////0.1747/0.0370.03470.03070.03810.03350.04660.06030.01540.02030.0280.68470.6238/0.04160.03660.03080.04440.04730.03950.03960.03620.08240.01310.07910.09430.02620.03570.02960.3308//
TCGA-VR-AA4G-01549other wise549censor/0.7497////////0.2446/0.05480.04410.04870.05520.03030.06860.07620.01410.01580.03150.58190.819/0.02940.03510.02790.03830.0530.02720.04630.03440.10710.01360.15070.20.02560.05780.02940.3756//
TCGA-L5-A43C-0196other wise96censor/0.807////////0.321/0.0930.04580.05060.0540.04890.05390.0870.01780.02010.03390.5930.8634/0.44940.46350.50790.5120.50260.49990.54530.54610.58610.53550.60650.61660.42130.42220.43490.4707//
TCGA-V5-A7RB-01161other wise161death/0.904////////0.222/0.06320.03760.0450.06170.04030.05680.0870.02060.02380.02830.35350.5852/0.61940.58940.63110.68610.48480.62560.6790.6630.7030.60660.66870.69070.56360.49050.5640.6099//
TCGA-R6-A6XQ-01193other wise193death/0.2666////////0.0967/0.0570.04610.04240.04750.04680.05960.07850.01840.02110.03350.11810.5982/0.72680.74060.82320.87940.78050.7170.72180.84060.84670.74210.79330.83910.76850.63790.72250.5055//
TCGA-R6-A6Y0-011641other wise1641censor/0.8703////////0.2433/0.05670.03950.03940.05310.0440.0520.07330.01940.01950.02650.55680.795/0.28650.32120.26190.24520.17440.35950.38820.3760.46920.42440.51750.54290.20920.27970.2920.4837//
TCGA-VR-A8EX-01//855death/0.8593////////0.2905/0.03850.04320.03520.0440.03090.04710.06460.01650.02020.02480.5660.6864/0.32590.38020.25120.33160.15930.43290.45450.39470.4850.39920.4980.49920.22740.27910.24330.503//
TCGA-VR-A8EU-01557other wise557death/0.902////////0.1889/0.04720.03510.03970.05170.03980.06480.06730.01750.01930.02880.86830.8899/0.04410.03370.03850.04060.05290.04950.0410.02550.10110.01460.05920.09550.0240.03640.04790.3012//
TCGA-VR-A8ER-01//378death/0.8998////////0.2219/0.04270.03890.04310.03520.02850.03690.06790.02370.02080.02480.79360.5685/0.03280.03890.02640.04520.05180.0350.04240.02860.08840.01480.09470.08590.02620.04020.03090.156//
TCGA-R6-A6DQ-01231other wise231death/0.8252////////0.2241/0.06780.03870.04170.03750.03850.05410.06150.01470.01390.03120.46490.7839/0.58030.58270.70510.63420.55440.60270.6860.72020.67850.61370.66140.84630.5280.4630.47740.5964//
TCGA-V5-AASW-01282new tumor282censor/0.8693////////0.1363/0.04580.02960.0430.04850.05620.0520.08520.01260.01620.02330.27620.8175/0.680.66660.75750.71910.67580.71810.72710.76380.73980.64280.70320.77740.6380.59760.64320.7069//
TCGA-R6-A8W8-0188other wise88death/0.824////////0.1677/0.05360.0460.05450.03970.04060.05310.06580.01330.01550.0310.27150.7296/0.76360.74380.71980.76910.52190.77690.8370.86110.7880.70920.73530.89210.70990.63520.62080.763//
TCGA-R6-A6XG-01572new tumor1168censor/0.8773////////0.1475/0.05590.04170.04070.05610.04190.03960.08150.02360.02410.0270.3530.8976/0.8010.740.83020.870.80950.78050.79550.88320.82080.71960.80910.87840.75790.68430.68130.7307//
TCGA-VR-A8Q7-011590other wise1590censor/0.6443////////0.2905/0.04680.04470.03660.04630.02150.05040.08520.01840.01450.030.57830.7695/0.41240.44850.44830.43240.33950.52840.53690.54720.59230.49730.57430.88890.40430.34620.40610.557//
TCGA-IG-A50L-01//16censor/0.8959////////0.2536/0.04570.0350.03780.04060.03420.03950.05520.02030.01590.02250.81310.8491/0.02690.02380.02630.0330.04670.02970.04770.02170.09090.01350.0780.06190.02140.04350.02210.3322//
TCGA-Z6-A8JE-0164other wise64censor/0.6096////////0.226/0.05930.0470.07620.04910.0350.06490.07740.01660.02090.02890.66480.4568/0.04960.04210.0570.090.07950.03810.06550.06450.13340.020.12690.33440.04530.06290.03860.5918//
TCGA-V5-A7RE-01294new tumor500censor/0.4425////////0.1425/0.06740.04290.04140.04650.03480.03410.06910.01520.02010.0310.18380.8798/0.75840.70950.81240.7910.68720.73940.77170.81890.75410.68230.75460.8520.73390.65680.69640.7828//
TCGA-R6-A6L4-01167new tumor496death/0.8563////////0.1335/0.05390.03440.04170.04340.02730.04360.06380.01760.01840.02140.34770.7953/0.48440.44930.51380.57550.50060.55650.56580.61620.59070.51860.61920.80590.44430.40430.45720.5734//
TCGA-VR-A8EQ-01694other wise694death/0.7624////////0.3162/0.04980.05340.03690.03960.0330.05570.07790.01990.03020.02650.73160.7784/0.46060.4690.4940.53030.40240.5450.58580.56360.64450.44820.60520.64960.44810.38430.43160.5362//
TCGA-LN-A49W-01403other wise403censor/0.8949////////0.2354/0.06230.03820.04420.0530.04160.04610.08110.02030.0160.02620.81960.8843/0.03430.02940.02380.03320.03750.03130.02890.02040.08520.01490.09480.04960.02240.06470.02410.3446//
TCGA-LN-A4A3-01388other wise388censor/0.8062////////0.2333/0.0540.04690.03920.06140.02980.04280.07830.01970.0190.03330.77450.6627/0.02390.03420.02660.03340.03240.0350.03250.02090.08410.01140.10570.06550.02120.04170.02590.3168//
TCGA-LN-A49R-01407other wise407censor/0.9024////////0.2537/0.06850.03870.04020.04420.04390.04510.07850.01360.01630.0340.29590.8653/0.02450.02590.02360.02690.03950.0360.04020.02570.07060.01480.10960.06720.01990.07820.03230.2606//
TCGA-LN-A4MQ-0125new tumor375censor/0.877////////0.4409/0.03940.0470.03370.04770.05410.0620.07430.02290.02330.02770.71240.8032/0.03250.03830.03410.03550.04780.02540.03610.02650.10340.01670.11910.06050.02960.05760.02310.234//
TCGA-LN-A4A4-01383other wise383censor/0.8943////////0.1645/0.04150.03870.05260.04890.03170.03520.07310.02660.0190.02490.70010.6699/0.63370.52550.67510.71480.66270.64870.64310.75610.74240.62910.69390.72040.62540.50260.58720.5413//
TCGA-R6-A6Y2-01//283death/0.8226////////0.2512/0.06250.04470.06070.04140.03480.0590.06710.01840.02730.04350.50820.8535/0.50880.53240.47140.54850.44190.54220.58280.58080.66370.53090.6470.69030.46820.47860.47330.5486//
