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Article

A New Epigenetic Model to Stratify Glioma Patients According to Their Immunosuppressive State

1
Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy
2
Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy
3
Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Division of Molecular Oncology, 33081 Aviano, Italy
4
Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
5
Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy
6
Bioinformatics and Statistical Genomics Unit, Istituto Auxologico Italiano IRCCS, 20095 Cusano Milanino, Italy
7
Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
8
Neurosurgery Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
9
Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Department of Radiotherapy, 33081 Aviano, Italy
*
Author to whom correspondence should be addressed.
Submission received: 25 January 2021 / Revised: 27 February 2021 / Accepted: 28 February 2021 / Published: 5 March 2021

Abstract

:
Gliomas are the most common primary neoplasm of the central nervous system. A promising frontier in the definition of glioma prognosis and treatment is represented by epigenetics. Furthermore, in this study, we developed a machine learning classification model based on epigenetic data (CpG probes) to separate patients according to their state of immunosuppression. We considered 573 cases of low-grade glioma (LGG) and glioblastoma (GBM) from The Cancer Genome Atlas (TCGA). First, from gene expression data, we derived a novel binary indicator to flag patients with a favorable immune state. Then, based on previous studies, we selected the genes related to the immune state of tumor microenvironment. After, we improved the selection with a data-driven procedure, based on Boruta. Finally, we tuned, trained, and evaluated both random forest and neural network classifiers on the resulting dataset. We found that a multi-layer perceptron network fed by the 338 probes selected by applying both expert choice and Boruta results in the best performance, achieving an out-of-sample accuracy of 82.8%, a Matthews correlation coefficient of 0.657, and an area under the ROC curve of 0.9. Based on the proposed model, we provided a method to stratify glioma patients according to their epigenomic state.

1. Introduction

Gliomas are brain tumors that arise from glial precursor cells. According to their pathological features, gliomas are subdivided in glioblastomas (GBMs), which have the highest grade (IV), and low-grade gliomas (LGGs), a heterogeneous group composed by various tumor types, such as astrocytic, oligodendroglial and ependymal tumors. Gliomas have a heterogeneous clinical outcome with the worse course happening in the GBM group, whereas LGGs are generally less severe. Several biomarkers have been proposed to predict the clinical outcome and response to treatments of gliomas, including genetic and epigenetic ones such as IDH mutation and methylation of the MGMT promoter. A detailed characterization of glioma-associated molecular signatures has made possible the development of novel therapies, including the use of tyrosine kinase inhibitors. On the other hand, based on the results obtained in the context of other tumors, the use of immune checkpoint inhibitors (ICIs) has been proposed for gliomas, including GBMs. However, despite the recently proposed novel targeted therapy and immunotherapy treatment approaches, treatment strategies for gliomas are in the majority of cases still conventional. In particular, for GBMs, the current standard of care still consists of surgical resection, followed by radiotherapy and chemotherapy [1]. Moreover, so far no immunotherapeutic approach against GBM has demonstrated efficacy in a controlled clinical trial [2,3,4].
The clinical outcome of gliomas is strictly related with the composition and cell cross-talk of tumor microenvironment (TME), in particular with the immune texture in terms of the distinct immune cell types as well as the different immunosuppressive cell populations, such as T regulatory cells (Tregs), myeloid-derived suppressor cells (MDSCs), tumor-associated macrophages (TAMs), dendritic cells and antigen-presenting cells specific to the brain such as microglia [5,6,7]. A significant infiltration of Tregs can be detected in a large fraction of gliomas, in particular in the GBM group. In this context, the activity of IDO can contribute to the immunosuppressive state of the TME by creating a tryptophan shortage, which contributes to the suppression of T cell activation and proliferation [8]. Within glioma tumors, microglia and macrophages can represent up to the 12% of the tumor mass [9,10,11,12].
With respect to the macrophages displaying the M1 phenotype, M2 macrophages are more strongly involved in the maintenance of an immunosuppressive state in the TME. Notably, M2 macrophages are generally characterized by the peculiar expression of several cell surface markers including CD163 [13,14,15,16]. The extracellular matrix (ECM) components such as glycosaminoglycans, glycoproteins, proteoglycans, play a crucial role in the invasion mechanisms of gliomas, mainly through promoting angiogenesis and tumor cell migration. Hypervascularity is a characteristic of gliomas with an increment in angiogenesis compared to healthy brain tissue. This tumor-associated vasculature is not completely formed with leaky vessels and associated with an increase in the interstitial fluid pressure [17].
The degree of immunosuppression of the glioma TME can be associated with a peculiar immunosuppressive signature, with the most accentued immunosuppressive state happening in the case of GBMs [18]. Moreover, specific immunosuppressive features such as depletion of tumor infiltrating lymphocytes (TIL), high PD-L1 expression, and a reduced IIFN signature have been associated with recurrent genomic mutations, such as IDH1, TP53, NF1, PTEN EGFR and MAPK pathway mutations. Epigenetic modifications including alteration of histone patterns, chromatin structure, changes in microRNA expression levels and DNA methylation status at specific promoters are involved in the modulation of the TME by allowing cells to grow and to escape from immune surveillance. Thus, the immunosuppressive state can be recapitulated by epigenetic regulation, in particular by DNA methylation influencing the expression of transcription factors and regulatory genes related to the immune cell transcriptome. Since DNA methylation plays an important role in cancers, many studies have utilized DNA methylated sequences as biomarkers for cancer detection, including CpG markers and promoter markers. In particular, DNA methylation has been demonstrated to resolve cell of origin of peripheral blood cells [19] and cell-free DNA [20,21,22], and was introduced as a complementary approach to classify central nervous system (CNS) tumors [23]. Moreover, irregular methylations in promoters of cancer-related genes could serve as biomarkers for early cancer diagnosis and prognosis. An example of this is MGMT promoter methylation that was demonstrated to be a predictive biomarker for cancer prognosis in GBMs and response to chemotherapy with temozolomide [24,25]. In this context, DNA methylation can be useful to more adequately understand the distribution of the different immune cell subtypes in the context of the TME [26,27,28]. In this study, we fed DNA methylation data into a machine learning model to classify gliomas over their immunosuppression state. We used methylation data as features for our dataset. The target is a novel binary indicator of the immunosuppression state. Due to the limited number of cases available in public datasets, we resorted to both expert and data-driven selection to shrink the number of features and decrease the noise. Given the large number of features and the possibly non-linear nature of the problem, we adopted properly tuned random forest (RF) and deep neural network as classifiers.
We found that the multi-layer perceptron deep outperforms the RF and that a proper feature selection is capable of improving the accuracy of the model. In light of the result of the study, a proper discussion of the biological implications of our study was provided. This classification model could be useful to predict the responsiveness of glioma-affected patients to novel immunotherapeutic approaches, such as the use of ICIs.

2. Materials and Methods

2.1. Data

The complete workflow, from raw data to the predictive model, is presented in Figure A2.
Our dataset is derived from The Cancer Genome Atlas (TCGA) data hub, available on Xena https://xenabrowser.net (accessed on 12 March 2020). From this source, we extracted the count (FPKM-UQ) of RNA sequencing (RNA-seq) and DNA methylation data for LGG and GBM. The clinical and pathological information of the patients was also gathered from TCGA and the Consortium publication on glioma [29]. The selection of the cases was based on the following criteria: (i) presence of a diagnosed GBM or LGG, (ii) availability of the DNA methylation and RNA sequencing data. A total of 573 cases of brain tumors were enrolled (Table 1).
The input to our machine learning model was made only of methylation data, while the RNA-seq data and the information about the patients were only used in the construction of the target or in ancillary analysis. The methylation at each 5′—C—phosphate—G—3′ (CpG) site is described by the β value, defined as the ratio between the intensity of the methylated probe and the intensity of the total probe. A total of 482,421 CpG sites throughout the genome were assessed and filtered using the procedure described by Bourgon et al. [30], resulting in an initial dataset containing 355,314 CpG probes. We called this dataset AllCpGs.
Taking into account the relevance of M2 macrophages and TReg populations in the modulation of immunosuppression in the context of the TME, cases were labeled for their putative capability of escaping an immunosuppressive state. To do this, we evaluated the immune cells in the TME using immunedecov [31]. First, the data relative to RNA-seq were log-transformed and standardized to zero mean and unit variance. We then defined three different criteria based on RNA-seq: (i) expression of the CD163 gene, (ii) expression of M2 macrophage signature (Macropage M2), and (iii) expression of Tregs signature (T cell regulatory Tregs). The two latter signatures were evaluated using quantiseq [32] and xCell [33]. The three parameters, (i) to (iii), were used to label cases based on their putative capability of escaping an immunosuppressive state. A case was labelled EvaDe Immune SuppressiON (EDISON) positive if it had more than two out of the three parameters, (i) to (iii), below the first quartile of expression. For the evaluation of the interactions between the immune system and the TME, we leveraged the signatures published on the “Immune-Subtype-Clustering” GitHub repository [34], as proposed in our previous study [35]. The EDISON label was used as a target for our classification models.

2.2. Feature Selection

Due to the high number of variables in the DNA methylation data compared to the number of cases, before applying any classification model, we opted to reduce the dimensionality of the input via feature selection. At first, we applied expert selection.
We included in the dataset the CpGs related to the genes which were shown to play crucial roles in gliomas. Specifically, we chose:
  • The genes linked to the putative response of immune suppression in the study by Thorston et al. [18];
  • The genes with the angiomatrix signatures [36];
  • The genes associated with the putative response for ICIs in GBMs [37];
  • The genes reported as with prognostic value for gliomas by Mesrati et al. [38];
  • The genes related to the extracellular matrix (ECM) recently linked to the glioma by Zhao et al. [39].
In order to evaluate the predictive power of different sets of genes, two different datasets were obtained. We called ImmuneAngioICIs the one containing the genes described in points 1, 2, and 3, while we called ImmuneAngioICIsMesECM the dataset containing the genes described in points 1, 2, 3, 4, and 5.
In order to assess the soundness and effectiveness of our expert selection, we also considered a dataset containing all the CpG probes without any filtering. Our results will show that including all the probes does not result in a better modelling: conversely, the additional features bring noise and worsen the predictive power of our models.
The expert selection reduces the number of CpG in the dataset by a factor of 50. Still, many uninformative features might be present. Given the limited number of available cases, the inclusion of uninformative features results in an increase in the noise and may have detrimental effects on the accuracy of the machine learning model. Therefore, we opted to adopt also a data-driven selection procedure. On each dataset, we applied the Boruta algorithm to detect the set of most relevant features [40]. A scheme with a 10-fold cross-validation and 100 repetitions was adopted. We called AllCpGs + BORUTA the dataset resulting after the application of Boruta to AllCpGs, ImmuneAngioICIs + BORUTA the dataset resulting after the application of Boruta to ImmuneAngioICIs, and ImmuneAngioICIsMesECM + BORUTA the dataset resulting after the application of Boruta to ImmuneAngioICIsMesECM. A summary of the datasets is presented in Table 2.

2.3. Modelling

To allow a proper evaluation of the machine learning models, each of the the available datasets, d, d {AllCpGs, ImmuneAngioICIs, ImmuneAngioICIsMesECM, AllCpGs + BORUTA, ImmuneAngioICIs + BORUTA, ImmuneAngioICIsMesECM + BORUTA}, was split into a training set T d , containing 80% of the samples, and a test set V d , including the remaining 20%. The feature selection and the tuning of model hyperparameters were allowed to only take advantage of the training set T d , while samples in V d were left apart for the final evaluation. It is important to note that the training sets T d only differ in the inputs, while the target variable and the target sample are the same irrespective of d. The same holds for the test sets V d . This point is critical to allow for a sound comparison among the performance of the models.
On each dataset, the classification models were then tuned and trained. At first, we considered a RF model. We optimized the hyperparameters, such as the number of trees in the forest, the maximum depth of a tree and the minimum number of samples in a leaf, using a grid-search cross-validation. The tuning procedure followed the one described in Vadalas et al. [41].
On the dataset leading to the best performance metrics, namely ImmuneAngioICIsMes ECM + BORUTA, two more models were trained. We selected two architectures of deep neural networks: a multi-layer perceptron (MLP) and a convolutional neural network (CNN). For both models, the hyperparameters such as number of hidden layers, neurons in each layer, and learning rate, were optimized using a grid-search cross-validation.
To further evaluate the complex regulation of methylation effect in different genomic localization, we investigated if the EDISON classification model could be improved by dividing ImmuneAngioICIsMesECM and ImmuneAngioICIs by regional sites and by applying the RF model.

2.4. Evaluation

In addition to the standard accuracy (ACC), we considered the Matthews Correlation Coefficient (MCC), and the area under the receiver operating characteristic (AUC) as performance metrics. First introduced by B.W. Matthews to assess the performance of the prediction of protein secondary structure [42], the MCC has become a widely used measure in biomedical research [43,44]. Due to their large popularity and simple interpretation, MCC and AUC were selected in the US FDA-led initiative MAQC-II, aimed at reaching a consensus on the best practices for the development and validation of predictive models for personalized medicine [43].
The evaluation metrics were computed both in cross-validation, on samples belonging to the train sets T d , and on the samples of the test set V d . For the cross-validation metrics, the 95% confidence intervals (CIs) were also computed. In order to substantiate the results, the McNemar test was used to assess the significance in performance difference among classifiers [45].

2.5. Evaluation of the 338 CpG Probes Used for the Model as Survival Prognosticator

We evaluated the prognostic role of the CpG probes used by the best performing model, i.e., the ones included in ImmuneAngioICIsMesECM + BORUTA with survival analysis. In particular, we adopted a random survival forest, an ensemble tree method for the analysis of censored survival data, described by Wang et al. [46]. The hyperparameters of the model were chosen with a randomized search and the feature importance was extracted from the best model using permutation importance.

2.6. Definition of a Possible CpG Signature Useful for Liquid Biopsy

The CpG probes used by the best performing model (ImmuneAngioICIsMesECM + BORUTA) were also analyzed using the Blood–Brain Epigenetic Concordance (BECon) to assess their possible use in liquid biopsy (https://redgar598.shinyapps.io/BECon/ (accessed on 12 March 2020)). We first chose the CpGs that presented a percentile rank of CpG Change Beta over 75. Then, we applied the least absolute shrinkage and selection operator (LASSO) Cox regression to develop an optimal risk signature with the minimum number of CpGs [47,48]. The correlation of the CpGs with gene expression was also evaluated.

2.7. Correlation Analysis between CpGs and Genes

To examine the impact of DNA methylation on the local regulation of gene expression, the Pearson correlation between the β values of the CpGs and the normalized expression of the corresponding genes was calculated. Moreover, in order to investigate the distant regulation of gene expression, we computed the correlation between the β values of CpGs of differentially methylated and expressed genes and the normalized expression of differentially expressed genes.

2.8. PPI Network Analysis of DNA Methylation-Driven Genes

The 338 CpG probes used by the best performing model (ImmuneAngioICIsMesECM + BORUTA) were mapped by Search Tool for the Retrieval of Interacting Genes (STRING) database (version 10.5 [49] ) by using Cytoscape (3.8.2) [50]. The PPI network was generated based on the medium confidence score of 0.40.

2.9. Computational Details

The classification pipeline was built on top of the Scikit Learn library, version 0.20.3 [51] and Python 3.6. All the experiments were run on a 32-core Intel Core i7 workstation with 128GB of RAM running CentOS 7.5. Cox regression and Kaplan–Meier survival curves were computed using R (version 3.6.1) with the survival and survminer packages. The Wilcoxon rank-sum test was used to compare the difference between the groups, while Kruskal–Wallis (K-W) test was adopted to evaluate the differences in risk scores across three or more groups.

3. Results

3.1. Definition of the EDISON Classification Flag

We analyzed publicly available datasets of primary glioma samples for which transcriptomic and epigenomic molecular profiles were available. We collected a total of 573 cases, of which 47 cases were GBMs and 506 cases were LGGs. This series of 573 glioma cases was used to develop the model irrespective of being GBMs or LGGs. Figure A2 represents the adopted workflow. Considering the transcriptomics to explore the immune environments landscape (Figure 1), we observed how the different subpopulations of gliomas based on the grade can be described by the the differential expression of some genes, capable of segregating GBMs from LGGs. The LGG group is enriched in IDH mutated cases. This is in keeping with previous published results showing that IDH mutations are associated with favorable immune composition within the TME and decreased leukocyte chemotaxis, leading to fewer tumor-associated immune cells and better outcome [52]. On the other hand, the GBM group is characterized by a high number of MGMT unmetylated cases [24]. Moreover, we evaluated all the cohort for the immune subtype classification, as described in Thorston et al. [18]. With this approach we found that the set of glioma cases employed in the present study is enriched in cases belonging to the subtype 4 (lymphocyte Depleted) and 5 (Immunologically Quiet). These results were in agreement with what previously described showing that the gliomas included in cluster subtype 4 are characterized by a more prominent macrophage signature, with a high M2 response and suppression of the Th1 T cell population, as well as that the glioma cases included in the cluster subtype 5 exhibit the lowest lymphocyte population and the highest macrophage response dominated by M2 macrophages [18,53,54,55].
Based on these characteristics, peculiar of an immune suppressive TME, we chose to assess the immune-related signatures of the 573 sample RNA-seq data by using immunedecov (xCell tools) to comprehensively evaluate the transcriptome-based cell-type quantification [31].
Figure 2 shows the immune-cell-related gene expression signatures for the glioma cases included in the study. In this context, increasing evidence indicates that TME plays a critical role in supporting the progression of gliomas. In fact, the majority of immune-related cells within brain tumors are macrophages, often comprising up to 30% of the tumor mass [10]. Most TAMs are considered to have M2 phenotype. Increased infiltration of TAMs correlated with improved glioma progression and tumor grade, and predicts poor prognosis in GBM patients. This raises the intriguing possibility that targeting TAMs may be a successful therapeutic strategy for intractable gliomas and GBMs [21]. On the other hand, the capacity to evade the anti-tumoral immune response is associated to the subset of T cells termed CD4+ CD25+ regulatory T cells (Treg), that have been shown to inhibit the actions of the effector T lymphocytes [5,56]. Thus, we considered the possible influence of two different cell populations, i.e., Tregs and M2 TAMs by evaluating RNA-seq data for gene expression signatures associated with the immunosuppressive role of these two populations. Moreover, we also evaluated the expression of CD163 itself, being CD163 one of the most important surface markers of M2 TAMs, that has been recently associated to a prognostic role [14]. We labeled cases as Evade Immune SuppressiON (EDISON) positive with a low immunosuppression state if at least two among these three parameters—CD163, M2 TAMs and Tregs—were below the first quartile. The resulting classification describes the possibility that a patient evades the immuno-suppression state and for this reason we called the flag EDISON (EvaDe Immune SuppressiON) positive. Consistently, as reported in Figure 2, EDISON positive cases showed less immunesuppressive phenotypes with both low values of the stromal signature score and the microenviroment signature score, as well as low endothelial signature score [57]. GBM was shown to be characterized by extensive endothelial hyperplasia [58] and the related signatures reported in Figure 2 confirmed this peculiar state.
We also evaluated the capability of the EDISON classification by Kaplan–Meyer for assessing a prognostic significance using both overall survival (OS) and progression-free survival (PFS) intervals. We found that the EDISON positive cases showed significantly longer OS and PFS intervals than EDISON negative cases, thus confirming the importance of the immuno-suppressive-related parameters included in the EDISON flag (Figure 2B,C and Table 3). Figure A1 shows the EDISON classification in the context of IDH mutatant or IDH wildtype cases taken separately for both OS and PFI intervals.

