Abstract
Neuroblastoma is the most common extracranial solid tumour in children, and genetic susceptibility plays a crucial role in its development. The impact of tRNA Dimethyltransferase 1 (TRDMT1), a primary methyltransferase catalysing 5-methylcytosine (m5C) RNA modification, on neuroblastoma susceptibility remains unexplored. We conducted a case-control study involving 402 neuroblastoma patients and 473 controls from Jiangsu, China. TRDMT1 polymorphisms (rs7074891 T>C, rs10904887 T>C and rs2273734 C>T) were genotyped via the TaqMan assay. Logistic regression was used to assess odds ratios (ORs) and 95% confidence intervals (CIs), while stratification analysis and expression quantitative trait locus (eQTL) analysis were used to examine subgroup-specific effects and regulatory impacts. Additionally, clinical correlation analysis and survival analysis were performed on neuroblastoma datasets used to evaluate. The rs7074891 TC/CC genotype reduced neuroblastoma risk (adjusted OR = 0.75, 95% CI = 0.57-0.98, p = 0.036), especially in children aged ≤ 18 months and those with mediastinal-origin tumours. Conversely, the rs10904887 CC (adjusted OR = 1.73, 95% CI = 1.27-2.38, p = 0.0006) and rs2273734 TT genotypes (adjusted OR = 1.80, 95% CI = 1.09-2.97, p = 0.023) were associated with increased risk, with distinct subgroup-specific effects. Combined 1-3 risk genotypes further confirmed increased susceptibility (adjusted OR = 1.81, 95% CI = 1.38-2.37, p < 0.0001), particularly in males and older children. eQTL analysis revealed that the rs7074891 C and rs10904887 C alleles increased TRDMT1 expression, whereas the rs2273734 T allele decreased it. Elevated TRDMT1 expression was correlated with poor prognosis and high-risk clinical features. TRDMT1 polymorphisms are significantly associated with neuroblastoma susceptibility, providing insights into their genetic and epigenetic mechanisms and potential as biomarkers and therapeutic targets.