TCGA-LN-A49N-01378other wise378censor/0.8837////////0.28/0.07290.0380.04370.04910.04080.05670.06830.01790.020.02850.53090.7917/0.02760.04450.03420.04440.05670.02840.05380.02610.10870.01370.14090.0630.02840.06270.02660.2421//
TCGA-IC-A6RF-01293new tumor477censor/0.8957////////0.2438/0.03020.03650.04670.04690.03850.05490.07390.02450.02230.02240.38390.7189/0.52190.61140.64030.68130.59270.58620.64630.6690.65230.5870.67260.66060.52350.49180.50510.5811//
TCGA-XP-A8T8-01437other wise437censor/0.9055////////0.1986/0.06030.05580.04620.06020.03450.05260.06110.01980.02250.02550.61790.7323/0.03080.03830.03120.0460.05810.0290.04210.0320.08060.01510.10890.08260.02120.05190.06180.5387//
TCGA-S8-A6BV-01267new tumor609censor/0.8899////////0.2078/0.04990.0430.03320.03430.02980.05050.06490.01810.01730.02380.59820.8659/0.48240.48580.52390.51810.43640.4940.60830.59120.6050.55310.60610.78950.4030.39480.41470.5159//
TCGA-VR-AA7I-01//484death/0.8391////////0.2089/0.05420.03660.04740.05380.04140.0630.08350.02260.0210.02790.44180.7658/0.02790.03120.0290.04160.0630.03960.03250.02410.0650.01580.15290.050.03180.05650.02560.277//
TCGA-LN-A49Y-0190new tumor379censor/0.1139////////0.1228/0.04580.04930.03760.0420.04520.04630.0670.01410.01660.02260.11440.2491/0.62670.5670.83860.95690.88660.77270.71030.92720.88870.84520.86510.84530.90580.75150.76490.7302//
TCGA-LN-A49P-01320new tumor375censor/0.9109////////0.2819/0.08960.06390.04180.04630.03660.05810.06170.02010.02050.03410.66640.7074/0.03720.03040.02610.03620.04050.03060.04150.02880.06370.01420.13580.06390.02690.07740.04150.4178//
TCGA-LN-A49K-01180other wise180death/0.8929////////0.2661/0.05940.04080.0430.05030.04570.04260.060.01750.02010.03090.61860.8136/0.03490.03030.03610.040.05530.03320.040.02570.06860.01490.12980.06810.02860.09410.04360.3822//
TCGA-LN-A49U-01467other wise467censor/0.8512////////0.1913/0.04810.04010.03730.04020.02190.02960.05560.03170.0220.02450.39690.7316/0.03320.0280.03370.04240.05340.050.03040.03210.05460.0130.07660.05590.02870.03450.02570.1633//
TCGA-LN-A4A1-01205new tumor383censor/0.6696////////0.1681/0.03190.04140.03520.04850.03230.04590.07620.01840.01670.02770.87390.8268/0.02470.02280.02610.03690.03910.02290.03980.02450.05320.01280.05640.05920.02070.03680.02650.3236//
TCGA-R6-A8WG-01//386death/0.4056////////0.1882/0.05140.04410.0480.03340.02190.0450.08610.01570.01650.03170.36730.6375/0.61220.60790.68880.63840.43150.66850.70890.67910.65260.59650.67190.85150.45580.44870.50740.6509//
TCGA-LN-A49S-0149new tumor400censor/0.8629////////0.2653/0.04920.02760.0290.04510.04750.04260.05690.01480.01740.02890.42970.543/0.0320.04380.02260.04020.05570.0340.03840.02120.05280.0150.12750.05530.02380.07730.02580.3319//
TCGA-LN-A4A2-01380other wise380censor/0.9061////////0.3182/0.04490.03480.03290.04010.0250.03560.06070.01930.01910.02290.45280.8448/0.0250.02120.02410.03320.040.02380.03190.01760.0390.01290.07840.05190.02260.050.01960.4797//
TCGA-R6-A8WC-0170other wise70censor/0.1862////////0.078/0.05180.04610.05750.05520.02730.05510.07340.01530.01910.03910.23630.8405/0.89080.84660.95290.94720.75590.92420.91410.95850.86060.87260.85780.89560.9490.80810.8860.8356//
TCGA-VR-A8EO-01785other wise785censor/0.8574////////0.4058/0.05410.03830.03780.04370.040.04060.05280.02590.02470.03580.79810.8747/0.05890.03990.04130.05350.07160.0460.05780.04240.09060.01920.06320.09960.03230.04220.040.5191//
TCGA-LN-A49V-01383other wise383censor/0.9257////////0.3911/0.0620.05110.05450.06230.0390.05120.07490.01940.0170.02620.65840.9173/0.53860.53230.6180.58690.58620.55050.63950.64470.66510.59210.64920.69740.54320.47560.5020.6771//
TCGA-LN-A49O-01193new tumor408censor/0.8392////////0.2169/0.06170.05790.03840.05550.03360.04060.04630.01580.01570.0250.72710.9017/0.0280.03510.02730.03160.04480.04190.04180.02950.09580.01340.13150.06110.02570.07720.03640.2519//
TCGA-LN-A49X-01384other wise384censor/0.8963////////0.3129/0.05280.04050.04270.04110.03620.05410.08040.01740.02030.03040.75480.861/0.02680.03880.02140.03130.04380.02990.03160.02250.08550.01090.08130.0540.01860.07160.02920.3866//
TCGA-LN-A49M-01385other wise385censor/0.6217////////0.293/0.03570.03510.02570.0450.02650.03390.05120.02170.01830.02310.4890.7971/0.02660.02140.0220.03270.05360.02460.03350.02780.06520.01480.07470.04720.0230.03280.02140.2337//
TCGA-LN-A4A9-01274new tumor351death/0.8559////////0.1811/0.06370.04260.04520.04690.06210.07460.07880.01640.01980.03060.22770.8781/0.02370.03530.03170.04070.03870.0330.03580.02650.08350.01720.18210.05810.02440.05570.0250.2188//
TCGA-LN-A4MR-01226new tumor402censor/0.9066////////0.2224/0.07990.04970.05350.04630.04630.05830.07810.02630.01830.02270.51130.7986/0.03030.02890.02420.04150.03560.02710.0340.02540.0760.01220.14570.04790.02730.07160.02970.2467//
TCGA-LN-A4A8-01250new tumor472censor/0.5523////////0.2296/0.04390.03430.0280.03990.03450.03340.06010.01520.01790.02480.53190.7719/0.02610.0230.03120.04250.04370.0280.03910.02360.0780.01320.1070.05520.02380.04960.03990.5333//
TCGA-LN-A4A5-01224new tumor681death/0.8679////////0.2395/0.03880.0340.03930.04770.03480.04480.04880.01980.01530.02070.69050.8777/0.01980.02290.0250.03360.04040.0250.03110.02390.05370.0140.08880.04370.02340.05080.03030.3385//
TCGA-LN-A49L-01318other wise318death/0.9206////////0.2305/0.07790.05360.04530.04970.04390.04480.07960.01560.02070.03150.4330.6468/0.0420.03460.02970.04190.05510.03540.05770.02810.08160.0140.15830.05370.02690.08830.06040.411//