3.2. From RNA Genes to the Classification Model

The procedure adopted to process the epigenetic data, that includes the creation the EDISON label for the immunosuppressive state, the development of the classification models and their evaluation, is summarized in Figure A2, while a focus on the machine learning models is provided in Figure A3. As described in Section 2.1, we considered a dataset where the input features are β values from CpG probes and the target is a binary label corresponding to the EDISON flag. Starting from the genes used in Thorston et al. [18], we extracted the more informative genes to classify the immunosuppressive state [54,55,59,60,61]. We included also genes associated with the angiogenic signature, according to the prominent role of macrophages in tumor growth and angiogenesis [62], by including the angiomatrix signature reported by Langlois et al. [36]. Moreover, based on the fact that the response of ICIs has been shown to be relevant in both GBM and LGG [63], we evaluated a series of genes putatively related to responsiveness to ICIs, according to the GBM-associated signature reported in Zhao et al. [37]. More precisely, we compared the gene expression of the six GBM cases reported as Responsive against six GBM cases reported as Not Responsive and we obtained that 490 genes were differentially expressed, with adjusted p-values lower than 0.01.
The CpG beta values from 450 k Human DNA methylation microarray analysis consisted of 485,577 CpG methylation probes that were pre-processed by applying different basic filters to remove the useless probes, resulting in a final series of 355,314 CpG probes. A total of 6387 CpG probes were included in the overall signature we created and we labeled this set ImmuneAngioICIs. On such 6387 CpG probes, a first RF was created (Figure A3), and an out-of-sample MCC of 523 was obtained on the test set V (see Table 4).
Based on a recent review evaluating prognostic genes for GBM [38], we evaluated the possibility of including a second model called ImmuneAngioICIsMesECM as described in Section 2.2 [17,39,48]. This procedure created a new set of 6754 CpG probes that were evaluated to classify EDISON positive cases. This second model resulted in an out-of-sample MCC of 0.490.
Figure 3 shows the expression of genes included in the model (left panel), and average mean β value for each gene (right panel). While a clearly different expression can be explained for the EDISON classification, the average value for methylation seemed not to be sufficient to capture the methylation status. This result is in agreement with the complex modulation operated by the epigenetic regulation on gene expression. The resulting performance metrics are reported in Table 4. The model trained on ImmuneAngioICIsMesECM achieved a better out-of-sample accuracy, but a worse MCC.
The application of a further step of feature selection, with the adoption of Boruta, resulted in an improvement of the metrics achieved by the RF classifiers, with the best results achieved with the dataset ImmuneAngioICIsMesECM + BORUTA. The 338 CpGs are listed in Table A2. As reported in Table 4, by using these features selected by Boruta in the datasets ImmuneAngioICIs + BORUTA and ImmuneAngioICIsMesECM + BORUTA, we obtained an out-of-sample MCC on V I m m u n e A n g i o I C I s + B O R U T A and V I m m u n e A n g i o I C I s M e s E C M + B O R U T A of 0.469 and 0.589, respectively.
Moreover, we evaluated the model fed by all the CpGs, either with or without the adoption of Boruta, and we observed a deterioration in the metrics with respect to our best performing model, trained on ImmuneAngioICIsMesECM + BORUTA (Table 4). This evidence substantiates the validity and the effectiveness of the expert selection.
To further improve the model, we also considered the regional studies of the principal genomic localization such as CpG islands, shores, shelves and open sea. However, by this approach, no improvement in performance was obtained (Table A1). However, shore regions showed a better predictive power with respect to the other regions. This is consistent with previous studies which showed that these regions are more correlated with the regulation of gene expression. Figure 4 shows the genome-wide methylation landscape based on the selected 338 CpG probes, divided by the EDISON flag. Several differences in methylation can be appreciated between EDISON negative and EDISON positive cases. Moreover, in both EDISON positive and EDISON negative categories, GBM and LGG show different behaviours.

3.3. Deep Learning for the EDISON Classification

We evaluated the adoption of a deep learning model in place of the RF. Fixing the dataset to ImmuneAngioICIsMesECM + BORUTA, we tested both a feed-forward multilayer perceptron (MLP) and a 1D convolutional architecture. We observed better results with an MLP consisting of the input layer (338 neurons), two hidden layers (128 neuron each) and the output layer (1 neuron). Such MLP achieved an out-of-sample MCC of 0.658 and an accuracy of 0.828 on the test set V I m m u n e A n g i o I C I s M e s E C M + B O R U T A (Table 5), outperforming the RF model.
To assess the significance of the difference, we applied the McNemar test. We found that the difference in performance is significant, with a p value of 0.00952. This fact can also be visually appreciated by comparing the ROC curves (Figure 5).

3.4. Biological Significance of the Selected CpG Probes

To gain insight into the biological significance of the model, we verified if the selected CpGs in ImmuneAngioICIsMesECM + BORUTA were correlated with the phenotype we tried to predict by our models. To do so, we applied the g-profile tool [64] to search for an enrichment in GO terms associated with the 338 CpG probes translated in genes. As expected, the selected go-terms were mainly associated with ECM organization, immune response, and regulation of cell adhesion (see Table 6 and Figure A5).
Moreover, we performed an analysis of the genes related to the 338 CpG probes of ImmuneAngioICIsMesECM + BORUTA using STRING in the Cytoscape app (Figure A6). We found that the genes resulted in a linked network of protein–protein interaction (PPI) of 165 nodes and 4058 edges (Figure A5). We also evaluated the involvement of CpG methylation genes in the modulation of the gene expression of gliomas. In Table A8, the CpG probes highly correlated with gene expression are reported. Among these CpGs, we found correlation with genes belonging to angiogenesys pathway, ECM organization, immune response and checkpoint molecules. In Figure A7, several examples of positive and negative correlation are shown.
To perform a further selection of the most important CpG among the 338 in ImmuneAngioICIsMesECM + BORUTA, we applied random survival forest. The importance values obtained by the permutation analysis are depicted in Figure 6, while overall survival and progression free intervals are reported in Table A3 and Table A4, respectively.

3.5. Evaluation of the Transferability of the CpG Methylation Signature in Liquid Biopsy Samples

The methylation signature discussed in this study was obtained from primary glioma samples. However, although DNA methylation is tissue-specific, surrogate tissues such as blood are necessary due to the inaccessibility of human brain samples. Thus, we evaluated the possibility to obtain the genome-wide methylation using the blood to implement a liquid biopsy approach.
BECon (Blood–Brain Epigenetic Concordance; https://redgar598.shinyapps.io/BECon/ (accessed on 12 March 2020) is a tool that allows one to evaluate the concordance of CpGs between blood and brain, and to estimate how strongly a CpG is affected by the cell composition in both blood and brain. To perform such analyses, we imported the 338 CpGs of ImmuneAngioICIsMesECM + BORUTA on the BECon software tool and we selected the CpGs which varied in the most consistent way in the blood and in the brain. BECon select 113 CpG probes among 338. A LASSO Coxnet feature selection was then performed to detect the CpGs that can best explained both the overall survival (Figure A8, panel A) and the progression-free interval (Figure A8, panel B). Eighteen CpG probes were selected for the OS interval and eight for PFS (Table A6). The coefficients obtained from LASSO Coxnet were reported in Table A6. Positive values of coefficients were considered risk-associated in contrast to negative values which considered protective-associated. The GO terms analysis performed in positive and negative CpG associated probes is reported in Table A5.

4. Discussion

Gliomas are among the most common and aggressive primary tumors in adults [65]. Despite improved insight into the underlying molecular mechanisms, they are still hard to be treated and the prognosis of patients remains poor due to fast progress and scarcity of effective treatment strategies. The highly heterogeneous TME plays a substantial role in tumor malignancy and treatment responses. It is also related to the resistance of glioma cells to chemotherapy [10,59,66,67]. The glioma TME exerts a key role in tumor progression, in particular by providing an immunosuppressive state, with low number of TILs and of other immune effectors cell types as well as a high number of M2 macrophages, that contribute to tumor proliferation and growth [68]. Among the different processes regulating immune escape, TME-associated soluble factors, and/or cell surface-bound molecules are mostly responsible for dysfunctional activity of tumor-specific CD8+T cells. This TME immunosuppression could be involved in the capability of gliomas to respond to ICI treatment. A good understanding of TME and its mutual effects with tumor is important to reveal the treatment resistance mechanisms but also provide new strategies to improve the efficacy of these treatments including immunotherapies [61,69,70,71]. In this study, we systematically evaluated the possibility of creating an epigenetic model to stratify patients according to their capability to evade the immunosuppressive state peculiar of gliomas. We proposed the novel EDISON (EvaDe Immune SuppressiON) flag to summarize the contribution of macrophage M2 and Tregs in the immune suppressive state of gliomas. By comparing a random forest and two different neural network classifiers we showed the superiority of a multi-layer perceptron composed by two hidden layers. Such result is in agreement with that reported by other recent studies [72]. For most of the considered datasets and the models, we recorded higher metrics in the out-of-sample evaluation on the test set with respect to the cross-validation on the train set. This is a symptom of underfitting in the models. The most obvious and effective way to solve the issue, would be to include more samples in the dataset. Unfortunately, we were not able to find larger datasets to integrate our analysis. This could be considered as a limitation even if in an attempt to address the lack of an independent validation set, we followed the recommendations described in Shi et al. [43]. Moreover, further experiments are needed.
The proposed model could be used to predict the capability of the glioma patients to respond to immunotherapy such as ICIs. In this context, the employment of DNA methylation in place of RNA-seq data seems to provide a faster and more cost-effective approach.
Based on the results of the modelling, we defined a set of CpGs to be used as features: we proposed a final series of 338 CpGs related to genes belonging to ECM organization, immune response, angiogenesis and regulation of cell adhesion. Notably, the model trained on the 338 CpGs of ImmuneAngioICIsMesECM + BORUTA achieved better out-of-sample metrics than the ones trained on AllCpGs and AllCpGs + BORUTA. This evidence substantiates the validity and the effectiveness of the expert selection. Finally, we proposed a methylation signature that could be useful in the prediction of the clinical outcome of gliomas when liquid biopsy samples are used. Liquid biopsy represents a minimally invasive procedure that can provide similar information to what is usually obtained from a tissue biopsy samples. We found a small set of CpG (18 CpGs belong OS C and 8 CpGs PFS) that could be easily transferable to the laboratory routine for the classification of glioma patient by using BECon, a tool for interpreting DNA methylation features from blood. This could be useful in the management of glioma patients during the treatments. Moreover, several further suggestions could be highlighted regarding the involvement of the epigenetic modulation of the genes defined by the proposed model in key processes and mechanisms affecting the glioma pathogenesis and progression, such as ECM organization, immune response, angiogenesis and regulation of cell adhesion.

5. Conclusions

Despite the advances of molecular understanding and therapies that can be used for glioma treatment, clinical benefits have remained limited. A revelant role in treatment response is exerted by the TME in which the number of TILs and M2 macrophages is responsible for the degree of immunosuppression. In the present study, we proposed an epigenetic model to stratify patients according to their capability to evade the immune suppressive state called EDISON (EvaDe Immune SuppressiON) peculiar of gliomas. We demonstrated the superiority of the neural network composed by two hidden layers to classify the immunosuppressive state with respect to the random forest and convolutional approach. We also proposed a methylation signature that could be useful in the prediction of the clinical outcome of gliomas when liquid biopsy samples are used.

Author Contributions

Conceptualization: M.P.; methodology and formal analysis: M.P., E.F.; writing—original draft preparation, M.P., E.A., M.D.B., E.F., D.G., G.T.; writing—review and editing, M.P., L.B., F.D.C., M.M., M.S., M.A., T.I., G.T., E.A., M.D.B., M.A., M.S., G.T.; funding acquisition G.T. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

All the results here showed are based on data generated by the TCGA Research Network: https:/cancer.gov/tcga (accessed on 12 March 2020).

Acknowledgments

All the results here showed are based on data generated by the TCGA Research Network: https:/cancer.gov/tcga (accessed on 12 March 2020). For the processing of the data, tools provided by the Garr consortium were used as part of the agreement with the Ministry of Health for IRCCS, through the Garr Cloud Platform, a GDPR-compliant private-cloud system certified ISO 27001, ISO 27017 and ISO 27018 for information protection.

Conflicts of Interest

The authors declare no conflict of interest.

Abbreviations

The following abbreviations are used in this manuscript:
MDPIMultidisciplinary Digital Publishing Institute
DOAJDirectory of open access journals
TLAThree-letter acronym
LDLinear dichroism
TMETumor microenvironment
EDISONEvade immunosuppresion
TCGAThe Cancer Genome Atlas
GBMGlioblastoma
LGGLow-grade glioma
CIConfidence interval
MLPMulti-layer percerptron
RFRandom Forest
CNNConvolutional neural network
ECMExtracellular matrix
ICIsImmune checkpoint inhibitors
BEConBlood–Brain Epigenetic Concordance
MCCMatthew correlation coefficient
ACCAccuracy
TregsT regulatory cells
MDSCsMyeloid-derived suppressor cells
TAMsTumor-associated macrophages

