Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer

Background Preoperative identification of breast cancer (BC) subtypes is essential for optimizing treatment strategies and improving patient outcomes. This study aimed to identify circulating cell-free DNA (cfDNA) methylation signatures to differentiate triple-negative breast cancer (TNBC) from othe...

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Main Authors: Lijing Gao, Yanbing Li, Chao Qu, Yan Dong, Qingzhen Fu, Haibo Zhou, Ning Zhao, Xianyu Zhang, Da Pang, Yashuang Zhao
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Language:English
Published: PeerJ Inc. 2025-08-01
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Online Access:https://peerj.com/articles/19888.pdf
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author Lijing Gao
Yanbing Li
Chao Qu
Yan Dong
Qingzhen Fu
Haibo Zhou
Ning Zhao
Xianyu Zhang
Da Pang
Yashuang Zhao
author_facet Lijing Gao
Yanbing Li
Chao Qu
Yan Dong
Qingzhen Fu
Haibo Zhou
Ning Zhao
Xianyu Zhang
Da Pang
Yashuang Zhao
author_sort Lijing Gao
collection DOAJ
description Background Preoperative identification of breast cancer (BC) subtypes is essential for optimizing treatment strategies and improving patient outcomes. This study aimed to identify circulating cell-free DNA (cfDNA) methylation signatures to differentiate triple-negative breast cancer (TNBC) from other BC subtypes (non-TNBC). Methods We initially performed a genome-wide analysis to identify differentially methylated CpG sites (DMCs; |Δβ| > 0.10 and P < 0.05) between five TNBC and nine non-TNBC tissues using the Infinium HumanMethylationEPIC BeadChip. These DMCs were further validated using large-scale data from the Cancer Genome Atlas (TCGA, n = 774; |Δβ| > 0. 25 and P < 0.05), and only CpG sites with average β values > 0.90 or < 0.10 in white blood cells (GSE50132, n = 233) were retained to minimize potential background methylation interference. Least absolute shrinkage and selection operator (LASSO) regression was applied to select optimal markers. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), and prognostic value was evaluated using Cox regression analysis. A multiplex digital droplet PCR (mddPCR) assay was developed to simultaneously detect cg06268921 and cg23247845 in cfDNA from TNBC (n = 33) and non-TNBC (n = 80) patients. Results We identified 113 DMCs, of which eight were selected as optimal markers. They effectively discriminated TNBC from non-TNBC tissues. Then an eight-marker diagnostic panel was developed with an AUC of 0.922 in TCGA and 0.875 in GSE69914. Among them, cg06268921 was significantly associated with overall survival (hazard ratio = 0.249, P = 0.044) and disease-free survival (hazard ratio = 0.194, P = 0.015) in the TCGA-TNBC cohort. In the cfDNA cohort, cg06268921 significantly differentiated TNBC from non-TNBC (P < 0.001), and the combination of both markers yielded an AUC of 0.728. The findings demonstrated the potential of methylation signatures as non-invasive diagnostic tools for TNBC. Future research with larger cohorts is warranted.
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spelling doaj-art-71afef9d93e8401d8e197a5cd2022eaf2025-08-22T15:05:11ZengPeerJ Inc.PeerJ2167-83592025-08-0113e1988810.7717/peerj.19888Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancerLijing Gao0Yanbing Li1Chao Qu2Yan Dong3Qingzhen Fu4Haibo Zhou5Ning Zhao6Xianyu Zhang7Da Pang8Yashuang Zhao9Department of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Breast Surgery, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Breast Surgery, Harbin Medical University, Harbin, Heilongjiang, ChinaDepartment of Epidemiology, Harbin Medical University, Harbin, Heilongjiang, ChinaBackground Preoperative identification of breast cancer (BC) subtypes is essential for optimizing treatment strategies and improving patient outcomes. This study aimed to identify circulating cell-free DNA (cfDNA) methylation signatures to differentiate triple-negative breast cancer (TNBC) from other BC subtypes (non-TNBC). Methods We initially performed a genome-wide analysis to identify differentially methylated CpG sites (DMCs; |Δβ| > 0.10 and P < 0.05) between five TNBC and nine non-TNBC tissues using the Infinium HumanMethylationEPIC BeadChip. These DMCs were further validated using large-scale data from the Cancer Genome Atlas (TCGA, n = 774; |Δβ| > 0. 25 and P < 0.05), and only CpG sites with average β values > 0.90 or < 0.10 in white blood cells (GSE50132, n = 233) were retained to minimize potential background methylation interference. Least absolute shrinkage and selection operator (LASSO) regression was applied to select optimal markers. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), and prognostic value was evaluated using Cox regression analysis. A multiplex digital droplet PCR (mddPCR) assay was developed to simultaneously detect cg06268921 and cg23247845 in cfDNA from TNBC (n = 33) and non-TNBC (n = 80) patients. Results We identified 113 DMCs, of which eight were selected as optimal markers. They effectively discriminated TNBC from non-TNBC tissues. Then an eight-marker diagnostic panel was developed with an AUC of 0.922 in TCGA and 0.875 in GSE69914. Among them, cg06268921 was significantly associated with overall survival (hazard ratio = 0.249, P = 0.044) and disease-free survival (hazard ratio = 0.194, P = 0.015) in the TCGA-TNBC cohort. In the cfDNA cohort, cg06268921 significantly differentiated TNBC from non-TNBC (P < 0.001), and the combination of both markers yielded an AUC of 0.728. The findings demonstrated the potential of methylation signatures as non-invasive diagnostic tools for TNBC. Future research with larger cohorts is warranted.https://peerj.com/articles/19888.pdfTriple-negative breast cancerCell-free DNAMultiplex droplet digital PCRDNA methylationDifferential diagnosisPrognosis
spellingShingle Lijing Gao
Yanbing Li
Chao Qu
Yan Dong
Qingzhen Fu
Haibo Zhou
Ning Zhao
Xianyu Zhang
Da Pang
Yashuang Zhao
Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer
PeerJ
Triple-negative breast cancer
Cell-free DNA
Multiplex droplet digital PCR
DNA methylation
Differential diagnosis
Prognosis
title Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer
title_full Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer
title_fullStr Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer
title_full_unstemmed Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer
title_short Genome-wide discovery of circulating cell-free DNA methylation signatures for the differential diagnosis of triple-negative breast cancer
title_sort genome wide discovery of circulating cell free dna methylation signatures for the differential diagnosis of triple negative breast cancer
topic Triple-negative breast cancer
Cell-free DNA
Multiplex droplet digital PCR
DNA methylation
Differential diagnosis
Prognosis
url https://peerj.com/articles/19888.pdf
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