TCGA-LN-A4A6-01158new tumor391censor/0.8501////////0.2577/0.04820.05090.05890.04960.03490.03690.06170.01490.01710.02170.44640.5069/0.02150.02790.02130.02510.03650.03760.03410.01930.05360.01160.11370.04510.01660.04740.02080.3249//
TCGA-KH-A6WC-01191other wise191censor/0.887////////0.2766/0.05010.05080.04860.05420.04020.04950.08660.0230.02170.02340.60060.6789/0.03430.03020.0260.03740.04050.03830.04810.02410.09470.01590.10520.06470.02620.05830.03850.3406//
TCGA-L5-A43J-0198new tumor131death/0.923////////0.1947/0.03990.06430.04590.04860.03950.04940.07180.03170.01690.03060.30590.8773/0.02540.03010.03030.04130.05760.03170.04260.02570.07230.01340.10910.07260.02490.08620.02480.5433//
TCGA-L5-A88T-01694other wise694censor/0.8861////////0.2464/0.04660.04950.03130.03270.03020.04910.07890.01650.02150.02750.38890.6071/0.0410.04410.0270.03670.05170.04210.06040.02740.09860.02690.10330.0830.02380.05750.03520.3332//
TCGA-L5-A4OS-011782other wise1782censor/0.8398////////0.3159/0.05960.05060.04910.04930.04520.0590.10040.02020.02170.040.75760.7289/0.30010.33940.34460.32860.29210.40480.45470.41930.46040.48720.52080.4480.24010.31190.30390.4146//
TCGA-L5-A88S-01471other wise471censor/0.826////////0.2272/0.06490.04260.0390.05090.03840.050.06580.01830.01770.03310.50730.6858/0.04060.03910.02630.03470.03910.03370.04430.02840.09590.01660.09680.10740.02680.04850.02530.2093//
TCGA-L5-A8NU-01//2532death/0.8547////////0.3081/0.06980.03860.04520.04140.04610.04960.07540.02010.02080.03510.6540.716/0.38830.42040.37930.34930.24620.45610.48360.42250.54860.44140.55730.55390.28350.34170.34690.4856//
TCGA-L5-A43M-01272other wise272censor/0.9364////////0.2172/0.080.04150.03770.05270.05510.04830.07090.01740.01660.03860.38320.8809/0.22180.20930.19910.19320.11940.33430.3840.28350.44910.41370.48740.46140.19380.27070.26120.6197//
TCGA-L5-A8NM-01236other wise236death/0.8598////////0.369/0.03930.03520.04080.04970.02660.0530.08450.01140.0190.02220.34750.8286/0.62490.60640.67790.67480.58690.68730.62130.72240.66590.62170.64960.88930.50510.52540.5030.5597//
TCGA-L5-A8NK-01//412censor/0.8736////////0.2036/0.03420.0320.02770.03750.01550.03140.05690.01110.01170.01870.47980.6888/0.02730.02090.02120.03680.06710.02390.03320.03410.09420.01150.05060.31610.02010.03990.01740.271//
TCGA-L5-A4OR-0196other wise96death/0.6327////////0.1964/0.05740.04680.04320.02690.03270.04380.05990.02010.01920.030.42040.6206/0.62810.5320.69060.72380.66370.68650.71510.78050.71950.65480.71610.70520.54070.57010.58980.6234//
TCGA-L5-A4OU-01882other wise882censor/0.8842////////0.2806/0.06090.04440.04920.04810.04090.05390.08110.02760.02120.02680.59240.8831/0.22210.24520.22620.17360.11590.26340.29450.23340.37230.34780.42870.26640.11840.21220.19690.3636//
TCGA-L5-A4OE-01730other wise730death/0.8447////////0.3586/0.05960.03640.03650.05760.04350.05540.04960.01720.01780.02530.45210.8975/0.56450.5670.63060.65970.66710.60540.61690.65280.65730.55830.64680.65070.54330.44840.48370.5701//
TCGA-L5-A8NN-01//167censor/0.9158////////0.1455/0.05210.04220.05220.04390.04220.05570.07710.01170.01430.02240.40920.8107/0.75850.72530.84020.8350.78570.76560.79120.8790.8070.69740.7790.89970.74880.63320.66030.7043//
TCGA-L5-A8NR-01//265censor/0.7968////////0.1531/0.06510.04750.05050.06010.0260.09110.07470.01440.01760.03280.27790.7783/0.67810.71950.74160.78730.54720.74340.74590.830.7140.64160.69720.87070.66770.580.62410.6632//
TCGA-2H-A9GR-01//987death/0.749////////0.2552/0.05720.0540.05080.04780.0180.05830.06860.01520.01740.030.5670.7744/0.65040.5610.49160.55170.3770.66980.64460.68210.63140.58410.61240.86650.36960.44740.49030.5564//
TCGA-2H-A9GQ-01//128death/0.7412////////0.1159/0.04770.02980.0420.05370.02350.04650.07560.01430.01560.0260.74890.8427/0.79860.76560.89390.85920.80650.83750.83830.9280.85780.76970.79530.91540.81760.67630.77580.7295//
TCGA-L5-A4OI-01267new tumor608censor/0.8627////////0.1253/0.04680.05220.0420.04860.03410.05360.07710.01490.01860.02420.17650.8974/0.7540.73540.84540.84180.80970.73660.76040.85740.7760.6990.78530.80180.74570.6320.67880.6954//
TCGA-L5-A8NI-01//410death/0.8213////////0.1204/0.06140.03770.04120.0560.02790.03650.07290.0150.01540.03590.22140.7292/0.54450.56530.59770.66090.40720.63210.68890.68510.66870.57850.60070.8620.44820.46870.46750.5084//
TCGA-L5-A4OG-01143other wise143censor/0.8704////////0.3013/0.07180.04420.04620.05470.02870.03790.05370.01970.01750.02680.5940.8368/0.02710.03580.02940.03730.0490.03220.04060.02710.08040.01180.03990.0520.02150.05590.0250.2667//
TCGA-JY-A6FB-011837other wise1837censor/0.4896////////0.1741/0.050.03510.03420.04170.0320.05640.07170.01780.01840.03320.50270.8682/0.65490.65660.74180.75980.79540.71480.72380.76310.78950.62890.73060.76260.65880.58290.60190.6337//
TCGA-L5-A8NE-011688other wise1688censor/0.8198////////0.2029/0.05420.03710.06060.05620.03380.06190.09230.01810.020.03860.26690.7485/0.70320.75150.77690.79290.60960.81180.64360.82660.73130.71030.75110.88270.65740.62660.67320.5896//
TCGA-L5-A8NG-011094other wise1094censor/0.7933////////0.2696/0.05950.03320.04670.0420.02470.05940.06910.01560.01570.02880.49590.8473/0.24660.27090.19840.24330.14950.34740.40010.27870.3910.38980.47170.63090.14460.25180.24330.5254//
TCGA-JY-A939-01660other wise660censor/0.8512////////0.2929/0.06940.02870.03480.04740.03180.0620.08310.01240.01350.03020.59940.8568/0.34720.40180.36610.4050.32180.49360.52410.48360.57750.49630.5620.81710.3780.37750.42170.5607//