Appendix A

Figure A1. (A) Kaplan–Meier survival curves showing OS interval based on the previously calculated flag on TCGA glioma patients with IDH wild-type status. Time is reported in days. (B) Kaplan–Meier survival curves showing OS intervals based on the previously calculated flag on TCGA glioma patients with IDH mutated. Time is reported in days. (C) Kaplan–Meier survival curves showing PFI interval based on the previously calculated flag on TCGA glioma patients. with IDH wild-type status. Time is reported in days. (D) Kaplan–Meier survival curves showing PFS intervals based on the previously calculated flag on TCGA glioma patients with IDH mutated. Time is reported in days.
Figure A1. (A) Kaplan–Meier survival curves showing OS interval based on the previously calculated flag on TCGA glioma patients with IDH wild-type status. Time is reported in days. (B) Kaplan–Meier survival curves showing OS intervals based on the previously calculated flag on TCGA glioma patients with IDH mutated. Time is reported in days. (C) Kaplan–Meier survival curves showing PFI interval based on the previously calculated flag on TCGA glioma patients. with IDH wild-type status. Time is reported in days. (D) Kaplan–Meier survival curves showing PFS intervals based on the previously calculated flag on TCGA glioma patients with IDH mutated. Time is reported in days.
Cells 10 00576 g0a1aCells 10 00576 g0a1b
Figure A2. Workflow for the development of a methylation-based machine learning model to predict the immune suppressive state responsiveness of glioma patients. (A) Development of the EDISON classification flag using transcriptomic data; (B) model construction on methylation dataset (Complete description present in Materials and Methods (Section 2.2).
Figure A2. Workflow for the development of a methylation-based machine learning model to predict the immune suppressive state responsiveness of glioma patients. (A) Development of the EDISON classification flag using transcriptomic data; (B) model construction on methylation dataset (Complete description present in Materials and Methods (Section 2.2).
Cells 10 00576 g0a2
Figure A3. Machine learning workflow for developing the classification model starting by glioma dataset composed by Human Methylation data (450 k) composed by brain low-grade glioma (LGG) patients and glioblastoma (GBM).
Figure A3. Machine learning workflow for developing the classification model starting by glioma dataset composed by Human Methylation data (450 k) composed by brain low-grade glioma (LGG) patients and glioblastoma (GBM).
Cells 10 00576 g0a3
Figure A4. ROC curves of some models for EDISON classification with the indication of dataset used and the machine learning model used. The out-of-sample AUC calculated on the test is also reported. Random Forest (RF); multi-layer perceptron (MLP); convolutional neural network (CNN).
Figure A4. ROC curves of some models for EDISON classification with the indication of dataset used and the machine learning model used. The out-of-sample AUC calculated on the test is also reported. Random Forest (RF); multi-layer perceptron (MLP); convolutional neural network (CNN).
Cells 10 00576 g0a4
Table A1. Model metrics in cross-validation (mean with confidence intervals) and on the test set using CpG probes derived from RNA. ACC: accuracy; MCC: Matthews Correlation, prec: Precision, recal: Recall Coefficient; CI: 95% studentized bootstrap confidence interval; RF: Random Forest.
Table A1. Model metrics in cross-validation (mean with confidence intervals) and on the test set using CpG probes derived from RNA. ACC: accuracy; MCC: Matthews Correlation, prec: Precision, recal: Recall Coefficient; CI: 95% studentized bootstrap confidence interval; RF: Random Forest.
ModelRegionsACC (CI)ACC TestMCC (CI)MCC Test
RFIImmuneAngioICIsMesECM-ISLAND0.724 (0.688–0.769)0.7470.460 (0.389–0.549)0.522
RFImmuneAngioICIsMesECM-OPENSEA0.725 (0.689–0.762)0.6910.456 (0.386–0.533)0.469
RFImmuneAngioICIsMesECM-SHORE0.749 (0.705–0.790)0.7740.501 (0.417–0.583)0.553
RFImmuneAngioICIsMesECM-SHELF0.758 (0.722–0.789)0.7470.529 (0.459–0.593)0.510
RFImmuneAngioICIs-ISLAND0.756 (0.716–0.792)0.7580.514 (0.439–0.587)0.518
RFImmuneAngioICIs-SHORE0.753 (0.710–0.798)0.7340.509 (0.422–0.598)0.536
RFImmuneAngioICIs- OPENSEA0.729 (0.757–0.700)0.7380.463 (0.406–0.520)0.490
RFImmuneAngioICIs-SHELF0.725 (0.685–0.763)0.7200.457 (0.373–0.537)0.543
Table A2. 338 CpG probes included in best model to classify patient according to the EDISON flag.
Table A2. 338 CpG probes included in best model to classify patient according to the EDISON flag.
CpGGene
cg01681098SENCR, FLI1
cg24457026GRN
cg13909178RP11-744N12.3 FLI1
cg03531211XXbac-BPG181M17.5, HLA-DMA
cg04917472CTSZ
cg21012874MMRN2, SNCG
cg13662634RALGPS1, ANGPTL2
cg17054708FBLN2
cg10453850AL645941.1, HLA-DMB, XXbac-BPG181M17.5
cg23008352COL4A1
cg24421410XXbac-BPG181M17.5, HLA-DMA
cg07852825GHSR
cg04499514C3AR1
cg16436782RP11-212E4.1, COL4A1
cg03677069MMRN2, SNCG
cg00215182C1QB
cg13353679AFF3, AC092667.2
cg14082886CD44
cg09552892MMRN2, SNCG
cg04275881SLAMF8
cg02072495ANXA2
cg00338116EPSTI1
cg10762214INPP5A
cg10070185SERPINA1
cg13810673GPR65
cg07857225PLXND1
cg11037750TGFB1
cg07450037HOTAIRM1, HOXA1, HOTAIRM1_1
cg22568423MYO1F
cg01436254CD86
cg17451419CYR61
cg18273417S100A4
cg18837947CCNG2
cg27565899AMPD2
cg07625783SLAMF8
cg13371976PRELP
cg24815934ITGB2
cg17599241VCAN-AS1, VCAN
cg10518264HLA-DMB, XXbac-BPG181M17.5
cg11800635DOK1, LOXL3
cg26357596GZMA
cg09456094SP100
cg11827097SP100
cg04131610CCR5, RP11-24F11.2
cg00609834SPON1
cg08076018RALGPS1, ANGPTL2
cg06746774KIAA1522
cg13700051TTC33
cg17928895CTSZ
cg15550100ATG4B
cg07251141ADAM12
cg26969179ADAM12
cg18245281CTSZ
cg00539174CTSZ
cg17571335FLI1
cg25428929ATG4B
cg01536987EPSTI1
cg20694619TRAF3IP3
cg03970350PES1, TCN2
cg13765206EMILIN2
cg04217515ITGB2
cg14994258PXDN
cg11029367HEG1
cg00765737COL4A2
cg07464217CTSZ
cg03075156PRKCE
cg08655071TRAF3IP3
cg00295382MYCL
cg14903689COL18A1
cg19408145CD48
cg17420036HSPG2
cg18274749HSPG2
cg07436701MMRN2, SNCG
cg02744249CTSZ
cg22116670CTB-113P19.1, SPARC
cg24192663HSPA6, RP11-25K21.6, FCGR2A
cg13785221ANXA2
cg17801352PXDN
cg05887821INPP5A
cg18411043LAPTM5
cg03478249EPSTI1
cg21936552BAHCC1
cg05200628CD48
cg01930947C1orf111, RP11-565P22.6, C1orf226
cg10330169DIS3L2
cg10587741LGALS1
cg24539923SERPINE1
cg10768321CTC-301O7.4, CD37
cg09538921IL27RA, CTB-55O6.4
cg18968623INPP5A
cg08064683FAT1
cg06330722PCOLCE, PCOLCE-AS1
cg10307548SOD3
cg09707038CALM2, RP11-761B3.1
cg16024530FLI1
cg13790288CD28
cg08139855CSF1
cg19919590LAPTM5
cg20600379HLA-DMB, XXbac-BPG181M17.5
cg24375627S100A6
cg12339920TGFBI
cg27617132INPP5A
cg03682712LOXL1, LOXL1-AS1
cg21746573PRKCE
cg19506628CEP72
cg17319576CYR61
cg17911539C3orf22, CHST13
cg04232128TMEM173
cg05360958C12orf60, MGP
cg04755674IL27RA, CTB-55O6.4
cg03013554ITGB2
cg04297819HSPG2
cg00799121ADAMTS2
cg08321366MMP14
cg19722814SERPINE1
cg14943796BAHCC1
cg04771838COL4A2
cg11581627CD33
cg14991595MB21D2
cg15347156MMRN2
cg04153551FBLN5
cg06222012AC078941.1, AC023115.2
cg04244970SLAMF7
cg22704788PRELP
cg21043746ADAMTS2
cg26532826PES1, TCN2
cg13962321HIST2H2BB, RP5-998N21.7, RP5-998N21.10
cg11702456SP100
cg09076123NCF2, SMG7
cg08825225FLI1
cg17713010LAIR1
cg15522984LAMC1
cg08682341INPP5A
cg03813885CFAP97, SNX25
cg10845380SLC7A7
cg12613839ADAMTS2
cg02588309TTC33
cg02189760CTC-301O7.4, CD37
cg16925003PXDN
cg07947930PRELP
cg06410158INPP5A
cg24644113TADA1
cg27547543POU5F1
cg21860679DUSP6, RP11-823E8.3
cg27329371ALDH3A1
cg00771084ATG4B
cg11594010INPP5A
cg11301254TTC33
cg09926389TGFB1
cg03982087RAB31
cg02286081HLA-DPA1, HLA-DPB1
cg26025068PPP1R8
cg00078334MMP2
cg23638686INPP5A
cg19755435GPR65
cg08530414RP4-607I7.1, CD44
cg15999547TMEM54, HPCA
cg26214645SECTM1
cg25206536MIR572
cg20502977COL6A3
cg23659056FOXD2, FOXD2-AS1
cg23986671ADAMTS5
cg26138144LGALS1
cg07855465BAHCC1
cg03196766THBS1
cg17859552INPP5A
cg18900669RP11-186B7.4, CD68
cg19915711EPSTI1
cg10974980LOXL1
cg08612539CTA-833B7.2, NCF4
cg18397405GPC6
cg00450164TRAF3IP3
cg26650846ADAMTS2
cg04098585CD28
cg16826739INPP5A
cg24767336TGFB1, CTC-435M10.3, TMEM91
cg03006477CD109
cg16713274COL18A1, LL21NC02-21A1.1
cg25450450CTB-118N6.2, SEMA6A
cg09277376FOXD2-AS1
cg03440588FOXD2, FOXD2-AS1
cg24129356XXbac-BPG181M17.5, HLA-DMA
cg16121744COL18A1
cg14139008DNM1
cg24226528TMEM37
cg11875119PES1, TCN2
cg01508380MMP14
cg09280946CTSC
cg02543462IL1RN
cg00142150LGALS1
cg21005525ARF1
cg07697770TGFBI
cg03930369COL4A2
cg06671298BAHCC1
cg15254671MYO1F
cg00292662LGALS1
cg21236655TNC
cg07724259EMILIN2
cg23865240HOTAIRM1, HOXA1
cg09321817HLA-DPA1
cg18595867FOXD2-AS1
cg22158252BMP8A
cg27438456INPP5A
cg07085815SERPINE2
cg18644834ANKRA2, UTP15
cg24287218HLA-DPA1
cg24707889ITGB2, ITGB2-AS1
cg09269866FOXD2, FOXD2-AS1
cg03753191EPSTI1
cg22716262MPP7
cg22595235SUMF1, LRRN1
cg19575208HLA-DRB1
cg06507307INPP5A
cg13939271DNM1
cg23225572RP11-565P22.6, NOS1AP, C1orf226
cg11197101KIAA1522
cg21869219ARHGAP31
cg10954654CTSS
cg20481110SECTM1
cg11804789CST7
cg25214684AKIRIN1
cg15114672VCAN
cg00516966ALDH3A1
cg14791054RP11-66B24.4, ALDH1A3
cg00816609FBLN2
cg03055440MS4A6A
cg21218883PRKCE
cg02458945MMP2
cg22118297ADAMTS9, ADAMTS9-AS1
cg20640433LAMA2
cg12689670LAMC1
cg03573861BAHCC1
cg07438421SERPINF1
cg05822532ELN
cg15849060ALDH3A1
cg02784696C2orf44, MFSD2B
cg26399819MIER3
cg18832223CEP72
cg09777237ELN
cg15504747PLXND1
cg01338658LAMC1
cg00894134DNM1
cg25306579INPP5A
cg00532319RPN1
cg07906179BAHCC1
cg24493834LAMA2, MESTP1
cg22136020CSPG4
cg01320433XXyac-YX65C7_A.2, THBS2
cg10989879CFAP97, SNX25
cg15459165LAPTM5
cg01623438CTSZ
cg12253414ITGB5
cg00777079SERPINF1
cg08638320FOXD2, FOXD2-AS1
cg05831823CR2
cg12630520SPARCL1
cg23446438MYO1F
cg06728055WWTR1
cg05492532INPP5A
cg09545579BAHCC1
cg26204079RP11-400N9.1, DGKD
cg14291900SLC7A7
cg21475610CCNG2
cg07575373CTC-301O7.4, CD37
cg05658236FOXD2-AS1
cg15046675CTC-301O7.4, CD37
cg22216491CASP6
cg05091653SP100
cg11076970HLA-DOA
cg26262232XXbac-BPG181M17.5, HLA-DMA
cg25645491HLA-DRA
cg23173573DUSP10
cg14880894CNOT6L
cg02316283MMP14
cg05041061BAHCC1
cg12937501AC106875.1, LPIN1
cg26034531LPPR5, RP5-896L10.1
cg06390079ALDH3A1
cg01120369PLXND1
cg18764513SLC7A7
cg05830842COL14A1
cg11728145PXDN
cg07659054HOTAIRM1, HOXA1
cg13802966CASP1
cg13865810COL15A1, RP11-92C4.6
cg07623567HLA-DMB, XXbac-BPG181M17.5
cg11912272SPATS2L
cg17016011INPP5A
cg00416645AC007563.5, IGFBP5
cg01997629TRAF3IP3
cg10928302RBM6, RBM5
cg02957057NID1
cg17081489RP4-798P15.3, SEC16B
cg10001720LAPTM5
cg20407868INPP5A
cg24769499TMEM37
cg26350754HLA-DPA1, HLA-DPB1
cg10949632GPC6
cg22905097EPSTI1
cg26066361CLEC7A
cg09099927RP11-333E13.4
cg17611512COL18A1, COL18A1-AS1
cg13477614BAHCC1
cg25913233CTB-113P19.1, SPARC
cg07616471CCR5, RP11-24F11.2
cg04654716CTD-2377O17.1, FAM169A
cg08471739PLXND1
cg27297192INPP5A
cg04851268GHSR
cg24931346C1QB
cg21784272FAT1
cg22987448MYO1F
cg22164238AMPD2, GNAT2
cg08288016FAT1
cg21398469CCNG2
cg22384395RP11-66B24.9, ALDH1A3
cg05710142KIAA1522
cg21904489ARHGAP31
cg01975495SERPINE1
cg12917072ADAMTS12
cg03393607AFF3, AC092667.2
cg01821226PXDN
cg05955301PRELP
cg27470554FCGR2A
cg06238491LAIR1
cg22695532RP11-475O6.1
cg00742851SUMF1, LRRN1
cg27553626PPP1R8
cg25394505INPP5A
cg08735211XXbacBPG181M17.5, HLA-DMA
cg09983885TRIM21
cg26514080KIAA1522
cg05886789PLXDC2
cg05826823CIZ1, DNM1
cg20367923XXyac-YX65C7_A.2, THBS2
cg24023498NR4A2
cg16239257LTBP2
cg17331738NES
Table A3. Top features detected by permutation analysis from Random Survival Forest using PFS selected by 338 CpG probes.
Table A3. Top features detected by permutation analysis from Random Survival Forest using PFS selected by 338 CpG probes.
FeatureWeightstdGeneDirection
cg024589450.001671490.0004095MMP2Positive
cg034782490.002457780.00088256EPSTI1Positive
cg041316100.003238430.00146985CCR5, RP11-24F11.2Positive
cg042175150.002003110.00073152ITGB2Positive
cg042449700.001665190.00067762SLAMF7Positive
cg050916530.002162620.00032063SP100Positive
cg058878210.002169720.00032553INPP5APositive
cg076235670.002104980.00037064HLA-DMB, XXbac-BPG181M17.5Positive
cg086125390.001853250.00028535CTA-833B7.2, NCF4Positive
cg090761230.001653260.0007419NCF2, SMG7Positive
cg103075480.002949710.00098171SOD3Positive
cg103301690.004189320.00097532DIS3L2Positive
cg111971010.002277630.00036055KIAA1522Positive
cg138658100.001765050.00045972COL15A1, RP11-92C4.6Positive
cg164367820.003908910.00123599RP11-212E4.1, COL4A1Positive
cg173317380.002649990.00031466NESPositive
cg197228140.001840120.00034522SERPINE1Positive
cg214756100.003375690.00100237CCNG2Positive
cg241926630.002032060.00052522HSPA6, RP11-25K21.6, FCGR2APositive
cg248159340.002837110.00098436ITGB2Positive
cg00450164−2.33 × 10 5 0.00011302TRAF3IP3Negative
cg00532319−5.25 × 10 5 9.97 × 10 5 RPN1Negative
cg00539174−1.10 × 10 5 0.0001254CTSZNegative
cg01623438−0.00011470.00016634CTSZNegative
cg23008352−6.65 × 10 5 0.00011621COL4A1Negative
Table A4. Top features detected by permutation analysis from Random Survival Forest using OS interval selected by 338 CpG probes.
Table A4. Top features detected by permutation analysis from Random Survival Forest using OS interval selected by 338 CpG probes.
FeatureWeightstdGeneDirection
cg01436254−0.00032910.00023658CD86Negative
cg03006477−0.0001430.00015906CD109Negative
cg03970350−0.00026180.0001385PES1, TCN2Negative
cg04098585−0.00023418.09 × 10 5 CD28Negative
cg04131610−0.00017560.00013193CCR5, RP11-24F11.2Negative
cg04217515−0.00035240.00027475ITGB2Negative
cg05200628−0.00035550.00013671CD48Negative
