Novel genetic and epigenetic alterations in ... - Ous-research.no

Novel genetic and epigenetic alterations in ... - Ous-research.no Novel genetic and epigenetic alterations in ... - Ous-research.no

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up with ExoSAP-IT (USB Corporation, Ohio, USA) and sequencing PCR using BigDye®Terminator v1.1 Cycle Sequencing Kit (Applied Biosystems) following the producer’sinstructions. Forward and reverse sequences were analyzed and compared with the genomicreference sequences. For primer details please see supplementary table.Selection of target genesA literature search was performed in order to survey known putative target genes, as alreadyreported.[10] From the 162 genes identified we applied different criteria in order tomaximize the genes with a possible impact on tumorigenesis which in turn will have a higherprobability of determining patient survival.For the initial selection a minimum cut-off mutation frequency of 15% across all tumortypes was chosen following the assessed background mutation level 12-13%.[8;12] To as faras possible ensure that the given mutation frequency was representative, this criterion wascoupled to a requirement of the existence of at least two studies of minimum twenty sampleseach, and a minimum of one hundred samples across all studies. These criteria returned 23genes.In order to include additional molecular markers a second set was defined. This included aminimum observed mutation frequency for the gene of 30%, a minimum of one study oftwenty tumor samples, and involvement in one of the following categories, which were inpart based on Hanahan and Weinberg’s acquired capabilities of cancer: DNA repair, cellsignaling, apoptosis, cell cycle, transcription or angiogenesis.[13]8

On the assumption that DNA repair and cell cycle genes significantly influence thedevelopment and prognosis of MSI tumors, genes falling into these categories were sortedaccording to mutation frequency, and those displaying mutations in over 15% of sampleswere included regardless of sample number. Finally, genes that are considered by Woerner etal. to be true target genes in MSI CRC were included,[14] resulting in a total of 41 genes.Statistics2 x 2 contingency tables were analyzed using Fisher’s exact test. 3 x 2 tables were analyzed bythe Pearson 2 test. Due to a low number of samples, Mann-Whitney Wilcoxon test wasperformed to evaluate the difference in total number of mutations in the right-sided andrectal tumors. An independent T-test was performed when comparing continuous normallydistributed data between two groups. Kruskal-Wallis one-way analysis of variance was usedto test the equality of mutation frequencies among the test and validation series as well as theliterature.Five year disease-free survival was analyzed using Kaplan-Meier plots, and the Breslow testwas used to compare the equality of the survival functions. Cox regression for multivariateanalyses was used to determine the parameters with the greatest impact on survival. P-valuesform the likelihood ratio test was used. Disease-free survival was defined as the time fromdiagnose to the first event of either death from disease, locally recurrent disease or distantmetastasis, while death from other reasons and death from surgery were censored. All Pvalues were derived from statistical tests using the SPSS 15.0 software (SPSS, Chicago, IL,USA), and considered statistically significant at P < 0.05.9

up with ExoSAP-IT (USB Corporation, Ohio, USA) <strong>and</strong> sequenc<strong>in</strong>g PCR us<strong>in</strong>g BigDye®Term<strong>in</strong>ator v1.1 Cycle Sequenc<strong>in</strong>g Kit (Applied Biosystems) follow<strong>in</strong>g the producer’s<strong>in</strong>structions. Forward <strong>and</strong> reverse sequences were analyzed <strong>and</strong> compared with the ge<strong>no</strong>micreference sequences. For primer details please see supplementary table.Selection of target genesA literature search was performed <strong>in</strong> order to survey k<strong>no</strong>wn putative target genes, as alreadyreported.[10] From the 162 genes identified we applied different criteria <strong>in</strong> order tomaximize the genes with a possible impact on tumorigenesis which <strong>in</strong> turn will have a higherprobability of determ<strong>in</strong><strong>in</strong>g patient survival.For the <strong>in</strong>itial selection a m<strong>in</strong>imum cut-off mutation frequency of 15% across all tumortypes was chosen follow<strong>in</strong>g the assessed background mutation level 12-13%.[8;12] To as faras possible ensure that the given mutation frequency was representative, this criterion wascoupled to a requirement of the existence of at least two studies of m<strong>in</strong>imum twenty sampleseach, <strong>and</strong> a m<strong>in</strong>imum of one hundred samples across all studies. These criteria returned 23genes.In order to <strong>in</strong>clude additional molecular markers a second set was def<strong>in</strong>ed. This <strong>in</strong>cluded am<strong>in</strong>imum observed mutation frequency for the gene of 30%, a m<strong>in</strong>imum of one study oftwenty tumor samples, <strong>and</strong> <strong>in</strong>volvement <strong>in</strong> one of the follow<strong>in</strong>g categories, which were <strong>in</strong>part based on Hanahan <strong>and</strong> We<strong>in</strong>berg’s acquired capabilities of cancer: DNA repair, cellsignal<strong>in</strong>g, apoptosis, cell cycle, transcription or angiogenesis.[13]8

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