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H3K27 trimethylation loss in malignant peripheral nerve sheath tumor: a systematic review and meta-analysis with
Victor M Lu1, Tomas Marek2, Hannah E Gilder2
1Department of Neurosurgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. lu.victor@mayo.edu.au.
Background:
Multiple studies have reported the loss of trimethylation at lysine (K) 27 on histone 3 (H3K27me3) in high-grade malignant peripheral nerve sheath tumors (MPNSTs). However, the diagnostic potential of this finding in MPNSTs remains yet to be fully substantiated. Correspondingly, our aim was to pool systematically-identified metadata in the literature and substantiate the incidence of H3K27me3 loss in this setting.
Methods:
Searches of 7 electronic databases from inception to May 2019 were conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. The incidence of loss was then pooled by random-effects meta-analysis of proportions.
Results:
Nine pertinent studies described a total of 823 high-grade MPNST samples. When pooled, incidence (sensitivity) of complete H3K27me3 loss was estimated to be 53% (95% CI 42-64%). For MPNST subtypes, estimated incidences of complete loss in NF1 subtype was 52% (95% CI 41-62), in sporadic subtype was 53% (95% CI 36-70%), in the epithelioid subtype was 0% (95% CI 0-7%), and radiation-associated subtype was 98% (95% CI 86-100%). Finally, incidence of incomplete loss (specificity) in 1231 MPNST-mimic samples was estimated to be 96% (95% CI 90-99%). Certainty of these outcomes ranged from very low to high.
Conclusions:
The incidence of complete H3K27me3 loss is substantial in high-grade MPNSTs and is low in MPNST-mimics. Greater cohort study and biological investigation will validate the certainty of these findings as well as elucidate their true molecular and clinical significances.
Insights
Loss of histone H3K27me3 trimethylation is common in malignant peripheral nerve sheath tumors (MPNSTs). This finding is infrequent in MPNST mimics, suggesting diagnostic potential for H3K27me3 loss in MPNSTs.
Area of Science:
- Oncology
- Epigenetics
- Tumor Biology
Background:
- Loss of histone 3 trimethylation at lysine 27 (H3K27me3) is frequently observed in high-grade malignant peripheral nerve sheath tumors (MPNSTs).
- The diagnostic utility of H3K27me3 loss in MPNSTs requires further validation.
- This study aimed to systematically review and pool existing data on the incidence of H3K27me3 loss in MPNSTs.
Purpose of the Study:
- To determine the incidence of H3K27me3 loss in high-grade MPNSTs.
- To assess the specificity of H3K27me3 loss in MPNST-mimicking conditions.
- To evaluate the diagnostic potential of H3K27me3 loss as a biomarker for MPNSTs.
Main Methods:
- A systematic literature search was conducted across 7 electronic databases adhering to PRISMA guidelines.
- Articles were screened based on predefined inclusion and exclusion criteria.
- A random-effects meta-analysis of proportions was employed to pool the incidence data.
Main Results:
- Nine studies comprising 823 high-grade MPNST samples were analyzed.
- The pooled incidence of complete H3K27me3 loss in MPNSTs was 53% (95% CI 42-64%).
- Incidence of complete H3K27me3 loss varied by MPNST subtype: NF1 (52%), sporadic (53%), epithelioid (0%), and radiation-associated (98%).
- The incidence of incomplete H3K27me3 loss in 1231 MPNST-mimic samples was 96% (95% CI 90-99%), indicating high specificity.
Conclusions:
- Substantial incidence of complete H3K27me3 loss in high-grade MPNSTs supports its potential as a diagnostic marker.
- Low incidence of H3K27me3 loss in MPNST mimics suggests high specificity.
- Further cohort studies and biological investigations are needed to confirm these findings and elucidate their clinical significance.
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