cg06728055−0.00021690.00021168WWTR1Negative
cg07625783−0.00025878.14 × 10 5 SLAMF8Negative
cg08321366−0.00025040.0001037MMP14Negative
cg08471739−0.00027630.00018392PLXND1Negative
cg11800635−0.00019980.00016978DOK1, LOXL3Negative
cg13939271−0.00020590.00018542DNM1Negative
cg14903689−0.00013550.00015751COL18A1Negative
cg16121744−0.00014520.00012391COL18A1Negative
cg17859552−0.00032780.00012804INPP5ANegative
cg19755435−0.00017860.00014323GPR65Negative
cg22384395−0.00020370.00018963RP11-66B24.9, ALDH1A3Negative
cg24421410−0.00017166.39 × 10 5 XXbac-BPG181M17.5, HLA-DMANegative
cg26066361−0.00015660.00031627CLEC7ANegative
cg002953820.000697850.00031361MYCLPositive
cg007770790.001948780.00093506SERPINF1Positive
cg019309470.002141950.00092059C1orf111, RP11-565P22.6, C1orf226Positive
cg029570570.000746690.00018464NID1Positive
cg031967660.002185070.00059328THBS1Positive
cg042978190.000818850.00047748HSPG2Positive
cg044995140.001422540.00078907C3AR1Positive
cg050916530.000806970.00048847SP100Positive
cg062220120.001359620.00059195AC078941.1, AC023115.2Positive
cg117024560.00289370.00103411SP100Positive
cg118270970.002013460.00095397SP100Positive
cg137652060.001581380.00079435EMILIN2Positive
cg140828860.000792450.00050107CD44Positive
cg142919000.001812380.00080766SLC7A7Positive
cg167132740.000667930.00025659COL18A1, LL21NC02-21A1.1Positive
cg184110430.00190830.00079707LAPTM5Positive
cg206404330.000887050.00032218LAMA2Positive
cg212188830.000945130.00049267PRKCEPositive
cg239866710.000696970.00025722ADAMTS5Positive
cg247694990.001162930.00021175TMEM37Positive
Table A5. Gene ontology (GO) that define biological function. The GO annotations, accompanied by evidence-based statements describe specific gene product and specific ontology term (biological function). g-profile enrichment terms obtained from positive and negative values of 18 CpGs selected from BECon on overal survival by LASSO procedure. All the data have p value low than 0.05. MF: molecular function, CC: cellular component, BP: biological process.
Table A5. Gene ontology (GO) that define biological function. The GO annotations, accompanied by evidence-based statements describe specific gene product and specific ontology term (biological function). g-profile enrichment terms obtained from positive and negative values of 18 CpGs selected from BECon on overal survival by LASSO procedure. All the data have p value low than 0.05. MF: molecular function, CC: cellular component, BP: biological process.
SourceTerm_NAMETerm_idAdjusted_p_ValueNegative_log10_of _Adjusted_p_ValueDirection Coefficient
GO:MFglycosaminoglycan bindingGO:00055390.0087882870855782.05609576449095Negative
GO:CCcollagen-containing extracellular matrixGO:00620230.0484743220929451.31448825575832Negative
KEGGECM-receptor interactionKEGG:045120.0372331884081271.42906977203396Negative
CORUMCD44-LRP1 complexCORUM:75350.0496980195541431.30366091738024Negative
GO:MFgrowth hormone secretagogue receptor activityGO:00016160.0497756115431611.3029833955258Positive
GO:BPregulation of neurotransmitter receptor localization to postsynaptic specialization membraneGO:00986960.0001670049249343.77727072142761Positive
GO:BPregulation of receptor localization to synapseGO:19026830.0011686450631962.93231737121765Positive
GO:BPprotein localization to postsynaptic specialization membraneGO:00996330.0013355449088792.8743415038609Positive
GO:BPneurotransmitter receptor localization to postsynaptic specialization membraneGO:00996450.0013355449088792.8743415038609Positive
GO:BPregulation of protein localization to synapseGO:19024730.0030708434277372.51274232624767Positive
GO:BPprotein localization to postsynaptic membraneGO:19035390.0070064186204252.15450391795907Positive
GO:BPprotein localization to postsynapseGO:00622370.0091177759964352.04011108165666Positive
GO:BPresponse to dexamethasoneGO:00715480.0091177759964352.04011108165666Positive
GO:BPregulation of postsynaptic membrane neurotransmitter receptor levelsGO:00990720.0136165246672611.86593372285098Positive
GO:BPreceptor localization to synapseGO:00971200.0136165246672611.86593372285098Positive
GO:BPprotein localization to synapseGO:00354180.0333452886572731.47696551870962Positive
Figure A5. Enrichment of GO terms from 338 CpG probes obtained from the best model. GO terms are plotted according to adjusted p-values (BH). Bar sizes represent the number of CpGs translated as genes that fall within a GO category; DE and colour represent the adjusted p-values (BH).
Figure A5. Enrichment of GO terms from 338 CpG probes obtained from the best model. GO terms are plotted according to adjusted p-values (BH). Bar sizes represent the number of CpGs translated as genes that fall within a GO category; DE and colour represent the adjusted p-values (BH).
Cells 10 00576 g0a5
Figure A6. Protein–protein interaction (PPI) network of the genes from 338 CpG probes of ImmuneAngioICIsMesECM + BORUTA using STRING in the Cytoscape app [50].
Figure A6. Protein–protein interaction (PPI) network of the genes from 338 CpG probes of ImmuneAngioICIsMesECM + BORUTA using STRING in the Cytoscape app [50].
Cells 10 00576 g0a6
Figure A7. Correlation between CpG probes selected among 338 CpGs with gene expression of some revelant genes. On the x-axis, the methylation status is reported, on the y-axis, RNA expression values are reported. Correlation values by Pearson and p-value are reported for each panel.
Figure A7. Correlation between CpG probes selected among 338 CpGs with gene expression of some revelant genes. On the x-axis, the methylation status is reported, on the y-axis, RNA expression values are reported. Correlation values by Pearson and p-value are reported for each panel.
Cells 10 00576 g0a7aCells 10 00576 g0a7b
Figure A8. Feature selection using LASSO COXNET of the 113 CpGs selected by BECon. The 18 CpGs selected for OS (A) and 8 for PFS interval (B) are reported.
Figure A8. Feature selection using LASSO COXNET of the 113 CpGs selected by BECon. The 18 CpGs selected for OS (A) and 8 for PFS interval (B) are reported.
Cells 10 00576 g0a8aCells 10 00576 g0a8b
Table A6. Feature selection with the coefficient value and gene name of CpG probe selected by LASSO COXNET in the context of the developed signature for liquid biopsy based on BECon.
Table A6. Feature selection with the coefficient value and gene name of CpG probe selected by LASSO COXNET in the context of the developed signature for liquid biopsy based on BECon.
CpGCOEFFICIENTGENEINTERVAL
cg01320433−0.1592041XXyac-YX65C7_A.2, THBS2PFS
cg01508380−0.33756425MMP14PFS
cg06222012−0.5359208AC078941.1, AC023115.2PFS
cg06728055−0.07162224WWTR1PFS
cg11029367−0.30043008HEG1PFS
cg13371976−1.39825624PRELPPFS
cg22716262−0.04181589MPP7PFS
cg26066361−0.17464321CLEC7APFS
cg01320433−0.37578276XXyac-YX65C7_A.2, THBS2OS
cg02744249−0.5024627CTSZOS
cg04244970−0.11253157SLAMF7OS
cg048512680.96144542GHSROS
cg06222012−1.06780331AC078941.1, AC023115.2OS
cg074384210.31295409SERPINF1OS
cg08612539−0.90719367CTA-833B7.2, NCF4OS
cg08655071−0.10973404TRAF3IP3OS
cg109496320.5123932GPC6OS
cg13371976−1.01620416PRELPOS
cg14082886−1.13578356CD44OS
cg149437960.65287911BAHCC1OS
cg185958670.93613126FOXD2-AS1OS
cg20367923−0.03248293XXyac-YX65C7_A.2, THBS2OS
cg22116670−0.75216037CTB-113P19.1, SPARCOS
cg22695532−0.67502749RP11-475O6.1OS
cg26066361−1.14858784CLEC7AOS
cg263507540.88852671HLA-DPA1, HLA-DPB1OS
Table A7. Correlation of CpG probes with genes that have high correlation values from 338 CpGs used to create the model.
Table A7. Correlation of CpG probes with genes that have high correlation values from 338 CpGs used to create the model.
CpGgeneCpGGenerhop ValueCorrelation Strength
cg13353679AFF3, AC092667.2HAVCR20.675202412.65 × 10 7 high
cg13353679AFF3, AC092667.2CCR40.626985643.13 × 10 6 high
cg13353679AFF3, AC092667.2TGFB10.725336051.19 × 10 8 high
cg13353679AFF3, AC092667.2IL100.757081061.14 × 10 9 high
cg22568423MYO1FHAVCR20.63911641.75 × 10 6 high
cg22568423MYO1FTGFB10.619365674.45 × 10 6 high
cg22568423MYO1FIL100.658158886.66 × 10 7 high
cg17599241VCAN-AS1, VCANHAVCR20.62258383.84 × 10 6 high
cg17599241VCAN-AS1, VCANTGFB10.660563855.87 × 10 7 high
cg17599241VCAN-AS1, VCANIL100.710152353.25 × 10 8 high
cg08064683FAT1CCR40.609465636.94 × 10 6 high
cg08064683FAT1TGFB10.74826462.26 × 10 9 high
cg08064683FAT1IL100.660593455.86 × 10 7 high
cg00799121ADAMTS2HAVCR20.68332611.67 × 10 7 high
cg00799121ADAMTS2TGFB10.697086837.37 × 10 8 high
cg00799121ADAMTS2IL100.710089683.26 × 10 8 high
cg04153551FBLN5HAVCR20.66429754.81 × 10 7 high
cg04153551FBLN5CCR40.639226061.74 × 10 6 high
cg04153551FBLN5TGFB10.644627651.33 × 10 6 high
cg04153551FBLN5IL100.756541891.19 × 10 9 high
cg22704788PRELPHAVCR20.669989953.53 × 10 7 high
cg22704788PRELPTGFB10.648749711.08 × 10 6 high
cg22704788PRELPIL100.715014112.37 × 10 8 high
cg12613839ADAMTS2HAVCR20.705468624.38 × 10 8 high
cg12613839ADAMTS2TGFB10.709666833.35 × 10 8 high
cg12613839ADAMTS2PDCD1LG20.603134699.15 × 10 6 high
cg12613839ADAMTS2IL100.73238747.25 × 10 9 high
cg02189760CTC-301O7.4, CD37HAVCR20.642761431.46 × 10 6 high
cg02189760CTC-301O7.4, CD37TGFB10.650602939.85 × 10 7 high
cg02189760CTC-301O7.4, CD37IL100.685577851.46 × 10 7 high
cg07947930PRELPHAVCR20.664243324.82 × 10 7 high
cg07947930PRELPTGFB10.687394491.32 × 10 7 high
cg07947930PRELPPDCD1LG20.622139513.92 × 10 6 high
cg07947930PRELPIL100.66926653.68 × 10 7 high
cg27329371ALDH3A1HAVCR20.630230072.68 × 10 6 high
cg27329371ALDH3A1TGFB10.6662984.32 × 10 7 high
cg27329371ALDH3A1PDCD1LG20.63183092.49 × 10 6 high
cg27329371ALDH3A1IL100.692205829.90 × 10 8 high
cg25206536MIR572HAVCR20.659670756.15 × 10 7 high
cg25206536MIR572TGFB10.654012048.27 × 10 7 high
cg25206536MIR572IL100.710590033.16 × 10 8 high
cg20502977COL6A3IL100.661115855.70 × 10 7 high
cg18397405GPC6CTLA40.629389672.79 × 10 6 high
cg18397405GPC6HAVCR20.645105351.30 × 10 6 high
cg18397405GPC6CCR40.656230647.37 × 10 7 high
cg18397405GPC6TGFB10.755782341.26 × 10 9 high
cg18397405GPC6IL100.766136125.48 × 10 10 high
cg16121744COL18A1HAVCR20.765622895.72 × 10 10 high
cg16121744COL18A1TGFB10.729257229.04 × 10 9 high
cg16121744COL18A1IL100.772145353.31 × 10 10 high
cg15254671MYO1FHAVCR20.738270554.76 × 10 9 high
cg15254671MYO1FIL100.705992244.24 × 10 8 high
cg22595235SUMF1, LRRN1CTLA40.610782046.55 × 10 6 high
cg09777237ELNHAVCR20.672502053.08 × 10 7 high
cg09777237ELNTGFB10.615886285.21 × 10 6 high
cg09777237ELNIL100.680550031.96 × 10 7 high
cg21475610CCNG2TGFB10.687928151.28 × 10 7 high
cg21475610CCNG2IL100.64703731.18 × 10 6 high
cg11076970HLA-DOACCL220.685676251.46 × 10 7 high
cg17611512COL18A1, COL18A1-AS1HAVCR20.674463872.76 × 10 7 high
cg17611512COL18A1, COL18A1-AS1TGFB10.755624881.28 × 10 9 high
cg17611512COL18A1, COL18A1-AS1IL100.766220665.44 × 10 10 high
cg22987448MYO1FHAVCR20.708352563.65 × 10 8 high
cg22987448MYO1FTGFB10.632487972.41 × 10 6 high
cg22987448MYO1FIL100.708351423.65 × 10 8 high
cg21398469CCNG2TGFB10.611267936.41 × 10 6 high
cg05955301PRELPHAVCR20.649151581.06 × 10 6 high
cg05955301PRELPTGFB10.6584976.55 × 10 7 high
cg05955301PRELPIL100.690429871.10 × 10 7 high
cg00742851SUMF1, LRRN1HAVCR20.641087211.59 × 10 6 high
cg00742851SUMF1, LRRN1CCR40.651026229.64 × 10 7 high
cg00742851SUMF1, LRRN1TGFB10.732936126.98 × 10 9 high
cg00742851SUMF1, LRRN1IL100.751679281.74 × 10 9 high
Table A8. Correlation among 338 CpG probes with gene expression of paired sample that present a high correlation value and significant p value.
Table A8. Correlation among 338 CpG probes with gene expression of paired sample that present a high correlation value and significant p value.
CpGGenerhop ValueCpGgeneMagnitude
cg02957057DEFB1260.99984824 4.85 × 10 79 NID1high
cg20640433LRRIQ4−0.8429582 2.00 × 10 13 LAMA2high
cg02957057ZDHHC8P1−0.8399142 2.96 × 10 13 NID1high
cg23986671KRTAP6-30.83840023 3.58 × 10 13 ADAMTS5high
cg20640433TXK−0.8184023 3.75 × 10 12 LAMA2high
cg20640433NLRP14−0.8100527 9.19 × 10 12 LAMA2high
cg20640433DEFB1260.80488085 1.57 × 10 11 LAMA2high
cg16713274OR56A50.79052422 6.38 × 10 11 COL18A1high
cg02957057RFESD−0.7883283 7.83 × 10 11 NID1high
cg02957057MMACHC−0.7871875 8.70 × 10 11 NID1high
cg20640433GRP−0.7852917 1.04 × 10 10 LAMA2high
cg02957057ISPD−0.7804697 1.60 × 10 10 NID1high
cg02957057OSBPL9−0.7789042 1.84 × 10 10 NID1high
cg20640433FBXO17−0.7746792 2.66 × 10 10 LAMA2high
cg16121744IL100.77214535 3.31 × 10 10 COL18A1high
cg18397405CCR50.76767048 4.82 × 10 10 GPC6high
cg18397405CD960.7668386 5.17 × 10 10 GPC6high
cg17611512IL100.76622066 5.44 × 10 10 COL18A1high
cg18397405IL100.76613612 5.48 × 10 10 GPC6high
cg16121744HAVCR20.76562289 5.72 × 10 10 COL18A1high
cg02957057PCGEM10.76170335 7.88 × 10 10 NID1high
cg02957057ANKRD7−0.7606609 8.57 × 10 10 NID1high
cg13353679IL100.75708106 1.14 × 10 9 AFF3, AC092667.2high
cg04153551IL100.75654189 1.19 × 10 9 FBLN5high
cg18397405TGFB10.75578234 1.26 × 10 9 GPC6high
cg17611512TGFB10.75562488 1.28 × 10 9 COL18A1, COL18A1-AS1high
cg18397405ITGB20.75480536 1.37 × 10 9 GPC6high
cg20640433FAHD2B−0.7544591 1.40 × 10 9 LAMA2high
cg00742851IL100.75167928 1.74 × 10 9 SUMF1, LRRN1high
cg23986671TAF1L−0.7511669 1.81 × 10 9 ADAMTS5high
cg08064683TGFB10.7482646 2.26 × 10 9 FAT1high
cg20640433IL22RA1−0.7447273 2.96 × 10 9 LAMA2high
cg18411043GIMAP50.74431857 3.05 × 10 9 LAPTM5high
cg02957057FRMPD2−0.7389076 4.54 × 10 9 NID1high
cg02957057FAHD2B−0.7387551 4.59 × 10 9 NID1high
cg15254671HAVCR20.73827055 4.76 × 10 9 MYO1Fhigh
cg18397405CD1630.73748155 5.04 × 10 9 GPC6high