TCGA-L5-A43I-01556other wise556death/0.7916////////0.131/0.06570.06260.04120.06540.05030.05930.08850.02410.01930.02850.21630.6709/0.7910.74980.86470.88850.87290.77960.77250.90040.83430.78390.82860.85510.8320.72070.72410.7098//
TCGA-L5-A4OT-01149other wise149death/0.8021////////0.2046/0.07280.04640.04980.06420.04440.05070.08230.02590.01810.03550.46260.7335/0.41540.42590.49170.43090.3480.46540.50220.52690.55470.48470.57870.49080.31790.320.36840.4947//
TCGA-L5-A8NJ-01//501censor/0.8252////////0.1088/0.07150.04190.02890.04350.04440.04670.05790.01570.01750.03350.2570.8807/0.90460.85340.93860.9410.89910.89810.86430.95570.88520.84580.87280.89760.93750.75640.83280.8376//
TCGA-L5-A8NS-01//408censor/0.734////////0.2302/0.08780.0590.0680.05550.04360.07850.06410.02210.02260.0444/0.6412/0.5050.60420.60190.52080.40310.62840.66250.61270.74380.56460.66140.80040.40.53030.49930.5813//
TCGA-L5-A88Y-01//11censor/0.5087////////0.2127/0.06290.04010.04640.06470.03890.05720.07140.01560.01650.03570.36580.79/0.64190.63130.70150.72550.62310.64880.69160.73620.70290.59840.68280.71960.61970.55530.56540.6524//
TCGA-JY-A938-01493new tumor1060censor/0.8299////////0.2015/0.0610.04290.04770.04940.03380.05860.07340.0130.01470.03240.79810.8251/0.49380.53820.57520.6210.49810.56240.60520.64060.62930.55010.6030.80810.45050.38810.46280.5174//
TCGA-L5-A43H-019other wise9death/0.9217////////0.1971/0.08750.05950.04120.06750.04390.06020.08690.02530.02120.02530.53330.6801/0.02840.03240.03260.04010.04450.03690.05070.02740.06320.01520.15050.04770.03850.07520.03380.3179//
TCGA-L5-A8NV-01//1599death/0.8792////////0.2639/0.03140.02420.03930.0460.02090.03950.05870.01410.01550.0230.42940.793/0.36730.38980.31120.34920.29930.45780.4490.42930.52290.42120.52710.77350.22010.30250.2970.4102//
TCGA-L5-A4OO-01//101censor/0.8859////////0.2936/0.05370.04660.0460.07330.04450.04650.08020.0180.0180.02320.40710.8668/0.28250.32940.27340.30970.29490.3950.40630.34620.45230.4090.51870.41290.17880.28840.26840.4557//
TCGA-L5-A4OQ-01//42death/0.8526////////0.2521/0.04140.04520.040.04850.06720.05250.06040.01670.01570.02380.42630.8038/0.52290.54910.59060.62580.58050.58040.5930.64240.67830.57760.660.64190.4170.45240.49760.5609//
TCGA-L5-A43E-01885new tumor920censor/0.6557////////0.1905/0.07770.04670.04260.05010.02660.05660.08440.02730.0220.02910.49930.875/0.68890.59740.70980.75810.75920.69420.73680.80040.75540.68850.73820.76270.72770.58270.64470.654//
TCGA-2H-A9GL-01//180death/0.6227////////0.1695/0.04710.04990.0520.060.02790.06750.06060.01530.01550.02960.35930.8212/0.85490.76630.84570.83890.71410.84340.84550.87140.79130.69310.80120.8820.78860.68680.71350.7846//
TCGA-LN-A7HX-01372other wise372censor/0.3937////////0.1615/0.05610.03020.04680.04610.04220.04870.07380.02310.02020.02850.46140.7574/0.03360.03090.02570.03240.05080.11710.06020.0330.16450.03360.21980.23190.03950.37550.29780.6036//
TCGA-IG-A3Y9-0126other wise26death/0.9145////////0.2336/0.05740.04310.04070.05290.05950.05480.07910.02160.01960.03180.58330.7594/0.03170.03660.02580.03140.04580.03560.05060.03020.07250.01390.12230.06510.02230.08250.04470.405//
TCGA-IG-A5B8-0124other wise24death/0.8608////////0.2409/0.05820.05140.05490.06250.04470.07490.09230.0170.02220.03460.50560.7203/0.03110.03450.0330.04470.04070.04090.03360.02630.0690.01590.14460.05910.02540.05340.02680.2378//
TCGA-RE-A7BO-01213other wise213death/0.4844////////0.2105/0.06120.03450.03980.04950.04250.05290.07560.0240.02220.02560.32730.8506/0.53540.58990.64470.63990.66150.62650.65630.70430.67440.61150.68510.69060.59620.49880.52540.5133//
TCGA-L5-A4OH-01992other wise992censor/0.8436////////0.2075/0.04630.03760.05890.04620.0320.04280.05510.02110.02070.02830.32150.8709/0.6430.59990.72250.70810.72320.66650.62980.73130.73290.58490.68820.73750.53670.50850.57880.5793//
TCGA-IG-A4QS-01118other wise118death/0.5874////////0.1657/0.05560.03740.04390.04990.0340.0440.06170.02540.01990.02490.34470.6991/0.77120.6920.73360.79380.78740.66680.7010.75390.75390.69660.76460.78020.62320.56390.6170.6756//
TCGA-L5-A8NQ-01//650death/0.8532////////0.281/0.05890.04290.05070.06150.02990.06510.0610.02210.0240.02660.72310.8615/0.04260.03480.03290.03980.06260.04240.04280.04320.06950.01560.05330.09190.03210.04780.0440.5103//
TCGA-L5-A893-0192other wise92censor/0.8638////////0.2245/0.04410.04640.04480.05070.02410.0520.07720.01810.02360.02870.53670.8397/0.57880.58940.64180.64130.60620.6520.68520.7310.71480.57660.66550.70640.6070.46270.5410.6512//
TCGA-LN-A9FR-01373other wise373censor/0.8665////////0.2462/0.04510.03470.04610.04340.02680.04710.06050.01390.01310.0210.6920.8575/0.0610.06450.050.07510.08870.04980.06250.06130.13950.02020.12040.47950.04490.07840.040.3573//
TCGA-2H-A9GN-01//272death/0.8413////////0.1271/0.04620.03960.0320.030.02210.0340.07020.01440.01490.02120.25210.8065/0.03360.03870.03710.05110.0570.04030.05290.04020.10250.01260.09320.38220.02850.03770.0260.3537//
TCGA-L5-A4OJ-01639other wise639censor/0.3929////////0.1999/0.03480.03810.03230.04650.02660.02780.04360.02010.01750.02210.4730.8448/0.02640.02890.02980.04260.04920.02850.03920.02810.06690.01150.0520.06150.02720.04070.02250.2069//
TCGA-L5-A88Z-01225other wise225censor/0.8947////////0.2051/0.04750.04350.06270.05910.02510.04450.05630.01590.02150.02350.31470.6396/0.03060.02980.03410.03580.05670.03320.0530.02760.11360.01590.04250.07030.03070.0240.02720.3572//
TCGA-X8-AAAR-01554other wise554censor/0.8284////////0.2293/0.07740.02970.05330.04750.03860.05230.08240.01190.02650.03110.47010.8172/0.62160.62130.70960.6720.57410.60340.65080.72520.68950.58670.65040.63520.48010.47870.54550.6319//
