A circulating cell-free DNA methylation signature for the detection of hepatocellular carcinoma
Si-Cho Kim, Da-Won Kim, Eun Ju Cho, Jin-Young Lee, Jiwon Kim, Chaesun Kwon, Jeongsil Kim‐Ha, Suk Kyun Hong, YoungRok Choi, Nam‐Joon Yi, Kwang‐Woong Lee, Kyung‐Suk Suh, Won Kim, Woo‐Jin Kim, Hyunsoo Kim, Yoon Jun Kim, Jung‐Hwan Yoon, Su Jong Yu, Young-Joon Kim
Abstract
To address the shortcomings of current hepatocellular carcinoma (HCC) surveillance tests, we set out to find HCC-specific methylation markers and develop a highly sensitive polymerase chain reaction (PCR)-based method to detect them in circulating cell-free DNA (cfDNA). The analysis of large methylome data revealed that Ring Finger Protein 135 (RNF135) and Lactate Dehydrogenase B (LDHB) are universally applicable HCC methylation markers with no discernible methylation level detected in any other tissue types. These markers were used to develop Methylation Sensitive High-Resolution Analysis (MS-HRM), and their diagnostic accuracy was tested using cfDNA from healthy, at-risk, and HCC patients. The combined MS-HRM RNF135 and LDHB analysis detected 57% of HCC, outperforming the alpha-fetoprotein (AFP) test's sensitivity of 45% at comparable specificity. Furthermore, when used with the AFP test, the methylation assay can detect 70% of HCC. Our findings suggest that the cfDNA methylation assay could be used for HCC liquid biopsy.