cg16713274C6orf132−0.7366047 5.37 × 10 9 COL18A1high
cg20640433ZDHHC8P1−0.7353041 5.89 × 10 9 LAMA2high
cg02957057MAP1LC3A−0.7341328 6.41 × 10 9 NID1high
cg00742851TGFB10.73293612 6.98 × 10 9 SUMF1, LRRN1high
cg12613839IL100.7323874 7.25 × 10 9 ADAMTS2high
cg18411043WDR76−0.7298891 8.65 × 10 9 LAPTM5high
cg16121744TGFB10.72925722 9.04 × 10 9 COL18A1high
cg18411043SALL3−0.7280974 9.80 × 10 9 LAPTM5high
cg20640433GUCY2D−0.7279513 9.90 × 10 9 LAMA2high
cg20640433ALDH7A1−0.7273038 1.04 × 10 8 LAMA2high
cg13353679TGFB10.72533605 1.19 × 10 8 AFF3, AC092667.2high
cg18397405CD740.72520583 1.20 × 10 8 GPC6high
cg14291900SFMBT20.72226357 1.46 × 10 8 SLC7A7high
cg22704788IL100.71501411 2.37 × 10 8 PRELPhigh
cg02957057DPEP3−0.7149296 2.38 × 10 8 NID1high
cg20640433C17orf82−0.7134266 2.63 × 10 8 LAMA2high
cg18411043KCNK60.71200028 2.89 × 10 8 LAPTM5high
cg02957057N6AMT2−0.7119956 2.89 × 10 8 NID1high
cg02957057SLC25A20−0.7113793 3.00 × 10 8 NID1high
cg18397405CD140.71124306 3.03 × 10 8 GPC6high
cg25206536IL100.71059003 3.16 × 10 8 MIR572high
cg02957057ITPRIPL1−0.7102111 3.24 × 10 8 NID1high
cg17599241IL100.71015235 3.25 × 10 8 VCAN-AS1, VCANhigh
cg00799121IL100.71008968 3.26 × 10 8 ADAMTS2high
cg20640433SVOPL−0.7100842 3.27 × 10 8 LAMA2high
cg12613839TGFB10.70966683 0.35 × 10 8 ADAMTS2high
cg22987448HAVCR20.70835256 3.65 × 10 8 MYO1Fhigh
cg22987448IL100.70835142 3.65 × 10 8 MYO1Fhigh
cg18397405CD680.70783649 3.77 × 10 8 GPC6high
cg18411043TGFBR20.70621641 4.18 × 10 8 LAPTM5high
cg15254671IL100.70599224 4.24 × 10 8 MYO1Fhigh
cg12613839HAVCR20.70546862 4.38 × 10 8 ADAMTS2high
cg04499514PDIA6−0.7048045 4.57 × 10 8 C3AR1high
cg20640433C9orf64−0.7042363 4.74 × 10 8 LAMA2high
cg02957057SLC35F3−0.7035707 4.94 × 10 8 NID1high
cg02957057POTEA0.70296616 5.13 × 10 8 NID1high
cg18411043IGFBP60.70161792 5.58 × 10 8 LAPTM5high
cg23986671TWIST2−0.7011775 5.73 × 10 8 ADAMTS5high
cg02957057OR10G70.70091288 5.83 × 10 8 NID1high
cg14291900FGD30.70047149 5.99 × 10 8 SLC7A7high
cg18397405GPR650.70013203 6.11 × 10 8 GPC6high
cg23986671MYOZ2−0.6993028 6.43 × 10 8 ADAMTS5high
cg23986671PDE6C−0.6980551 6.95 × 10 8 ADAMTS5high
cg00799121TGFB10.69708683 7.37 × 10 8 ADAMTS2high
cg20640433AREG−0.6964744 7.65 × 10 8 LAMA2high
cg20640433NMNAT3−0.6951494 8.29 × 10 8 LAMA2high
cg20640433XKR8−0.6950749 8.33 × 10 8 LAMA2high
cg20640433SLC25A440.69436599 8.69 × 10 8 LAMA2high
cg02957057ANKK1−0.6934215 9.20 × 10 8 NID1high
cg18397405GRN0.69317267 9.34 × 10 8 GPC6high
cg18411043TNFRSF10D0.6931024 9.38 × 10 8 LAPTM5high
cg18411043KIF22−0.6926606 9.63 × 10 8 LAPTM5high
cg20640433HDHD3−0.6922066 9.90 × 10 8 LAMA2high
cg27329371IL100.69220582 9.90 × 10 8 ALDH3A1high
cg18411043C19orf57−0.6912927 1.05 × 10 7 LAPTM5high
cg18411043SERPINB90.69077738 1.08 × 10 7 LAPTM5high
cg05955301IL100.69042987 1.10 × 10 7 PRELPhigh
cg18411043CACNA2D40.6878496 1.28 × 10 7 LAPTM5high
cg21475610TGFB10.68792815 1.28 × 10 7 CCNG2high
cg20640433SSH3−0.6876975 1.29 × 10 7 LAMA2high
cg07947930TGFB10.68739449 1.32 × 10 7 PRELPhigh
cg18411043CLDN230.68678752 1.36 × 10 7 LAPTM5high
cg02957057ZNF683−0.6867046 1.37 × 10 7 NID1high
cg02189760IL100.68557785 1.46 × 10 7 CTC-301O7.4, CD37high
cg11076970CCL220.68567625 1.46 × 10 7 HLA-DOAhigh
cg13765206AMN−0.6852093 1.50 × 10 7 EMILIN2high
cg02957057ISG20L20.68458461 1.55 × 10 7 NID1high
cg20640433MAP1LC3A−0.683593 1.64 × 10 7 LAMA2high
cg18397405CCL50.68360635 1.64 × 10 7 GPC6high
cg00799121HAVCR20.6833261 1.67 × 10 7 ADAMTS2high
cg18411043MKS1−0.6816571 1.84 × 10 7 LAPTM5high
cg18411043IL4R0.68111791 1.89 × 10 7 LAPTM5high
cg09777237IL100.68055003 1.96 × 10 7 ELNhigh
cg18411043GIMAP60.68005964 2.01 × 10 7 LAPTM5high
cg02957057STK33−0.6799005 2.03 × 10 7 NID1high
cg02957057PYDC20.67988313 2.03 × 10 7 NID1high
cg20640433MYD88−0.6798431 2.04 × 10 7 LAMA2high
cg14291900PIK3IP10.67958882.07 × 10 7 SLC7A7high
cg18411043NUSAP1−0.67943552.08 × 10 7 LAPTM5high
cg23986671RFPL3S−0.67941462.09 × 10 7 ADAMTS5high
cg20640433HEBP1−0.67898052.14 × 10 7 LAMA2high
cg04499514RUNX1−0.67820382.23 × 10 7 C3AR1high
cg18397405GZMA0.677852532.28 × 10 7 GPC6high
cg02957057FAM19A1−0.67720022.37 × 10 7 NID1high
cg02957057SPRR1A0.676680582.44 × 10 7 NID1high
cg20640433MSN−0.67617212.51 × 10 7 LAMA2high
cg11827097PTK60.675300722.63 × 10 7 SP100high
cg13353679HAVCR20.675202412.65 × 10 7 AFF3, AC092667.2high
cg20640433SH3RF2−0.67495812.68 × 10 7 LAMA2high
cg17611512HAVCR20.674463872.76 × 10 7 COL18A1, COL18A1-AS1high
cg20640433PACSIN3−0.67386272.85 × 10 7 LAMA2high
cg02957057CMBL−0.6732382.95 × 10 7 NID1high
cg18411043MCTP20.673003022.99 × 10 7 LAPTM5high
cg07436701CD74−0.67299082.99 × 10 7 MMRN2, SNCGhigh
cg14082886PPP1R15A−0.67271443.04 × 10 7 CD44high
cg18411043NCAPD3−0.67262253.06 × 10 7 LAPTM5high
cg09777237HAVCR20.672502053.08 × 10 7 ELNhigh
cg02957057TYSND1−0.67160863.23 × 10 7 NID1high
cg04499514TSPO−0.67092733.35 × 10 7 C3AR1high
cg18411043TMEM87B0.670841183.37 × 10 7 LAPTM5high
cg23986671ZBTB32−0.67073263.39 × 10 7 ADAMTS5high
cg14291900ZNF71−0.6699913.53 × 10 7 SLC7A7high
cg22704788HAVCR20.669989953.53 × 10 7 PRELPhigh
cg18411043B3GNT20.669939263.54 × 10 7 LAPTM5high
cg07947930IL100.66926653.68 × 10 7 PRELPhigh
cg18411043MAPK130.668867093.76 × 10 7 LAPTM5high
cg20640433SHROOM1−0.66878243.77 × 10 7 LAMA2high
cg14291900ZNF134−0.66652284.27 × 10 7 SLC7A7high
cg27329371TGFB10.6662984.32 × 10 7 ALDH3A1high
cg07436701CCR5−0.66624344.33 × 10 7 MMRN2, SNCGhigh
cg18411043CYP1B10.665079744.61 × 10 7 LAPTM5high
cg18411043EMB0.664497184.76 × 10 7 LAPTM5high
cg04153551HAVCR20.66429754.81 × 10 7 FBLN5high
cg07947930HAVCR20.664243324.82 × 10 7 PRELPhigh
cg04499514MAPT0.664004294.89 × 10 7 C3AR1high
cg13765206ITCH0.662926285.18 × 10 7 EMILIN2high
cg20640433RFESD−0.66278525.22 × 10 7 LAMA2high
cg14082886CLVS20.662210875.38 × 10 7 CD44high
cg18411043CHEK1−0.6614723 5.59 × 10 7 LAPTM5high
cg11702456TAGLN2−0.6614648 5.60 × 10 7 SP100high
cg18397405CD2440.66144045 5.60 × 10 7 GPC6high
cg20502977IL100.66111585 5.70 × 10 7 COL6A3high
cg18411043PAPSS20.66103523 5.73 × 10 7 LAPTM5high
cg00295382MKRN3−0.6607885 5.80 × 10 7 MYCLhigh
cg08064683IL100.66059345 5.86 × 10 7 FAT1high
cg17599241TGFB10.66056385 5.87 × 10 7 VCAN-AS1, VCANhigh
cg23986671GCOM1−0.660442 5.91 × 10 7 ADAMTS5high
cg18411043LYVE10.6597996 6.11 × 10 7 LAPTM5high
cg25206536HAVCR20.65967075 6.15 × 10 7 MIR572high
cg14082886RGS90.65942308 6.24 × 10 7 CD44high
cg14082886NEK6−0.6591273 6.33 × 10 7 CD44high
cg18411043NUMB0.65897549 6.38 × 10 7 LAPTM5high
cg20640433SLC43A3−0.6588459 6.43 × 10 7 LAMA2high
cg23986671VTCN1−0.6588003 6.44 × 10 7 ADAMTS5high
cg20640433RFPL2−0.6584724 6.55 × 10 7 LAMA2high
cg05955301TGFB10.658497 6.55 × 10 7 PRELPhigh
cg22568423IL100.65815888 6.66 × 10 7 MYO1Fhigh
cg18397405CCR40.65623064 7.37 × 10 7 GPC6high
cg18397405CCR40.65623064 7.37 × 10 7 GPC6high
cg14291900YPEL20.65585997 7.51 × 10 7 SLC7A7high
cg20640433ZDHHC1−0.6557248 7.57 × 10 7 LAMA2high
cg18411043MAP3K80.6551703 7.79 × 10 7 LAPTM5high
cg02957057HSD17B7−0.6541632 8.21 × 10 7 NID1high
cg25206536TGFB10.65401204 8.27 × 10 7 MIR572high
cg18411043GAB1−0.6539384 8.30 × 10 7 LAPTM5high
cg18411043OIP5−0.6532665 8.59 × 10 7 LAPTM5high
cg04499514LGALS1−0.6531144 8.66 × 10 7 C3AR1high
cg23986671HYALP10.65295592 8.73 × 10 7 ADAMTS5high
cg02957057SCAMP30.65296148 8.73 × 10 7 NID1high
cg20640433DYNLT3−0.6527851 8.81 × 10 7 LAMA2high
cg04499514CD63−0.6526897 8.85 × 10 7 C3AR1high
cg04499514CD63−0.6526897 8.85 × 10 7 C3AR1high
cg18411043HIST1H4A−0.652456 8.96 × 10 7 LAPTM5high
cg18397405IGF10.65236854 9.00 × 10 7 GPC6high
cg14291900ZNF787−0.6523244 9.02 × 10 7 SLC7A7high
cg20640433SH2D4A−0.6513244 9.50 × 10 7 LAMA2high
cg23986671MMP1−0.6510743 9.62 × 10 7 ADAMTS5high
cg07436701ITGB2−0.6510564 9.63 × 10 7 MMRN2, SNCGhigh
cg00742851CCR40.65102622 9.64 × 10 7 SUMF1, LRRN1high
cg04499514RPS6KA50.65061879 9.84 × 10 7 C3AR1high
cg02189760TGFB10.65060293 9.85 × 10 7 CTC-301O7.4, CD37high
cg18411043CD590.65051987 9.89 × 10 7 LAPTM5high
cg18411043ST3GAL10.64986187 1.02 × 10 6 LAPTM5high
cg18411043ZNF620−0.6492829 1.05 × 10 6 LAPTM5high
cg04499514CRELD2−0.6492545 1.06 × 10 6 C3AR1high
cg05955301HAVCR20.64915158 1.06 × 10 6 PRELPhigh
cg20640433ACSF2−0.6487996 1.08 × 10 6 LAMA2high
cg02957057PARVA−0.6487478 1.08 × 10 6 NID1high
cg22704788TGFB10.64874971 1.08 × 10 6 PRELPhigh
cg16713274BCL2L10−0.6485899 1.09 × 10 6 COL18A1high
cg20640433SLC35F3−0.6482366 1.11 × 10 6 LAMA2high
cg14291900KLHL320.6481981 1.11 × 10 6 SLC7A7high
cg11702456RIPK1−0.6478933 1.13 × 10 6 SP100high
cg11702456PTK60.64795892 1.13 × 10 6 SP100high
cg14291900ZNF473−0.6477937 1.14 × 10 6 SLC7A7high
cg13765206CRNKL10.64734872 1.16 × 10 6 EMILIN2high
cg14291900AKAP8−0.6473027 1.16 × 10 6 SLC7A7high
cg18411043PSTPIP20.64723289 1.17 × 10 6 LAPTM5high
cg21475610IL100.6470373 1.18 × 10 6 CCNG2high
cg11702456RAB34−0.6468892 1.19 × 10 6 SP100high
cg02957057XKR8−0.6468834 1.19 × 10 6 NID1high
cg18411043LTBP20.64651112 1.21 × 10 6 LAPTM5high
cg18411043WHSC1−0.6464405 1.22 × 10 6 LAPTM5high
cg04499514SMAGP−0.6459406 1.25 × 10 6 C3AR1high
cg11827097RIPK1−0.6456769 1.26 × 10 6 SP100high
cg18411043B4GALT10.64554786 1.27 × 10 6 LAPTM5high
cg02957057UCHL1−0.6451568 1.30 × 10 6 NID1high
cg18397405HAVCR20.64510535 1.30 × 10 6 GPC6high
cg11702456EMP3−0.6447434 1.32 × 10 6 SP100high
cg18411043LILRB20.64470941 1.33 × 10 6 LAPTM5high
cg04153551TGFB10.64462765 1.33 × 10 6 FBLN5high
cg18411043PLK4−0.6445754 1.34 × 10 6 LAPTM5high
cg18411043TNFRSF10A0.64435812 1.35 × 10 6 LAPTM5high
cg13765206HPS1−0.6438577 1.38 × 10 6 EMILIN2high
cg02957057PPP1R3C−0.6439269 1.38 × 10 6 NID1high
cg13765206KLHDC7B−0.643828 1.39 × 10 6 EMILIN2high
cg18411043GPSM2−0.6430751 1.44 × 10 6 LAPTM5high
cg18411043POLA2−0.6428379 1.46 × 10 6 LAPTM5high
cg02189760HAVCR20.64276143 1.46 × 10 6 CTC-301O7.4, CD37high
cg18411043MCM2−0.6424966 1.48 × 10 6 LAPTM5high
cg04499514HSP90B1−0.6419106 1.52 × 10 6 C3AR1high
cg14291900HPN0.64190596 1.53 × 10 6 SLC7A7high
cg04499514EMILIN2−0.6416321 1.55 × 10 6 C3AR1high
cg04499514EMILIN2−0.6416321 1.55 × 10 6 C3AR1high
cg14082886HSPA5−0.6412986 1.57 × 10 6 CD44high
cg18411043ASGR20.6412585 1.57 × 10 6 LAPTM5high
cg18411043PRKCD0.64119535 1.58 × 10 6 LAPTM5high
cg00742851HAVCR20.64108721 1.59 × 10 6 SUMF1, LRRN1high
cg18411043FAM181B−0.6409853 1.60 × 10 6 LAPTM5high
cg00295382ZNF292−0.6404944 1.63 × 10 6 MYCLhigh
cg11702456TSEN34−0.6397343 1.70 × 10 6 SP100high
cg04153551CCR40.63922606 1.74 × 10 6 FBLN5high
cg22568423HAVCR20.6391164 1.75 × 10 6 MYO1Fhigh
cg04499514SPRR2A0.63900466 1.76 × 10 6 C3AR1high
cg20640433CRHR2−0.6389645 1.76 × 10 6 LAMA2high
cg14291900ERMN0.63877586 1.78 × 10 6 SLC7A7high
cg16713274VWDE−0.6386629 1.79 × 10 6 COL18A1high
cg20640433SCAMP30.63863905 1.79 × 10 6 LAMA2high
cg02957057SMG50.63832232 1.82 × 10 6 NID1high
cg18411043CDCA5−0.637901 1.86 × 10 6 LAPTM5high
cg18411043SMC2−0.6376489 1.88 × 10 6 LAPTM5high
cg23986671GPS10.63753383 1.89 × 10 6 ADAMTS5high
cg20640433OR10G70.63739025 1.90 × 10 6 LAMA2high
cg20640433VNN3−0.6368153 1.96 × 10 6 LAMA2high
cg18411043RNF144B0.63671956 1.97 × 10 6 LAPTM5high
cg02957057NMNAT3−0.6360154 2.03 × 10 6 NID1high
cg18411043FANCC−0.6359325 2.04 × 10 6 LAPTM5high
cg14291900SLC46A30.63593824 2.04 × 10 6 SLC7A7high
cg04499514TSEN34−0.6356583 2.07 × 10 6 C3AR1high
cg14082886PCYT1A−0.63512892.12 × 10 6 CD44high
cg18411043ARPC1B0.635019522.13 × 10 6 LAPTM5high
cg18411043GPR1320.634979352.14 × 10 6 LAPTM5high
cg02957057ELOVL3−0.63447932.19 × 10 6 NID1high
cg13765206C2CD4D−0.63441312.20 × 10 6 EMILIN2high
cg14291900SEMA4A0.634408492.20 × 10 6 SLC7A7high
cg18411043KIF15−0.63400362.24 × 10 6 LAPTM5high
cg18411043NCF40.633897212.25 × 10 6 LAPTM5high
cg23986671DCST1−0.63350872.30 × 10 6 ADAMTS5high
cg00777079N4BP2−0.63351142.30 × 10 6 SERPINF1high
cg23986671CLEC4F−0.63300942.35 × 10 6 ADAMTS5high
cg04499514DUSP4−0.6328342.37 × 10 6 C3AR1high
cg14291900TCF3−0.63283272.37 × 10 6 SLC7A7high
cg14291900ZNF416−0.63282582.37 × 10 6 SLC7A7high
cg18411043CD1D0.632780192.38 × 10 6 LAPTM5high
cg22987448TGFB10.632487972.41 × 10 6 MYO1Fhigh
cg20640433GLIS3−0.63196282.47 × 10 6 LAMA2high
cg04499514SEC24D−0.6318272.49 × 10 6 C3AR1high
cg02957057NLRX1−0.63177662.49 × 10 6 NID1high
cg27329371PDCD1LG20.63183092.49 × 10 6 ALDH3A1high
cg18411043PSMC3IP−0.6317092.50 × 10 6 LAPTM5high
cg23986671GOLGA4−0.63159582.52 × 10 6 ADAMTS5high
cg14291900U2AF2−0.63147222.53 × 10 6 SLC7A7high
cg18411043CEP72−0.63108132.58 × 10 6 LAPTM5high
cg18411043NCAPH−0.63085922.61 × 10 6 LAPTM5high
cg18411043TRIM380.630559422.64 × 10 6 LAPTM5high
cg27329371HAVCR20.630230072.68 × 10 6 ALDH3A1high
cg04499514S100A11−0.63015232.69 × 10 6 C3AR1high
cg18411043GIMAP80.630122772.70 × 10 6 LAPTM5high
cg18411043LMNB1−0.62982772.74 × 10 6 LAPTM5high
cg04499514SEMA3D0.629569732.77 × 10 6 C3AR1high
cg18397405CTLA40.629389672.79 × 10 6 GPC6high
cg14291900DOCK50.629292092.81 × 10 6 SLC7A7high
cg14291900ACSM50.629209972.82 × 10 6 SLC7A7high
cg04499514TWF2−0.62905652.84 × 10 6 C3AR1high
cg18411043MRC10.628958632.85 × 10 6 LAPTM5high
cg18411043TNFRSF1B0.628927782.86 × 10 6 LAPTM5high
cg18411043MEN1−0.62885122.87 × 10 6 LAPTM5high
cg18411043RAB11FIP10.628658292.89 × 10 6 LAPTM5high
cg18411043F13A10.628654762.89 × 10 6 LAPTM5high
cg18411043TESC0.628588432.90 × 10 6 LAPTM5high
cg14291900LGALS9C0.628579272.90 × 10 6 SLC7A7high
cg18411043GIPC20.628497572.91 × 10 6 LAPTM5high
cg02957057LRRIQ4−0.62854852.91 × 10 6 NID1high
cg14291900NKAIN20.62845292.92 × 10 6 SLC7A7high
cg01930947TACR10.628347532.93 × 10 6 C1orf111high
cg14082886COL4A30.628337532.94 × 10 6 CD44high