TCGA-L5-A8NT-01//825censor/0.8825////////0.1788/0.05230.03540.03680.04680.03160.04520.06330.01330.01580.02730.40010.706/0.57090.55560.56060.69490.47230.62750.67840.64190.70040.57820.6690.8270.51940.45170.45770.6385//
TCGA-IG-A5S3-01712other wise712censor/0.8973////////0.1757/0.07260.05470.05680.05580.04570.07420.10060.03030.02180.02640.47220.8463/0.08970.1150.05790.07330.06260.16140.18430.07060.23230.26380.37530.17750.07810.16830.24580.5941//
TCGA-2H-A9GI-01//435death/0.7672////////0.2072/0.05950.03910.04950.05110.02330.05350.06890.01360.01320.05220.45260.8012/0.64120.69490.64940.64160.56650.66030.69230.740.7850.63460.68740.89480.53880.48960.57850.6768//
TCGA-V5-AASV-01322new tumor467censor/0.26////////0.1995/0.05870.03650.0480.05210.04510.04480.06550.01150.0140.03230.83540.8545/0.72050.80730.80040.87190.64660.81660.84970.88160.84760.74520.76080.89710.77950.7010.73160.829//
TCGA-2H-A9GF-01//784death/0.8907////////0.1222/0.05460.04570.05670.06230.02570.04750.0870.01450.01640.03070.26280.8388/0.73640.72640.76170.82330.76690.7740.8190.85430.84070.6850.72830.89480.64630.61290.65730.716//
TCGA-L5-A88W-01//764death/0.5977////////0.1997/0.0460.03990.04630.04710.04210.05320.06620.01860.02210.02980.29250.6497/0.62660.62320.71220.75690.69210.660.71160.74060.69910.64640.72720.74050.65070.52710.61130.5412//
TCGA-LN-A8I1-01401other wise401censor/0.8666////////0.2903/0.05610.04520.03640.04550.03150.02780.04590.02620.02240.0250.47450.8809/0.04130.0490.04160.07160.08140.04980.0710.04610.12760.01520.04630.10150.03630.05620.0250.2366//
TCGA-L5-A4OP-01218other wise218censor/0.8911////////0.2771/0.05660.03090.03950.04720.0290.04450.07090.01930.0220.02960.420.8625/0.34330.50650.4890.61750.55960.62520.61470.65660.65170.5990.68940.68680.51830.47910.49960.5793//
TCGA-2H-A9GG-01//610death/0.8233////////0.1325/0.03930.02420.03240.03910.02540.06980.060.01450.01710.02480.37110.7585/0.83020.80070.82470.88540.79550.83130.85750.86730.76950.66840.74460.87330.74120.61360.65840.7351//
TCGA-L5-A4ON-01558other wise558death/0.8388////////0.1452/0.04690.04250.04970.04770.02690.0270.06580.01680.020.02450.22940.7921/0.69010.70950.80370.84060.77720.67760.69430.79640.76130.65530.74760.76560.68770.58950.62170.5561//
TCGA-ZR-A9CJ-01163new tumor600death/0.8458////////0.2371/0.06810.03690.03210.04450.02430.04040.04390.01150.01490.02440.54990.7597/0.48670.55180.49370.54640.33830.63450.69230.59640.65820.54080.58660.89540.44510.43880.50.5767//
TCGA-L5-A4OF-01801other wise801death/0.7798////////0.1488/0.03960.05550.04520.05460.03050.03760.0860.02380.01690.02260.54250.8377/0.03450.04960.03740.03850.05120.0570.05520.03120.10140.07030.17830.09640.02640.08280.03570.277//
TCGA-XP-A8T7-011254other wise1254censor/0.8914////////0.1954/0.08370.03780.05510.04930.02980.05140.05490.01890.02230.03240.73030.7604/0.04230.03910.02970.04330.06050.04010.03830.0350.08660.01860.07690.06230.03180.03850.03040.1596//
TCGA-IG-A3YC-01542new tumor612censor/0.8016////////0.2532/0.05990.03660.05390.04570.04490.04640.06380.01850.01670.03080.64540.7865/0.0330.03140.02650.03080.04580.0370.03110.02410.0550.01550.12830.05270.02390.07770.03340.3839//
TCGA-L7-A6VZ-01315other wise315censor/0.8697////////0.1825/0.04510.03970.03830.04080.03130.05350.07220.02080.01630.02390.25290.7942/0.77580.73720.81770.8820.86040.73640.73790.84450.80250.7030.78170.8730.74160.66450.67140.7368//
TCGA-IG-A8O2-01142other wise142death/0.7048////////0.2851/0.05660.03820.04270.04230.02820.04470.04640.02010.02230.03560.57140.6395/0.03530.04990.02630.04610.04430.02970.0480.03330.07210.01590.10840.0910.03310.04470.02780.2267//
TCGA-LN-A9FQ-0182new tumor391censor/0.8838////////0.186/0.05750.03740.03190.04620.03360.07360.04660.01610.01590.03290.76010.8003/0.08610.04010.04480.05980.09280.05830.1090.05160.150.01130.08870.52680.03740.05840.03970.3026//
TCGA-JY-A93E-01767other wise767censor/0.5534////////0.274/0.03790.03490.05030.04670.03450.04530.0670.01440.01480.02310.59670.8526/0.50390.52730.52870.52240.38540.56680.60230.59260.58190.54050.59920.88010.3970.44940.46570.6228//
TCGA-Q9-A6FW-01238other wise238censor/0.8805////////0.1447/0.04710.0410.05170.04690.03820.04570.05710.02090.01870.03770.43210.8145/0.56510.58670.61350.68050.49540.60910.67110.67280.69820.57420.68750.84680.48980.50250.5270.5698//
TCGA-IG-A3YB-0180other wise80censor/0.9283////////0.2097/0.06980.04960.04440.05520.04520.0610.07410.02310.02220.03880.86570.9041/0.64130.63020.71770.72780.70740.68460.71270.74210.73790.64760.70890.75860.64980.5670.60460.6566//
TCGA-IG-A625-01390other wise390death/0.8469////////0.1696/0.07050.04540.03990.0410.03120.05710.04770.0180.01630.0180.39260.7074/0.030.02560.02370.03020.03990.02860.03370.02270.04430.01620.07780.22510.02190.04430.02130.1768//
TCGA-L5-A4OX-01226other wise226death/0.7188////////0.1614/0.08850.04890.04760.05130.04390.05710.07880.02990.02080.03120.35260.8601/0.40860.46140.50470.46990.39520.46780.53050.54040.5320.47440.590.46690.36780.33550.38430.6044//
TCGA-L5-A88V-0179other wise79censor/0.9184////////0.1319/0.04890.0360.04540.03430.02660.04690.06070.01890.02010.03110.15150.742/0.78850.76970.79920.8310.67290.77080.80670.83320.82910.7140.77770.83820.73870.6410.73440.7472//
TCGA-R6-A8W5-01//480death/0.7575////////0.2145/0.05750.04390.03750.0410.04610.06890.08720.01350.01440.03270.58510.7077/0.03850.05440.02880.04090.04890.06020.0540.0310.07820.05110.18140.19140.02530.06410.04270.3135//