cg04499514RPS6KA3−0.62823542.95 × 10 6 C3AR1high
cg14291900LHPP0.628221462.95 × 10 6 SLC7A7high
cg11702456GALNS−0.62803562.98 × 10 6 SP100high
cg18411043AMICA10.62787093.00 × 10 6 LAPTM5high
cg20640433ISG20L20.627900943.00 × 10 6 LAMA2high
cg13765206PLEKHG6−0.62783793.01 × 10 6 EMILIN2high
cg04499514TTC38−0.62742353.06 × 10 6 C3AR1high
cg20640433RAB36−0.6274273.06 × 10 6 LAMA2high
cg20640433CST3−0.62742263.06 × 10 6 LAMA2high
cg18411043MLKL0.627168673.10 × 10 6 LAPTM5high
cg02957057C9orf64−0.6271943.10 × 10 6 NID1high
cg11702456S100A13−0.6269893.13 × 10 6 SP100high
cg01930947TMEFF20.626813233.15 × 10 6 C1orf111high
cg18411043MAN1A10.626761933.16 × 10 6 LAPTM5high
cg02957057FBXO17−0.62679283.16 × 10 6 NID1high
cg02957057SH3BP2−0.62660513.18 × 10 6 NID1high
cg05091653SERPINF2−0.62636063.22 × 10 6 SP100high
cg18411043TRPM20.626245933.24 × 10 6 LAPTM5high
cg18411043CD330.626139193.25 × 10 6 LAPTM5high
cg18411043CD460.625910613.29 × 10 6 LAPTM5high
cg14291900NR2C2AP−0.62585453.30 × 10 6 SLC7A7high
cg20640433PALM2−0.62574423.32 × 10 6 LAMA2high
cg18411043P2RY60.625600173.34 × 10 6 LAPTM5high
cg24769499FGF60.625601593.34 × 10 6 TMEM37high
cg00295382UBE4A−0.62537073.37 × 10 6 MYCLhigh
cg04499514FBLIM1−0.62515493.41 × 10 6 C3AR1high
cg00777079RFWD3−0.62503663.43 × 10 6 SERPINF1high
cg18411043CTSB0.624835583.46 × 10 6 LAPTM5high
cg16713274NXPH2−0.6248513.46 × 10 6 COL18A1high
cg18411043INCENP−0.62479483.47 × 10 6 LAPTM5high
cg14291900CDK6−0.6244043.53 × 10 6 SLC7A7high
cg02957057DEFB1250.624219763.56 × 10 6 NID1high
cg18411043CSF1R0.624005373.60 × 10 6 LAPTM5high
cg18411043TIGD3−0.62385213.62 × 10 6 LAPTM5high
cg23986671ATP6V0D2−0.62370793.65 × 10 6 ADAMTS5high
cg20640433RIT10.623631353.66 × 10 6 LAMA2high
cg14082886SLCO1A20.623568073.67 × 10 6 CD44high
cg18411043ALOX50.623498133.68 × 10 6 LAPTM5high
cg18411043MSI1−0.62342193.69 × 10 6 LAPTM5high
cg23986671DBH−0.62319963.73 × 10 6 ADAMTS5high
cg00295382NDUFB20.623144363.74 × 10 6 MYCLhigh
cg20640433EVC2−0.62288473.79 × 10 6 LAMA2high
cg17599241HAVCR20.62258383.84 × 10 6 VCAN-AS1, VCANhigh
cg18411043RUNX20.622364073.88 × 10 6 LAPTM5high
cg13765206TCHH−0.62218343.91 × 10 6 EMILIN2high
cg07947930PDCD1LG20.622139513.92 × 10 6 PRELPhigh
cg18411043POLD3−0.62184153.97 × 10 6 LAPTM5high
cg04499514MFSD5−0.6216644.01 × 10 6 C3AR1high
cg18411043MPP10.621638394.01 × 10 6 LAPTM5high
cg18411043HRH20.621638384.01 × 10 6 LAPTM5high
cg18411043TOP2A−0.6216074.02 × 10 6 LAPTM5high
cg18411043IRAK30.621399514.06 × 10 6 LAPTM5high
cg18397405GPC2−0.62107584.12 × 10 6 GPC6high
cg18411043OAF0.621046594.12 × 10 6 LAPTM5high
cg04499514SPRY4−0.62099674.13 × 10 6 C3AR1high
cg18411043C1S0.62096734.14 × 10 6 LAPTM5high
cg02957057ALDH7A1−0.62095144.14 × 10 6 NID1high
cg14291900CNOT3−0.62091494.15 × 10 6 SLC7A7high
cg02957057TXK−0.62071984.18 × 10 6 NID1high
cg07436701IGF1−0.62066494.19 × 10 6 MMRN2, SNCGhigh
cg18411043KIF18B−0.62056854.21 × 10 6 LAPTM5high
cg18411043ARHGAP300.62033514.26 × 10 6 LAPTM5high
cg18411043AIF10.620253594.27 × 10 6 LAPTM5high
cg00295382TGM20.620169954.29 × 10 6 MYCLhigh
cg14291900SLC26A90.620003994.32 × 10 6 SLC7A7high
cg23986671TMEM52−0.61977624.37 × 10 6 ADAMTS5high
cg18411043LHFPL20.619741034.38 × 10 6 LAPTM5high
cg14291900SLC1A70.61968984.39 × 10 6 SLC7A7high
cg04499514DUSP6−0.6195044.42 × 10 6 C3AR1high
cg11702456APOBEC3F−0.61952674.42 × 10 6 SP100high
cg22568423TGFB10.619365674.45 × 10 6 MYO1Fhigh
cg14082886ADAM220.619224224.48 × 10 6 CD44high
cg11827097TAGLN2−0.61850184.63 × 10 6 SP100high
cg02957057CSRP1−0.61843564.64 × 10 6 NID1high
cg21218883HSPBP1−0.6183244.67 × 10 6 PRKCEhigh
cg00295382HGFAC−0.6182394.69 × 10 6 MYCLhigh
cg14291900GRWD1−0.61799754.74 × 10 6 SLC7A7high
cg18411043CMKLR10.617811324.78 × 10 6 LAPTM5high
cg18411043CYTH40.617559454.83 × 10 6 LAPTM5high
cg02957057ACADS−0.61730544.89 × 10 6 NID1high
cg18411043FANCI−0.61705114.95 × 10 6 LAPTM5high
cg20640433LGALS8−0.6169794.96 × 10 6 LAMA2high
cg04499514CD276−0.61682485.00 × 10 6 C3AR1high
cg18411043TNFSF100.616607665.05 × 10 6 LAPTM5high
cg18411043VENTX0.616490435.07 × 10 6 LAPTM5high
cg04499514CASC30.615962135.20 × 10 6 C3AR1high
cg09777237TGFB10.615886285.21 × 10 6 ELNhigh
cg18411043SIGLEC100.615645035.27 × 10 6 LAPTM5high
cg14291900FAM124A0.615348995.34 × 10 6 SLC7A7high
cg11702456APOBEC3C−0.61532175.35 × 10 6 SP100high
cg20640433KHNYN−0.61514945.39 × 10 6 LAMA2high
cg14291900RAB40B0.615105765.40 × 10 6 SLC7A7high
cg04499514TAGLN2−0.61497635.43 × 10 6 C3AR1high
cg18411043RAC3−0.61499575.43 × 10 6 LAPTM5high
cg14082886EMP1−0.61492465.44 × 10 6 CD44high
cg14291900MRVI10.614933375.44 × 10 6 SLC7A7high
cg14082886TAGLN2−0.6149135.45 × 10 6 CD44high
cg18411043FGD20.614802695.47 × 10 6 LAPTM5high
cg18411043DSE0.61478445.48 × 10 6 LAPTM5high
cg23986671UBP1−0.61472295.49 × 10 6 ADAMTS5high
cg23986671XKR5−0.61457965.53 × 10 6 ADAMTS5high
cg18411043POLD40.614288785.60 × 10 6 LAPTM5high
cg18411043FMNL10.614311125.60 × 10 6 LAPTM5high
cg04499514SPAG90.614181625.63 × 10 6 C3AR1high
cg18411043EZH2−0.61417155.63 × 10 6 LAPTM5high
cg14291900EFHD10.614158755.63 × 10 6 SLC7A7high
cg18411043TPX2−0.61407285.66 × 10 6 LAPTM5high
cg11702456EFEMP2−0.61388115.70 × 10 6 SP100high
cg04499514APBA10.613755155.74 × 10 6 C3AR1high
cg01930947DNM30.613629785.77 × 10 6 C1orf111high
cg14082886DAAM20.613573965.78 × 10 6 CD44high
cg04499514SDF2L1−0.61326955.86 × 10 6 C3AR1high
cg02957057ACSF2−0.61308675.91 × 10 6 NID1high
cg18411043TMEM97−0.61273856.00 × 10 6 LAPTM5high
cg18411043CDC25A−0.61264246.03 × 10 6 LAPTM5high
cg18411043GIMAP70.612478676.07 × 10 6 LAPTM5high
cg14291900ZNF45−0.61251046.07 × 10 6 SLC7A7high
cg02957057SH2D4A−0.61238116.10 × 10 6 NID1high
cg04499514ATP1A40.612226636.14 × 10 6 C3AR1high
cg18411043KIF2C−0.61210916.17 × 10 6 LAPTM5high
cg18411043SLC20A10.611948676.22 × 10 6 LAPTM5high
cg20640433MMACHC−0.61193546.22 × 10 6 LAMA2high
cg18411043ECM10.611877766.24 × 10 6 LAPTM5high
cg00295382C5orf51−0.61184496.25 × 10 6 MYCLhigh
cg18411043CMTM70.611769446.27 × 10 6 LAPTM5high
cg04499514EHD4−0.6116636.30 × 10 6 C3AR1high
cg18411043CRISPLD20.611593736.32 × 10 6 LAPTM5high
cg00295382ATF7IP−0.61133186.39 × 10 6 MYCLhigh
cg07436701CD163−0.61132816.39 × 10 6 MMRN2, SNCGhigh
cg21398469TGFB10.611267936.41 × 10 6 CCNG2high
cg07436701CD244−0.61125256.41 × 10 6 MMRN2, SNCGhigh
cg14291900ABCG10.611237956.42 × 10 6 SLC7A7high
cg14291900ZNF761−0.61102136.48 × 10 6 SLC7A7high
cg18411043HHEX0.610885196.52 × 10 6 LAPTM5high
cg22595235CTLA40.610782046.55 × 10 6 SUMF1, LRRN1high
cg24769499IL220.610650466.59 × 10 6 TMEM37high
cg18411043MNDA0.610341536.68 × 10 6 LAPTM5high
cg18411043FAH0.610251316.71 × 10 6 LAPTM5high
cg11702456SP100−0.61022756.71 × 10 6 SP100high
cg23986671DUOXA1−0.61025386.71 × 10 6 ADAMTS5high
cg00295382PANK3−0.61019896.72 × 10 6 MYCLhigh
cg18411043CLEC10A0.610139646.74 × 10 6 LAPTM5high
cg18411043TRAF3IP30.610075076.76 × 10 6 LAPTM5high
cg13765206CAPN8−0.60970626.87 × 10 6 EMILIN2high
cg14291900PAQR80.609596936.90 × 10 6 SLC7A7high
cg02957057SDC4−0.6095946.90 × 10 6 NID1high
cg20640433ISPD−0.60957966.91 × 10 6 LAMA2high
cg08064683CCR40.609465636.94 × 10 6 FAT1high
cg04499514AP2S1−0.60928517.00 × 10 6 C3AR1high
cg04499514ITPRIP−0.609177.03 × 10 6 C3AR1high
cg04499514ADHFE10.609169787.03 × 10 6 C3AR1high
cg00295382ARPC1B0.609124817.05 × 10 6 MYCLhigh
cg18411043ZNF90−0.60901917.08 × 10 6 LAPTM5high
cg00295382CREBZF−0.60895247.10 × 10 6 MYCLhigh
cg14291900DPEP20.608943557.10 × 10 6 SLC7A7high
cg02957057CCDC163P−0.6088347.14 × 10 6 NID1high
cg04499514AKAP10.608660347.19 × 10 6 C3AR1high
cg20640433SLC2A10−0.60859697.21 × 10 6 LAMA2high
cg14291900TPD52L10.608527447.24 × 10 6 SLC7A7high
cg11827097PRMT2−0.60814787.36 × 10 6 SP100high
cg23986671PRPH2−0.60810637.37 × 10 6 ADAMTS5high
cg18397405ITGB10.607956547.42 × 10 6 GPC6high
cg02957057RRP120.607902967.44 × 10 6 NID1high
cg18411043ADAP20.607819427.46 × 10 6 LAPTM5high
cg18411043CCR10.607835677.46 × 10 6 LAPTM5high
cg18411043IL15RA0.607804187.47 × 10 6 LAPTM5high
cg11702456CMTM3−0.60772147.50 × 10 6 SP100high
cg04499514FBXW120.607655217.52 × 10 6 C3AR1high
cg14291900ADRBK20.607583557.54 × 10 6 SLC7A7high
cg18411043WDR34−0.60724027.66 × 10 6 LAPTM5high
cg18411043LAIR10.607147717.69 × 10 6 LAPTM5high
cg00295382ZBTB44−0.60708747.71 × 10 6 MYCLhigh
cg13765206NRAP−0.60676667.82 × 10 6 EMILIN2high
cg14291900SLCO1A20.606350087.96 × 10 6 SLC7A7high
cg16713274OLFM3−0.60627937.99 × 10 6 COL18A1high
cg00295382FAM166A−0.60617658.02 × 10 6 MYCLhigh
cg02957057RAB36−0.60613958.03 × 10 6 NID1high
cg14291900TMEM86A0.606079858.05 × 10 6 SLC7A7high
cg14291900EVI2A0.606051568.06 × 10 6 SLC7A7high
cg18411043CTSZ0.605978078.09 × 10 6 LAPTM5high
cg13765206NCR3−0.60579648.16 × 10 6 EMILIN2high
cg13765206KRTAP5-9−0.6057378.18 × 10 6 EMILIN2high
cg18411043HES5−0.60566638.20 × 10 6 LAPTM5high
cg11702456ARSI−0.60565738.20 × 10 6 SP100high
cg18411043MFSD10.60562112 8.22 × 10 6 LAPTM5high
cg00295382ZG16−0.6055812 8.23 × 10 6 MYCLhigh
cg20640433DPEP3−0.6054516 8.28 × 10 6 LAMA2high
cg18411043MAP2−0.6053901 8.30 × 10 6 LAPTM5high
cg18411043ADAMTS140.60538276 8.30 × 10 6 LAPTM5high
cg04499514KDELR1−0.605255 8.35 × 10 6 C3AR1high
cg04499514RALGPS10.60522199 8.36 × 10 6 C3AR1high
cg18411043BRIP1−0.6052277 8.36 × 10 6 LAPTM5high
cg14291900DLEU70.60520069 8.37 × 10 6 SLC7A7high
cg18411043RNF1490.60510698 8.40 × 10 6 LAPTM5high
cg18411043LEPROT0.60482116 8.51 × 10 6 LAPTM5high
cg18411043GIMAP40.60467954 8.56 × 10 6 LAPTM5high
cg00295382RGS190.60458767 8.60 × 10 6 MYCLhigh
cg18411043IL10RA0.60450736 8.63 × 10 6 LAPTM5high
cg18411043SLCO2B10.60445283 8.65 × 10 6 LAPTM5high
cg00295382TTC380.60437946 8.67 × 10 6 MYCLhigh
cg14291900PTBP1−0.6043814 8.67 × 10 6 SLC7A7high
cg18411043IL160.60434727 8.69 × 10 6 LAPTM5high
cg04499514PPIB−0.6040378 8.80 × 10 6 C3AR1high
cg18411043MAPKAPK20.60396534 8.83 × 10 6 LAPTM5high
cg04499514TGFBI−0.6038334 8.88 × 10 6 C3AR1high
cg04499514IGFBP2−0.6037505 8.91 × 10 6 C3AR1high
cg11702456SLC2A40.60343179 9.04 × 10 6 SP100high
cg04499514IKBIP−0.603409 9.05 × 10 6 C3AR1high
cg04499514ETV5−0.603302 9.09 × 10 6 C3AR1high
cg12613839PDCD1LG20.60313469 9.15 × 10 6 ADAMTS2high
cg04499514KIAA1324L0.60307321 9.18 × 10 6 C3AR1high
cg18411043FMN10.60306718 9.18 × 10 6 LAPTM5high
cg18411043SH3TC10.6029736 9.22 × 10 6 LAPTM5high
cg02957057LEKR1−0.6029529 9.23 × 10 6 NID1high
cg18411043GRB20.60266775 9.34 × 10 6 LAPTM5high
cg04499514PSD20.60262221 9.36 × 10 6 C3AR1high
cg11702456CASP8−0.6025684 9.38 × 10 6 SP100high
cg04499514IFNGR2−0.6025283 9.40 × 10 6 C3AR1high
cg14082886DCAF80.60237965 9.46 × 10 6 CD44high
cg02957057C10orf107−0.6023697 9.46 × 10 6 NID1high
cg04499514CKAP4-0.6023102 9.49 × 10 6 C3AR1high
cg02957057RTP20.60230352 9.49 × 10 6 NID1high
cg18411043RFC5−0.6022106 9.53 × 10 6 LAPTM5high
cg11827097TSEN34−0.6020259 9.60 × 10 6 SP100high
cg18411043YWHAZ0.60194076 9.64 × 10 6 LAPTM5high
cg02957057TMIE−0.6019364 9.64 × 10 6 NID1high
cg02957057GLIS3−0.6017402 9.72 × 10 6 NID1high
cg00295382TRO−0.60165 9.76 × 10 6 MYCLhigh
cg20640433FAM19A1−0.6014471 9.84 × 10 6 LAMA2high
cg18411043LCORL−0.6013862 9.87 × 10 6 LAPTM5high
cg20640433PAOX−0.6011955 9.95 × 10 6 LAMA2high
cg14291900SAE1−0.6011065 9.99 × 10 6 SLC7A7high
cg18411043DENND1C0.60107737 1.00 × 10 5 LAPTM5high
cg00295382ZNF510−0.60095761.01 × 10 5 MYCLhigh
cg18411043MED24−0.60088141.01 × 10 5 LAPTM5high
cg14082886ATP8A10.600583421.02 × 10 5 CD44high
cg18411043RAD54L−0.6006781.02 × 10 5 LAPTM5high
cg18411043SP4−0.60059931.02 × 10 5 LAPTM5high
cg04499514TIMP1−0.60010841.04 × 10 5 C3AR1high
cg14291900RASGEF1B0.600121591.04 × 10 5 SLC7A7high
cg02957057ZDHHC1−0.60006781.04 × 10 5 NID1high
cg02957057HRASLS5−0.60002431.05 × 10 5 NID1high
cg07436701CD96−0.59930431.08 × 10 5 MMRN2, SNCGhigh
cg07436701CCR4−0.59729571.18 × 10 5 MMRN2, SNCGhigh
cg18397405ITGA40.594181471.34 × 10 5 GPC6high
cg03677069CD740.59295197 1.41 × 10 5 MMRN2, SNCGhigh
cg07436701GPR65−0.5925407 1.43 × 10 5 MMRN2, SNCGhigh
cg18397405CDC34−0.590695 1.55 × 10 5 GPC6high
cg07436701FLT3−0.5827163 2.15 × 10 5 MMRN2, SNCGhigh
cg07436701GPC20.5754121 2.87 × 10 5 MMRN2, SNCGhigh
cg07436701E2F20.5728996 3.17 × 10 5 MMRN2, SNCGhigh
cg07436701CD14−0.568245 3.80 × 10 5 MMRN2, SNCGhigh
cg18397405EZH2−0.5582639 5.54 × 10 5 GPC6high
cg18397405CDKN1B−0.5581881 5.56 × 10 5 GPC6high
cg07436701CDC340.55769852 5.66 × 10 5 MMRN2, SNCGhigh
cg07436701CD68−0.5556475 6.11 × 10 5 MMRN2, SNCGhigh
cg26350754EMILIN2−0.554466 6.38 × 10 5 HLA-DPA1, HLA-DPB1high
cg14082886MRC2−0.5539332 6.51 × 10 5 CD44high
cg18397405E2F2−0.5518593 7.02 × 10 5 GPC6high
cg18397405FLT30.54987539 7.55 × 10 5 GPC6high
cg10949632GPC60.54286496 9.70 × 10 5 GPC6high
cg03677069GPR650.541889410.00010045MMRN2, SNCGhigh
cg14082886FGFR20.53400320.00013232CD44high
cg16713274GPC6−0.53177790.00014285COL18A1, LL21NC02-21A1.1high
cg03677069CD1630.528325570.00016069MMRN2, SNCGhigh
cg21012874CD740.527601470.00016467MMRN2, SNCGhigh
cg09552892CD740.522373750.00019625MMRN2, SNCGhigh
cg04499514EZH10.52014970.00021127C3AR1high
cg07436701EZH20.518762070.00022116MMRN2, SNCGhigh
cg14082886CD63−0.51738980.00023136CD44high
cg04098585EMILIN2−0.51231530.00027286CD28high
cg07436701GZMA−0.51216740.00027417MMRN2, SNCGhigh
cg03677069ITGB20.51103160.00028438MMRN2, SNCGhigh
cg07436701CCL5−0.51059680.00028837MMRN2, SNCGhigh
cg03677069E2F2−0.50951740.00029852MMRN2, SNCGhigh
cg03677069CD140.506076050.00033306MMRN2, SNCGhigh
cg04499514FGFR1−0.50484880.00034622C3AR1high
cg07436701GRN−0.50451340.0003499MMRN2, SNCGhigh
cg18397405CD630.501086560.00038956GPC6high

References

  1. Stupp, R.; Mason, W.P.; van den Bent, M.J.; Weller, M.; Fisher, B.; Taphoorn, M.J.; Belanger, K.; Brandes, A.A.; Marosi, C.; Bogdahn, U.; et al. Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma. N. Engl. J. Med. 2005, 352, 987–996. [Google Scholar] [CrossRef] [PubMed]
  2. Cloughesy, T.F.; Mochizuki, A.Y.; Orpilla, J.R.; Hugo, W.; Lee, A.H.; Davidson, T.B.; Wang, A.C.; Ellingson, B.M.; Rytlewski, J.A.; Sanders, C.M.; et al. Neoadjuvant anti-PD-1 immunotherapy promotes a survival benefit with intratumoral and systemic immune responses in recurrent glioblastoma. Nat. Med. 2019, 25, 477–486. [Google Scholar] [CrossRef]
  3. Bagley, S.J.; Desai, A.S.; Nasrallah, M.P.; O’Rourke, D.M. Immunotherapy and Response Assessment in Malignant Glioma: Neuro-oncology Perspective. Top. Magnetic Resonance Imag. TMRI 2020, 29, 95–102. [Google Scholar] [CrossRef]
  4. Schalper, K.A.; Rodriguez-Ruiz, M.E.; Diez-Valle, R.; López-Janeiro, A.; Porciuncula, A.; Idoate, M.A.; Inogés, S.; de Andrea, C.; López-Diaz de Cerio, A.; Tejada, S.; et al. Neoadjuvant nivolumab modifies the tumor immune microenvironment in resectable glioblastoma. Nat. Med. 2019, 25, 470–476. [Google Scholar] [CrossRef]
  5. Gieryng, A.; Pszczolkowska, D.; Walentynowicz, K.A.; Rajan, W.D.; Kaminska, B. Immune microenvironment of gliomas. Lab. Investig. 2017, 97, 498–518. [Google Scholar] [CrossRef] [Green Version]
  6. Glass, R.; Synowitz, M. CNS macrophages and peripheral myeloid cells in brain tumours. Acta Neuropathol. 2014, 128, 347–362. [Google Scholar] [CrossRef] [Green Version]
  7. Zhao, B.; Wang, Y.; Wang, Y.; Chen, W.; Liu, P.H.; Kong, Z.; Dai, C.; Wang, Y.; Ma, W. Systematic identification, development, and validation of prognostic biomarkers involving the tumor-immune microenvironment for glioblastoma. J. Cell. Physiol. 2020. [Google Scholar] [CrossRef]
  8. Wainwright, D.A.; Dey, M.; Chang, A.; Lesniak, M.S. Targeting Tregs in Malignant Brain Cancer: Overcoming IDO. Front. Immunol. 2013, 4. [Google Scholar] [CrossRef] [Green Version]
  9. Ye, X.Z.; Xu, S.L.; Xin, Y.H.; Yu, S.C.; Ping, Y.F.; Chen, L.; Xiao, H.L.; Wang, B.; Yi, L.; Wang, Q.L.; et al. Tumor-associated microglia/macrophages enhance the invasion of glioma stem-like cells via TGFBETA1 signaling pathway. J. Immunol. 2012, 189, 444–453. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  10. Graeber, M.B.; Scheithauer, B.W.; Kreutzberg, G.W. Microglia in brain tumors. Glia 2002, 40, 252–259. [Google Scholar] [CrossRef] [PubMed]
  11. Grabowski, M.M.; Sankey, E.W.; Ryan, K.J.; Chongsathidkiet, P.; Lorrey, S.J.; Wilkinson, D.S.; Fecci, P.E. Immune suppression in gliomas. J. Neuro-Oncol. 2020. [Google Scholar] [CrossRef]
  12. Hambardzumyan, D.; Gutmann, D.H.; Kettenmann, H. The role of microglia and macrophages in glioma maintenance and progression. Nat. Neurosci. 2016, 19, 20–27. [Google Scholar] [CrossRef] [Green Version]
  13. Skytthe, M.K.; Graversen, J.H.; Moestrup, S.K. Targeting of CD163+ Macrophages in Inflammatory and Malignant Diseases. Int. J. Mol. Sci. 2020, 21, 5497. [Google Scholar] [CrossRef]
  14. Liu, S.; Zhang, C.; Maimela, N.R.; Yang, L.; Zhang, Z.; Ping, Y.; Huang, L.; Zhang, Y. Molecular and clinical characterization of CD163 expression via large-scale analysis in glioma. Oncoimmunology 2019, 8. [Google Scholar] [CrossRef]
  15. Ostuni, R.; Kratochvill, F.; Murray, P.J.; Natoli, G. Macrophages and cancer: From mechanisms to therapeutic implications. Trends Immunol. 2015, 36, 229–239. [Google Scholar] [CrossRef]
  16. Yang, L.; Zhang, Y. Tumor-associated macrophages: From basic research to clinical application. J. Hematol. Oncol. 2017, 10, 58. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  17. Ferrer, V.P.; Moura Neto, V.; Mentlein, R. Glioma infiltration and extracellular matrix: Key players and modulators. Glia 2018, 66, 1542–1565. [Google Scholar] [CrossRef]
  18. Thorsson, V.; Gibbs, D.L.; Brown, S.D.; Wolf, D.; Bortone, D.S.; Ou Yang, T.H.; Porta-Pardo, E.; Gao, G.F.; Plaisier, C.L.; Eddy, J.A.; et al. The Immune Landscape of Cancer. Immunity 2018, 48, 812–830.e14. [Google Scholar] [CrossRef] [Green Version]
  19. Houseman, E.A.; Accomando, W.P.; Koestler, D.C.; Christensen, B.C.; Marsit, C.J.; Nelson, H.H.; Wiencke, J.K.; Kelsey, K.T. DNA methylation arrays as surrogate measures of cell mixture distribution. BMC Bioinf. 2012, 13, 86. [Google Scholar] [CrossRef] [Green Version]
  20. Moss, J.; Magenheim, J.; Neiman, D.; Zemmour, H.; Loyfer, N.; Korach, A.; Samet, Y.; Maoz, M.; Druid, H.; Arner, P.; et al. Comprehensive human cell-type methylation atlas reveals origins of circulating cell-free DNA in health and disease. Nat. Commun. 2018, 9, 5068. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  21. Liu, B.; Liu, Y.; Pan, X.; Li, M.; Yang, S.; Li, S.C. DNA Methylation Markers for Pan-Cancer Prediction by Deep Learning. Genes 2019, 10, 778. [Google Scholar] [CrossRef] [Green Version]
  22. Noushmehr, H.; Sabedot, T.S.; Malta, T.M.; Nelson, K.; Snyder, J.; Wells, M.; deCarvalho, A.; Mukherjee, A.; Chitale, D.; Mosella, M.; et al. Detection of glioma and prognostic subtypes by non-invasive circulating cell-free DNA methylation markers. bioRxiv 2019, 601245. [Google Scholar] [CrossRef]
  23. Capper, D.; Jones, D.T.W.; Sill, M.; Hovestadt, V.; Schrimpf, D.; Sturm, D.; Koelsche, C.; Sahm, F.; Chavez, L.; Reuss, D.E.; et al. DNA methylation-based classification of central nervous system tumours. Nature 2018, 555, 469–474. [Google Scholar] [CrossRef]
  24. Rivera, A.L.; Pelloski, C.E.; Gilbert, M.R.; Colman, H.; De La Cruz, C.; Sulman, E.P.; Bekele, B.N.; Aldape, K.D. MGMT promoter methylation is predictive of response to radiotherapy and prognostic in the absence of adjuvant alkylating chemotherapy for glioblastoma. Neuro-Oncology 2010, 12, 116–121. [Google Scholar] [CrossRef]
  25. Oldrini, B.; Vaquero-Siguero, N.; Mu, Q.; Kroon, P.; Zhang, Y.; Galán-Ganga, M.; Bao, Z.; Wang, Z.; Liu, H.; Sa, J.K.; et al. MGMT genomic rearrangements contribute to chemotherapy resistance in gliomas. Nat. Commun. 2020, 11, 3883. [Google Scholar] [CrossRef] [PubMed]
  26. Zhang, M.W.; Fujiwara, K.; Che, X.; Zheng, S.; Zheng, L. DNA methylation in the tumor microenvironment. J. Zhejiang Univ. Sci. B 2017, 18, 365–372. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  27. Cui, X.; Ma, C.; Vasudevaraja, V.; Serrano, J.; Tong, J.; Peng, Y.; Delorenzo, M.; Shen, G.; Frenster, J.; Morales, R.T.T.; et al. Dissecting the immunosuppressive tumor microenvironments in Glioblastoma-on-a-Chip for optimized PD-1 immunotherapy. eLife 2020, 9. [Google Scholar] [CrossRef] [PubMed]
  28. Dejaegher, J.; Solie, L.; Hunin, Z.; Sciot, R.; Capper, D.; Siewert, C.; Van Cauter, S.; Wilms, G.; van Loon, J.; Ectors, N.; et al. DNA methylation based glioblastoma subclassification is related to tumoral T-cell infiltration and patient survival. Neuro-Oncology 2020. [Google Scholar] [CrossRef]
  29. D’Angelo, F.; Ceccarelli, M.; Tala, N.; Garofano, L.; Zhang, J.; Frattini, V.; Caruso, F.P.; Lewis, G.; Alfaro, K.D.; Bauchet, L.; et al. The molecular landscape of glioma in patients with Neurofibromatosis 1. Nat. Med. 2019, 25, 176–187. [Google Scholar] [CrossRef]
  30. Bourgon, R.; Gentleman, R.; Huber, W. Independent filtering increases detection power for high-throughput experiments. Proc. Natl. Acad. Sci. USA 2010, 107, 9546–9551. [Google Scholar] [CrossRef] [Green Version]
  31. Sturm, G.; Finotello, F.; Petitprez, F.; Zhang, J.D.; Baumbach, J.; Fridman, W.H.; List, M.; Aneichyk, T. Comprehensive evaluation of transcriptome-based cell-type quantification methods for immuno-oncology. Bioinformatics (Oxford, England) 2019, 35, i436–i445. [Google Scholar] [CrossRef]
  32. Finotello, F.; Mayer, C.; Plattner, C.; Laschober, G.; Rieder, D.; Hackl, H.; Krogsdam, A.; Loncova, Z.; Posch, W.; Wilflingseder, D.; et al. Molecular and pharmacological modulators of the tumor immune contexture revealed by deconvolution of RNA-seq data. Genome Med. 2019, 11, 34. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  33. Aran, D.; Hu, Z.; Butte, A.J. xCell: Digitally portraying the tissue cellular heterogeneity landscape. Genome Biol. 2017, 18, 1–14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  34. ImmuneSubtypeClassifier. Available online: https://github.com/CRI-iAtlas/ImmuneSubtypeClassifier (accessed on 27 July 2020).
  35. Polano, M.; Chierici, M.; Dal Bo, M.; Gentilini, D.; Di Cintio, F.; Baboci, L.; Gibbs, D.L.; Furlanello, C.; Toffoli, G. A Pan-Cancer Approach to Predict Responsiveness to Immune Checkpoint Inhibitors by Machine Learning. Cancers 2019, 11, 1562. [Google Scholar] [CrossRef] [Green Version]
  36. Langlois, B.; Saupe, F.; Rupp, T.; Arnold, C.; van der Heyden, M.; Orend, G.; Hussenet, T. AngioMatrix, a signature of the tumor angiogenic switch-specific matrisome, correlates with poor prognosis for glioma and colorectal cancer patients. Oncotarget 2014, 5, 10529–10545. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  37. Zhao, J.; Chen, A.X.; Gartrell, R.D.; Silverman, A.M.; Aparicio, L.; Chu, T.; Bordbar, D.; Shan, D.; Samanamud, J.; Mahajan, A.; et al. Immune and genomic correlates of response to anti-PD-1 immunotherapy in glioblastoma. Nat. Med. 2019, 25, 462–469. [Google Scholar] [CrossRef] [PubMed]
  38. Hassn Mesrati, M.; Behrooz, A.B.; Y Abuhamad, A.; Syahir, A. Understanding Glioblastoma Biomarkers: Knocking a Mountain with a Hammer. Cells 2020, 9, 1236. [Google Scholar] [CrossRef]
  39. Zhao, Y.; Zhang, X.; Yao, J.; Jin, Z.; Liu, C. Expression patterns and the prognostic value of the EMILIN/Multimerin family members in low-grade glioma. PeerJ 2020, 8. [Google Scholar] [CrossRef]
  40. Degenhardt, F.; Seifert, S.; Szymczak, S. Evaluation of variable selection methods for random forests and omics data sets. Brief. Bioinf. 2017, 20, 492–503. [Google Scholar] [CrossRef] [Green Version]
  41. Vabalas, A.; Gowen, E.; Poliakoff, E.; Casson, A.J. Machine learning algorithm validation with a limited sample size. PLoS ONE 2019, 14, e0224365. [Google Scholar] [CrossRef]
  42. Matthews, B.W. Comparison of the predicted and observed secondary structure of T4 phage lysozyme. Bioch. Biophys. Acta 1975, 405, 442–451. [Google Scholar] [CrossRef]
  43. Shi, L.; Campbell, G.; Jones, W.D.; Campagne, F.; Wen, Z.; Walker, S.J.; Su, Z.; Chu, T.M.; Goodsaid, F.M.; Pusztai, L.; et al. The MicroArray Quality Control (MAQC)-II study of common practices for the development and validation of microarray-based predictive models. Nat. Biotechnol. 2010, 28, 827–838. [Google Scholar] [CrossRef]
  44. Boughorbel, S.; Jarray, F.; El-Anbari, M. Optimal classifier for imbalanced data using Matthews Correlation Coefficient metric. PLoS ONE 2017, 12, e0177678. [Google Scholar] [CrossRef]
  45. Sundjaja, J.H.; Shrestha, R.; Krishan, K. McNemar And Mann-Whitney U Tests. In StatPearls; Treasure Island: London, UK, 2020. [Google Scholar]
  46. Wang, H.; Li, G. A Selective Review on Random Survival Forests for High Dimensional Data. Quant. Bio-Sci. 2017, 36, 85–96. [Google Scholar] [CrossRef]
  47. Chai, R.C.; Zhang, K.N.; Chang, Y.Z.; Wu, F.; Liu, Y.Q.; Zhao, Z.; Wang, K.Y.; Chang, Y.H.; Jiang, T.; Wang, Y.Z. Systematically characterize the clinical and biological significances of 1p19q genes in 1p/19q non-codeletion glioma. Carcinogenesis 2019, 40, 1229–1239. [Google Scholar] [CrossRef]
  48. Chai, R.C.; Chang, Y.Z.; Wang, Q.W.; Zhang, K.N.; Li, J.J.; Huang, H.; Wu, F.; Liu, Y.Q.; Wang, Y.Z. A Novel DNA Methylation-Based Signature Can Predict the Responses of MGMT Promoter Unmethylated Glioblastomas to Temozolomide. Front. Genet. 2019, 10. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  49. STRING v10: Protein-protein interaction networks, integrated over the tree of life. Nucleic Acids Res. 2015, 43, 1362–4962.
  50. Shannon, P.; Markiel, A.; Ozier, O.; Baliga, N.S.; Wang, J.T.; Ramage, D.; Amin, N.; Schwikowski, B.; Ideker, T. Cytoscape: A software environment for integrated models of biomolecular interaction networks. Genome Res. 2003, 13, 2498–2504. [Google Scholar] [CrossRef] [PubMed]
  51. Pedregosa, F.; Varoquaux, G.; Gramfort, A.; Michel, V.; Thirion, B.; Grisel, O.; Blondel, M.; Prettenhofer, P.; Weiss, R.; Dubourg, V.; et al. Scikit-learn: Machine Learning in Python. J. Mach. Learn. Res. 2011, 12, 2825–2830. [Google Scholar]
  52. Amankulor, N.M.; Kim, Y.; Arora, S.; Kargl, J.; Szulzewsky, F.; Hanke, M.; Margineantu, D.H.; Rao, A.; Bolouri, H.; Delrow, J.; et al. Mutant IDH1 regulates the tumor-associated immune system in gliomas. Genes Devel. 2017, 31, 774–786. [Google Scholar] [CrossRef] [Green Version]
  53. Jin, M.Z.; Jin, W.L. The updated landscape of tumor microenvironment and drug repurposing. Signal Transd. Target. Ther. 2020, 5, 1–16. [Google Scholar] [CrossRef] [PubMed]
  54. Vidyarthi, A.; Agnihotri, T.; Khan, N.; Singh, S.; Tewari, M.K.; Radotra, B.D.; Chatterjee, D.; Agrewala, J.N. Predominance of M2 macrophages in gliomas leads to the suppression of local and systemic immunity. Cancer Immunol. Immunother. CII 2019, 68, 1995–2004. [Google Scholar] [CrossRef] [PubMed]
  55. Razavi, S.M.; Lee, K.E.; Jin, B.E.; Aujla, P.S.; Gholamin, S.; Li, G. Immune Evasion Strategies of Glioblastoma. Front. Surg. 2016, 3. [Google Scholar] [CrossRef]
  56. Sonabend, A.M.; Rolle, C.E.; Lesniak, M.S. The role of regulatory T cells in malignant glioma. Anticancer Res. 2008, 28, 1143–1150. [Google Scholar]
  57. Pitroda, S.P.; Zhou, T.; Sweis, R.F.; Filippo, M.; Labay, E.; Beckett, M.A.; Mauceri, H.J.; Liang, H.; Darga, T.E.; Perakis, S.; et al. Tumor endothelial inflammation predicts clinical outcome in diverse human cancers. PLoS ONE 2012, 7, e46104. [Google Scholar] [CrossRef]