TCGA-LN-A9FP-01290new tumor366censor/0.8697////////0.3261/0.05790.04340.05040.05650.03320.05220.05370.0150.02180.03960.61630.7822/0.10180.13850.0930.09150.07140.14770.1720.07350.22840.2210.31760.31640.0510.13380.13420.3723//
TCGA-IC-A6RE-01234other wise234censor/0.5999////////0.1757/0.03520.03610.03670.04230.02390.04480.07940.01750.020.02150.2870.7999/0.62760.58430.6760.71080.60380.58710.67610.71380.70550.60570.64520.70920.57230.50650.58160.6103//
TCGA-LN-A7HW-0197new tumor365censor/0.9306////////0.1705/0.05220.03720.04930.05110.03250.04460.07380.02110.0240.04010.85820.8945/0.03560.04180.0330.03870.03770.03630.05070.02480.08940.01680.08610.08690.02180.04580.02730.196//
TCGA-M9-A5M8-011007other wise1007censor/0.8723////////0.2155/0.06120.04280.05350.05850.05350.05120.07220.01770.02620.03450.43020.5826/0.03060.03940.03190.05750.0490.03620.04140.03350.16620.01950.14510.07370.03360.06090.02910.2713//
TCGA-IG-A97I-01370other wise370censor/0.916////////0.1503/0.05260.04050.03750.06260.03320.04210.06670.01180.01370.02710.30860.785/0.03650.0330.02520.04970.04910.04490.0490.03520.08120.01590.09760.47940.02660.05680.03450.1899//
TCGA-LN-A7HV-01320other wise320censor/0.8584////////0.2688/0.05790.03730.03750.05780.04140.05920.05060.01610.02250.03160.61320.779/0.03140.03690.03590.04150.05290.03310.04760.03760.09130.01870.08690.11290.03140.03870.0280.3198//
TCGA-2H-A9GO-01//494death/0.7083////////0.2928/0.03430.05240.04320.03960.0260.0270.07110.0180.01540.02620.64780.6114/0.28930.31910.19120.22740.14460.44570.43670.38140.50320.40930.50610.72850.17740.3020.22360.4044//
TCGA-JY-A93F-01731other wise731censor/0.4008////////0.1608/0.0640.04660.04140.06370.02680.060.08490.01690.01830.02850.71210.8441/0.66060.72350.84150.8250.73490.76650.80850.85840.73220.69040.75830.88720.73830.61580.66560.7167//
TCGA-LN-A5U5-01136other wise136death/0.8911////////0.166/0.07580.04780.03930.04710.04140.04970.06270.03260.01850.02510.44690.7303/0.02850.02980.02260.0360.03270.03350.03060.02140.11730.01560.13250.05610.02490.06860.02290.3662//
TCGA-L5-A8NF-0181other wise81death/0.8484////////0.1383/0.05880.03740.05170.0420.02540.0570.08590.01830.01780.03290.2020.8219/0.84050.83630.90580.92910.82390.84260.84680.94260.85140.78180.81190.95140.84110.69390.75340.7628//
TCGA-Z6-AAPN-0181other wise81censor/0.8631////////0.2825/0.05610.03790.04970.0530.03220.05230.09770.020.01920.03350.62390.8405/0.33850.39020.44490.38730.30220.42240.45120.43260.48680.47820.53520.42580.27950.29690.33540.5342//
TCGA-2H-A9GJ-01//1781death/0.8132////////0.1379/0.060.05480.05860.04480.04340.06270.07680.01290.01350.03320.17550.764/0.02860.02860.0280.040.0480.03430.04650.0330.10550.01530.14070.34650.03130.05170.02470.1591//
TCGA-Q9-A6FU-01//157death/0.8272////////0.1775/0.0470.0380.03520.04570.02780.04310.05410.02060.01890.02370.51640.6797/0.04260.03550.03890.04330.06030.03850.0470.02960.04210.01190.11610.23210.02990.04360.02280.2322//
TCGA-JY-A6F8-013714other wise3714censor/0.2822////////0.1506/0.03640.03390.03880.03850.02830.03950.07330.0210.02540.02830.19590.6397/0.7380.72450.84340.86340.79390.73080.79260.85930.81610.7210.790.81660.73660.65290.67680.7192//
TCGA-L5-A8NL-01402other wise402censor/0.735////////0.2404/0.06160.04270.05310.06290.03080.0870.10820.01890.01980.03080.40760.6824/0.40340.53230.47850.52750.36250.56570.53130.53640.5740.47530.57580.80790.3170.40470.38990.5072//
TCGA-LN-A8HZ-01375other wise375censor/0.8952////////0.2229/0.06380.03580.03940.04240.03810.04570.05550.01740.01910.02610.4980.7764/0.03280.03350.0290.05090.04870.03580.04380.03330.08410.01340.07670.06550.02590.03480.03340.2433//
TCGA-IG-A4QT-01283other wise283death/0.7519////////0.3922/0.04340.03950.04360.04970.04580.04030.06790.01640.02040.02850.87830.8889/0.02880.03060.01950.03130.05170.03240.03630.02070.09350.01450.11870.05870.02240.07290.03180.3716//
TCGA-L5-A4OW-01217other wise217death/0.8368////////0.2207/0.06470.0520.05470.05030.04330.04660.09730.01950.02410.02460.44920.8052/0.50260.54260.57520.62310.52540.56390.58830.6310.64430.52550.63420.56820.4750.40180.42960.5599//
TCGA-L5-A8NW-01//1402death/0.6781////////0.1687/0.02620.03520.04080.04290.02180.02840.0640.01350.01490.0240.31270.775/0.62210.67830.67990.72890.53440.65710.71120.74220.71720.57360.64350.89030.62220.51910.5370.664//
TCGA-IG-A3QL-011071other wise1071censor/0.9184////////0.1271/0.07590.04340.04480.04160.04130.05990.08310.02150.01890.03140.14460.9014/0.03430.04440.03230.04280.0490.03250.05870.03150.12890.01880.12840.07210.03430.07910.02870.3125//
TCGA-XP-A8T6-01763other wise763death/0.8417////////0.2556/0.05840.04620.03890.04720.02270.03910.04380.01440.01830.02820.4840.6421/0.03440.02410.02980.04090.05440.03710.04020.03310.09420.0140.08410.10640.02470.03870.03120.2282//
TCGA-LN-A5U6-01375other wise375censor/0.8736////////0.1644/0.06560.04710.05330.03570.0330.05120.06940.02860.01910.03460.50490.8889/0.03540.03810.03170.04540.05820.02620.04050.02980.04850.01820.13840.07130.0270.05230.02970.3829//
TCGA-IG-A6QS-01303other wise303death/0.8958////////0.1963/0.05120.04470.04130.05740.03470.05890.08130.01880.02080.02560.4860.8554/0.03170.03290.02580.03240.03960.03140.03850.02210.1010.0290.13720.06130.02670.06240.04140.3143//
TCGA-L5-A8NH-01//393death/0.4814////////0.2113/0.04520.03110.03620.04020.02340.03390.0650.01360.01230.02550.49440.8452/0.58980.57690.62330.72840.54110.61920.67360.75440.66720.57490.67770.86810.46610.49460.56790.6543//
TCGA-L5-A4OM-011458other wise1458death/0.8686////////0.4697/0.03260.04780.03940.03210.03490.05560.04260.02150.02050.0310.51050.7954/0.02940.02890.02560.03430.05420.02810.03510.0240.07430.01330.08640.06020.02410.04560.03230.3977//