  58. Zhao, C.; Gomez, G.A.; Zhao, Y.; Yang, Y.; Cao, D.; Lu, J.; Yang, H.; Lin, S. ETV2 mediates endothelial transdifferentiation of glioblastoma. Signal Transd. Target. Ther. 2018, 3, 4. [Google Scholar] [CrossRef]
  59. Tormoen, G.W.; Crittenden, M.R.; Gough, M.J. Role of the immunosuppressive microenvironment in immunotherapy. Adv. Rad. Oncol. 2018, 3, 520–526. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  60. Wiencke, J.K.; Koestler, D.C.; Salas, L.A.; Wiemels, J.L.; Roy, R.P.; Hansen, H.M.; Rice, T.; McCoy, L.S.; Bracci, P.M.; Molinaro, A.M.; et al. Immunomethylomic approach to explore the blood neutrophil lymphocyte ratio (NLR) in glioma survival. Clin. Epigenetics 2017, 9, 10. [Google Scholar] [CrossRef] [Green Version]
  61. Zou, J.P.; Morford, L.A.; Chougnet, C.; Dix, A.R.; Brooks, A.G.; Torres, N.; Shuman, J.D.; Coligan, J.E.; Brooks, W.H.; Roszman, T.L.; et al. Human Glioma-Induced Immunosuppression Involves Soluble Factor(s) That Alters Monocyte Cytokine Profile and Surface Markers. J. Immunol. 1999, 162, 4882–4892. [Google Scholar]
  62. Zhang, L.; Xu, Y.; Sun, J.; Chen, W.; Zhao, L.; Ma, C.; Wang, Q.; Sun, J.; Huang, B.; Zhang, Y.; et al. M2-like tumor-associated macrophages drive vasculogenic mimicry through amplification of IL-6 expression in glioma cells. Oncotarget 2016, 8, 819–832. [Google Scholar] [CrossRef] [Green Version]
  63. Hanaei, S.; Afshari, K.; Hirbod-Mobarakeh, A.; Mohajer, B.; Amir Dastmalchi, D.; Rezaei, N. Therapeutic efficacy of specific immunotherapy for glioma: A systematic review and meta-analysis. Rev. Neurosci. 2018, 29, 443–461. [Google Scholar] [CrossRef]
  64. Raudvere, U.; Kolberg, L.; Kuzmin, I.; Arak, T.; Adler, P.; Peterson, H.; Vilo, J. g:Profiler: A web server for functional enrichment analysis and conversions of gene lists (2019 update). Nucleic Acids Res. 2019, 47, W191–W198. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  65. Weller, M.; Wick, W.; Aldape, K.; Brada, M.; Berger, M.; Pfister, S.M.; Nishikawa, R.; Rosenthal, M.; Wen, P.Y.; Stupp, R.; et al. Glioma. Nat. Rev. Disease Primers 2015, 1, 1–18. [Google Scholar] [CrossRef]
  66. Lombardi, G.; Barresi, V.; Castellano, A.; Tabouret, E.; Pasqualetti, F.; Salvalaggio, A.; Cerretti, G.; Caccese, M.; Padovan, M.; Zagonel, V.; et al. Clinical Management of Diffuse Low-Grade Gliomas. Cancers 2020, 12, 3008. [Google Scholar] [CrossRef] [PubMed]
  67. Roesch, S.; Rapp, C.; Dettling, S.; Herold-Mende, C. When Immune Cells Turn Bad-Tumor-Associated Microglia/Macrophages in Glioma. Int. J. Mol. Sci. 2018, 19, 436. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  68. Quail, D.F.; Joyce, J.A. The Microenvironmental Landscape of Brain Tumors. Cancer Cell 2017, 31, 326–341. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  69. Tang, Y.; Le, W. Differential Roles of M1 and M2 Microglia in Neurodegenerative Diseases. Mol. Neurobiol. 2016, 53, 1181–1194. [Google Scholar] [CrossRef]
  70. Prosniak, M.; Harshyne, L.A.; Andrews, D.W.; Kenyon, L.C.; Bedelbaeva, K.; Apanasovich, T.V.; Heber-Katz, E.; Curtis, M.T.; Cotzia, P.; Hooper, D.C. Glioma Grade Is Associated with the Accumulation and Activity of Cells Bearing M2 Monocyte Markers. Clin. Cancer Res. 2013, 19, 3776–3786. [Google Scholar] [CrossRef] [Green Version]
  71. Shabo, I.; Olsson, H.; Sun, X.F.; Svanvik, J. Expression of the macrophage antigen CD163 in rectal cancer cells is associated with early local recurrence and reduced survival time. Int. J. Cancer 2009, 125, 1826–1831. [Google Scholar] [CrossRef]
  72. Zheng, C.; Xu, R. Predicting cancer origins with a DNA methylation-based deep neural network model. PLoS ONE 2020, 15, e0226461. [Google Scholar] [CrossRef]
Figure 1. Transcriptomics landscape of patients with either glioblastoma (GBM) or low-grade glioma (LGG). The 2365 genes shown were used to develop the immune cluster subtype by Thorston et al. [18].
Figure 1. Transcriptomics landscape of patients with either glioblastoma (GBM) or low-grade glioma (LGG). The 2365 genes shown were used to develop the immune cluster subtype by Thorston et al. [18].
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Figure 2. Immune landscape of glioma patients. (A) Heatmap of immune signature computed on glioma cohorts from the TCGA study. The signature was calculated using immunodeconv (xCell) and the expression of gene CD163. The mutational status and immuno subtype are reported. (B) Kaplan–Meier survival curves showing OS interval based on the previously calculated flag on TCGA glioma patients. Time is reported in days. (C) Kaplan–Meier survival curves showed progression-free survival (PFS) intervals based on the previously calculated flag on TCGA glioma patients. Time is reported in days.
Figure 2. Immune landscape of glioma patients. (A) Heatmap of immune signature computed on glioma cohorts from the TCGA study. The signature was calculated using immunodeconv (xCell) and the expression of gene CD163. The mutational status and immuno subtype are reported. (B) Kaplan–Meier survival curves showing OS interval based on the previously calculated flag on TCGA glioma patients. Time is reported in days. (C) Kaplan–Meier survival curves showed progression-free survival (PFS) intervals based on the previously calculated flag on TCGA glioma patients. Time is reported in days.
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Figure 3. Genome-wide mean methylation status and matched transciptomic landscape from glioma cohort used in this study.
Figure 3. Genome-wide mean methylation status and matched transciptomic landscape from glioma cohort used in this study.
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Figure 4. Genomic landscape of the 338 CpG probe selected for the classification model according to the EDISON classification flag.
Figure 4. Genomic landscape of the 338 CpG probe selected for the classification model according to the EDISON classification flag.
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Figure 5. ROC curves of 3 models for EDISON classification using multilayer perceptron (MLP), convolutional neural network (CNN) and random forest (RF). All the models were trained on the dataset ImmuneAngioICIsMesECM + BORUTA. The out-of-sample AUC calculated on the test is also reported.
Figure 5. ROC curves of 3 models for EDISON classification using multilayer perceptron (MLP), convolutional neural network (CNN) and random forest (RF). All the models were trained on the dataset ImmuneAngioICIsMesECM + BORUTA. The out-of-sample AUC calculated on the test is also reported.
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Figure 6. Variable importance of random survival forest model. (A) Top 20 CpG probes are reported with positive value influencing the OS interval, (B) Top 20 CpG probes are reported with negative influence OS interval, (C) Top 20 CpG probes are reported with positive value influencing the progression free survival, (D) Top 5 probes are reported with positive value influencing the progression-free survival.
Figure 6. Variable importance of random survival forest model. (A) Top 20 CpG probes are reported with positive value influencing the OS interval, (B) Top 20 CpG probes are reported with negative influence OS interval, (C) Top 20 CpG probes are reported with positive value influencing the progression free survival, (D) Top 5 probes are reported with positive value influencing the progression-free survival.
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Table 1. Cases included in the study from The Cancer Genome Atlas (TCGA) cohorts for Glioma cancer types.
Table 1. Cases included in the study from The Cancer Genome Atlas (TCGA) cohorts for Glioma cancer types.
CohortCancer TypeCasesCases Flagged as EDISON Positive
LGGBrain lower grade glioma506271
GBMGlioblastoma multiforme4710
Table 2. Summary of the datasets, with the number of CpGs included in each one.
Table 2. Summary of the datasets, with the number of CpGs included in each one.
DatasetCpG Count
AllCpGs355,314
ImmuneAngioICIs6368
ImmuneAngioICIsMesECM6754
AllCpGs + BORUTA3554
ImmuneAngioICIs + BORUTA512
ImmuneAngioICIsMesECM + BORUTA338
Table 3. Univariate Cox regression analysis of OS and PFS in the entire cohort included in the study using classification derived from RNA-seq data.
Table 3. Univariate Cox regression analysis of OS and PFS in the entire cohort included in the study using classification derived from RNA-seq data.
EndpointStatusNumber of SamplesHR95% CI for HRp Value
OSEDISON+n = 5530.550.39–0.77<0.01
PFIEDISON+n = 5530.570.43–0.75<0.01
Abbreviations: OS, overall survival; PFI, progression-free survival; HR, hazard ratio; CI, confidence interval.
Table 4. Metrics obtained for the random forest model on different datasets. The metrics were computed both in cross-validation (CV) on the train set T (mean with 95% confidence intervals) and in out-of-sample evaluation on the test set V . In bold, the best performer.
Table 4. Metrics obtained for the random forest model on different datasets. The metrics were computed both in cross-validation (CV) on the train set T (mean with 95% confidence intervals) and in out-of-sample evaluation on the test set V . In bold, the best performer.
DatasetACC CV (CI)ACC TestMCC CV (CI)MCC Test
AllCpGs0.713 (0.676–0.747)0.7560.435 (0.359–0.502)0.538
ImmuneAngioICIs0.7155 (0.679–0.754)0.7160.436 (0.368–0.512)0.523
ImmuneAngioICIsMesECM0.710 (0.674–0.748)0.7390.429 (0.354–0.504)0.490
AllCpGs + BORUTA0.736 (0.699–0.770)0.7550.478 (0.404–0.547)0.532
ImmuneAngioICIs + BORUTA0.717 (0.681–0.752)0.7290.443 (0.373–0.511)0.469
ImmuneAngioICIsMesECM + BORUTA0.747 (0.713–0.780)0.7930.498 (0.432–0.563)0.589
Table 5. Metrics obtained for the random forest and the MLP model on dataset ImmuneAngioICIsMesECM + BORUTA. The metrics were computed both in cross-validation (CV) on the train set T (mean with 95% confidence intervals) and in out-of-sample evaluation on the test set V . In bold, the best performer.
Table 5. Metrics obtained for the random forest and the MLP model on dataset ImmuneAngioICIsMesECM + BORUTA. The metrics were computed both in cross-validation (CV) on the train set T (mean with 95% confidence intervals) and in out-of-sample evaluation on the test set V . In bold, the best performer.
ModelACC CV (CI)ACC TestMCC CV (CI)MCC Test
RF0.747 (0.713–0.780)0.7930.498 (0.432–0.563)0.589
MLP0.807 (0.795–0.819)0.8280.625 (0.601–0.647)0.657
Table 6. Top 30 terms’ signatures from enrichment analysis using gProfile on 338 CpG probe from the best model [64].
Table 6. Top 30 terms’ signatures from enrichment analysis using gProfile on 338 CpG probe from the best model [64].
#Term IDTerm DescriptionObserved Gene CountBackground Gene CountStrengthFalse Discovery Rate
GO:0030198extracellular matrix organization312961.14 1.01 × 10 21
GO:0006955immune response4315600.56 1.14 × 10 10
GO:0002376immune system process4923700.43 3.46 × 10 8
GO:0030155regulation of cell adhesion236230.68 4.40 × 10 7
GO:0048514blood vessel morphogenesis183810.79 7.85 × 10 7
GO:0001568blood vessel development194640.73 2.19 × 10 6
GO:0007155cell adhesion258430.59 3.49 × 10 6
GO:0009653anatomical structure morphogenesis4019920.42 3.56 × 10 6
GO:0001525angiogenesis152970.82 3.73 × 10 6
GO:0035239tube morphogenesis216150.65 3.73 × 10 6
GO:0048583regulation of response to stimulus5938820.3 7.44 × 10 6
GO:0010033response to organic substance4828150.35 8.17 × 10 6
GO:0035295tube development237930.58 1.03 × 10 5
GO:0002684positive regulation of immune system process248820.55 1.54 × 10 5
GO:0071310cellular response to organic substance4022190.37 3.37 × 10 5
GO:2000026regulation of multicellular organismal development3618760.4 3.54 × 10 5
GO:0007492endoderm development8761.14 3.63 × 10 5
GO:0050896response to stimulus9178240.18 3.99 × 10 5
GO:0050776regulation of immune response238730.54 4.03 × 10 5
GO:0045765regulation of angiogenesis132770.79 4.46 × 10 5
GO:0045321leukocyte activation238940.53 5.56 × 10 5
GO:0002443leukocyte mediated immunity196320.59 6.19 × 10 5
GO:0070887cellular response to chemical stimulus4426720.33 6.19 × 10 5
GO:0002274myeloid leukocyte activation185740.61 6.69 × 10 5
GO:0010757negative regulation of plasminogen activation461.94 6.84 × 10 5
GO:0051239regulation of multicellular organismal process4527880.32 6.84 × 10 5
GO:0002682regulation of immune system process2913910.43 8.66 × 10 5
GO:0006027glycosaminoglycan catabolic process7621.17 8.66 × 10 5
GO:0050778positive regulation of immune response185890.6 8.66 × 10 5
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Polano, M.; Fabbiani, E.; Andreuzzi, E.; Cintio, F.D.; Bedon, L.; Gentilini, D.; Mongiat, M.; Ius, T.; Arcicasa, M.; Skrap, M.; et al. A New Epigenetic Model to Stratify Glioma Patients According to Their Immunosuppressive State. Cells 2021, 10, 576. https://0-doi-org.brum.beds.ac.uk/10.3390/cells10030576

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Polano M, Fabbiani E, Andreuzzi E, Cintio FD, Bedon L, Gentilini D, Mongiat M, Ius T, Arcicasa M, Skrap M, et al. A New Epigenetic Model to Stratify Glioma Patients According to Their Immunosuppressive State. Cells. 2021; 10(3):576. https://0-doi-org.brum.beds.ac.uk/10.3390/cells10030576

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Polano, Maurizio, Emanuele Fabbiani, Eva Andreuzzi, Federica Di Cintio, Luca Bedon, Davide Gentilini, Maurizio Mongiat, Tamara Ius, Mauro Arcicasa, Miran Skrap, and et al. 2021. "A New Epigenetic Model to Stratify Glioma Patients According to Their Immunosuppressive State" Cells 10, no. 3: 576. https://0-doi-org.brum.beds.ac.uk/10.3390/cells10030576

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