TCGA-JY-A6FH-011441other wise1441censor/0.8326////////0.1736/0.05110.04580.04460.04610.04450.04390.06130.02580.0240.03170.25070.7376/0.7660.73840.8370.84650.90160.7940.78550.84550.78720.73090.78540.86380.73430.64460.68050.6909//
TCGA-IG-A3YA-01632other wise632censor/0.9167////////0.2965/0.07730.05490.05330.04610.05340.05450.06610.02220.01890.0320.65620.7658/0.03380.03430.0340.02760.04420.03430.04850.01940.0580.01430.14360.05580.02670.08160.04030.4062//
TCGA-Z6-A8JD-01104other wise104censor/0.8024////////0.3156/0.05370.0430.04690.05680.03420.05220.07390.02010.02630.03250.74060.875/0.04380.04150.02840.04520.04780.03690.04670.03210.09350.01310.06930.09660.02660.03880.04350.2948//
TCGA-Z6-A9VB-0140other wise40censor/0.8549////////0.2196/0.03430.04280.03330.04180.02420.02560.05850.01640.01730.0310.50230.6962/0.03940.03340.0370.04680.06450.04450.05360.03930.10730.01110.0560.32310.0230.03030.0350.2797//
TCGA-2H-A9GM-01//424death/0.3129////////0.1586/0.06110.03520.04070.04850.04920.08830.09130.01380.01530.04760.26110.7994/0.65810.6530.68660.78170.59320.72830.71980.8040.6890.66550.71870.8990.59590.51640.5780.6098//
TCGA-LN-A8I0-0157new tumor407censor/0.8984////////0.1972/0.05590.04050.0370.03280.03990.06260.05670.02190.02550.03460.64630.8536/0.05060.04580.04260.07060.06980.04520.06270.04580.09620.01660.08640.11430.04330.03730.03840.3699//
TCGA-JY-A93D-01732new tumor960death/0.7641////////0.274/0.05570.040.04470.04870.02620.07030.06350.01260.01370.02230.70350.8798/0.35450.36820.25610.33070.17290.4630.44060.44570.61590.45250.54310.83670.21160.28970.33480.5404//
TCGA-S8-A6BW-01620other wise620censor/0.8793////////0.1312/0.05660.03290.03990.04850.02890.04150.05160.01710.01670.02830.54750.6918/0.03190.03120.03110.04260.05580.03430.0390.02760.07560.01170.13710.19310.02860.04370.02250.1137//
TCGA-L5-A891-01114other wise114censor/0.3617////////0.175/0.05210.03870.04430.04980.04340.05120.06710.0270.02260.03960.23150.8835/0.82950.74820.79570.89790.82710.81060.78770.86520.80730.75560.82690.86170.82190.70240.75630.7507//
TCGA-JY-A6FA-01//1361death/0.5798////////0.136/0.06720.04480.05350.05460.03330.04180.07110.0220.02040.02450.61160.5032/0.02930.03690.02040.02410.03410.03710.03430.0190.1210.01870.15510.06920.02490.09230.14570.587//
TCGA-JY-A6FD-012069other wise2069censor/0.5468////////0.212/0.06980.04320.03830.040.04370.04430.06480.02050.01870.03040.39670.7515/0.03130.02430.02050.02690.03440.04060.03330.02370.07940.01330.06430.0370.02310.04410.04280.2895//
TCGA-IG-A3I8-011012other wise1012censor/0.9076////////0.2628/0.05910.04450.04650.040.04410.03680.04540.01950.01790.03640.48280.9054/0.03840.02610.02910.04470.05850.03580.04380.02270.08640.01120.12330.07120.03470.05120.02190.3402//
TCGA-JY-A6FG-011263other wise1263death/0.7197////////0.1426/0.05030.0470.04560.0630.03430.04520.06250.01520.01680.02170.17330.704/0.02960.02560.0230.03150.05250.02720.04020.03020.07630.0190.08220.05760.01890.09150.02660.5591//
TCGA-LN-A7HY-0188new tumor366censor/0.8792////////0.3061/0.06990.04680.04420.05080.03210.07670.07910.02210.02350.03530.5840.8667/0.03540.03310.03120.04270.04480.0330.05390.02960.08960.02070.120.09720.02570.04280.02930.3916//
TCGA-IG-A7DP-01452other wise452censor/0.7932////////0.3751/0.05640.03380.04480.04980.04190.04980.0680.01980.02140.03370.82180.8398/0.13340.18170.13180.11870.08180.20280.19370.15440.25640.27550.38770.28970.08020.16240.15980.5019//
TCGA-LN-A7HZ-01117new tumor401censor/0.7621////////0.2136/0.05190.03670.04740.05130.03770.03790.06650.02150.02060.030.87190.8397/0.03440.03710.02940.03720.05070.04570.0420.02810.08180.01580.0660.05460.02650.05080.02910.2136//
TCGA-JY-A6FE-01//112death/0.7778////////0.1559/0.04510.04440.05090.03760.03270.0370.06740.02550.01980.02810.34220.8666/0.03970.03150.02230.03320.04260.03020.04020.03040.1010.01320.09320.0420.02370.02220.03180.1795//
TCGA-IG-A4P3-01567other wise567death/0.8767////////0.2577/0.05160.03430.0370.04380.03010.03970.0720.01810.02030.02120.75240.7789/0.02880.02590.02130.02680.03380.03610.02860.0190.07180.0150.07820.04660.02050.04980.03430.3536//
TCGA-JY-A93C-01652new tumor705censor/0.8509////////0.1435/0.05720.04940.03940.03580.03180.05220.05270.01160.01410.02450.17360.8486/0.8220.77430.81980.86450.61150.83280.84390.8740.81090.7280.72880.91490.78320.70470.75130.7527//
TCGA-LN-A5U7-01535new tumor768censor/0.7093////////0.1208/0.0570.04920.04290.0410.04280.05750.06270.01780.01490.0240.87770.8544/0.02510.02750.02940.0270.04240.02820.03280.02360.06630.01440.1420.18080.02760.05250.01950.2918//
TCGA-2H-A9GH-01//951death/0.8552////////0.1451/0.06110.04270.05610.0630.03820.0920.06860.01360.0170.03310.17080.7794/0.04110.03950.03290.04150.04670.05040.05780.04190.10590.02790.18620.30240.03040.06410.07010.4104//
TCGA-2H-A9GK-01//232death/0.8695////////0.2078/0.04790.04070.04590.05360.04310.07530.08290.0130.01240.02670.46220.8046/0.46260.54750.60050.60720.41440.59150.60380.62730.62920.56410.60490.85670.430.4270.42720.5642//
TCGA-LN-A9FO-014other wise4censor/0.7838////////0.1952/0.05640.04580.04470.04710.03590.05520.07710.01370.02040.02550.46140.8033/0.03070.0270.02350.03460.04090.03310.04440.0270.07710.01550.10610.04820.02420.0660.02870.3175//
TCGA-IG-A97H-01441other wise441censor/0.8513////////0.2449/0.06520.04070.0470.05490.16210.03730.01450.0140.01280.02560.75990.8235/0.05980.06960.04630.0680.06280.03560.07570.0490.10540.01450.08420.53380.0370.04750.0440.5701/

Abbreviations: EC, esophageal cancer; TCGA, The Cancer Genome Atlas.

  49 in total

1.  DNA methylation profiling of esophageal adenocarcinoma using Methylation Ligation-dependent Macroarray (MLM).

Authors:  Isabelle Guilleret; Lorena Losi; Sonia T Chelbi; Sergio Fonda; Stéphanie Bougel; Sara Saponaro; Gaia Gozzi; Loredana Alberti; Richard Braunschweig; Jean Benhattar
Journal:  Biochem Biophys Res Commun       Date:  2016-09-12       Impact factor: 3.575

2.  Aberrant promoter CpG island hypermethylation of the adenomatosis polyposis coli gene can serve as a good prognostic factor by affecting lymph node metastasis in squamous cell carcinoma of the esophagus.

Authors:  Y T Kim; J-Y Park; Y K Jeon; S J Park; J Y Song; C H Kang; S W Sung; J H Kim
Journal:  Dis Esophagus       Date:  2008-10-01       Impact factor: 3.429

3.  p16 gene silencing along with p53 single-nucleotide polymorphism and risk of esophageal cancer in Northeast India.

Authors:  Mandakini Das; Santanu Kumar Sharma; Gaganpreet Singh Sekhon; Jagadish Mahanta; Rup Kumar Phukan; Bimal Kumar Jalan
Journal:  Tumour Biol       Date:  2017-05

4.  Accumulation of promoter methylation suggests epigenetic progression in squamous cell carcinoma of the esophagus.

Authors:  Mingzhou Guo; Jingli Ren; Michael G House; Yu Qi; Malcolm V Brock; James G Herman
Journal:  Clin Cancer Res       Date:  2006-08-01       Impact factor: 12.531

5.  Oesophageal squamous cell carcinoma may develop within a background of accumulating DNA methylation in normal and dysplastic mucosa.

Authors:  T Ishii; J Murakami; K Notohara; H M Cullings; H Sasamoto; T Kambara; Y Shirakawa; Y Naomoto; M Ouchida; K Shimizu; N Tanaka; J R Jass; N Matsubara
Journal:  Gut       Date:  2006-06-19       Impact factor: 23.059

6.  Detection of Promoter DNA Methylation of APC, DAPK, and GSTP1 Genes in tissue Biopsy and Matched Serum of Advanced-Stage Lung Cancer Patients.

Authors:  Ashraf Ali; Sachin Kumar; Vinod Kumar Kakaria; Anant Mohan; Kalpana Luthra; Ashish Dutt Upadhyay; Randeep Guleria
Journal:  Cancer Invest       Date:  2017-05-19       Impact factor: 2.176

7.  Methylation Analysis of BRCA1 and APC in Breast Cancer and It's Relationship to Clinicopathological Features.

Authors:  Halaleh Shakeri; Ashraf Fakhrjou; Alireza Nikanfar; Seyyed M Mohaddes-Ardebili
Journal:  Clin Lab       Date:  2016-12-01       Impact factor: 1.138

8.  Genome-wide hypomethylation and specific tumor-related gene hypermethylation are associated with esophageal squamous cell carcinoma outcome.

Authors:  Sojun Hoshimoto; Hiroya Takeuchi; Shigeshi Ono; Myung Shin Sim; Jamie L Huynh; Sharon K Huang; Diego M Marzese; Yuko Kitagawa; Dave S B Hoon
Journal:  J Thorac Oncol       Date:  2015-03       Impact factor: 15.609

9.  Effects of Helicobacter pylori infection on genetic instability, the aberrant CpG island methylation status and the cellular phenotype in Barrett's esophagus in a Japanese population.

Authors:  Kentaro Moriichi; Jiro Watari; Kiron M Das; Hiroki Tanabe; Mikihiro Fujiya; Toshifumi Ashida; Yutaka Kohgo
Journal:  Int J Cancer       Date:  2009-03-15       Impact factor: 7.396

10.  Localization of specialized intestinal metaplasia and the molecular alterations in Barrett esophagus in a Japanese population: an analysis of biopsy samples based on the "Seattle" biopsy protocol.

Authors:  Shota Fukui; Jiro Watari; Toshihiko Tomita; Takahisa Yamasaki; Takuya Okugawa; Takashi Kondo; Tomoaki Kono; Katsuyuki Tozawa; Hisatomo Ikehara; Yoshio Ohda; Tadayuki Oshima; Hirokazu Fukui; Kiron M Das; Hiroto Miwa
Journal:  Hum Pathol       Date:  2016-01-07       Impact factor: 3.466

View more
  2 in total

Review 1.  Methylation as a critical epigenetic process during tumor progressions among Iranian population: an overview.

Authors:  Iman Akhlaghipour; Amir Reza Bina; Mohammad Reza Abbaszadegan; Meysam Moghbeli
Journal:  Genes Environ       Date:  2021-04-21

2.  Profiles of differentially expressed circRNAs in esophageal and breast cancer.

Authors:  Peiyi Shi; Jian Sun; Biyu He; Huan Song; Zhongqi Li; Weimin Kong; Jianping Wang; Jianming Wang; Hengchuan Xue
Journal:  Cancer Manag Res       Date:  2018-07-23       Impact factor: 3.989

  2 in total

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