Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
World J Gastroenterol. 2013 Jul 28;19(28):4568-75. doi: 10.3748/wjg.v19.i28.4568.
To investigate the contribution of the fibroblast growth factor receptor 4 (FGFR4) Gly388Arg polymorphism as a genetic risk factor for gastric cancer (GC) and to investigate any associations between this polymorphism and clinicopathological parameters and survival.
Tumors and matched adjacent non-cancer tissues were collected from 304 GC patients, and 5 mL of venous blood was collected from 62 GC patients and 392 age- and sex-matched healthy controls without cancer history from the same ethnic population. DNA was extracted, and direct sequencing analyses were performed to genotype the FGFR4 Gly388Arg polymorphism in all the samples. Differences in the genotype frequencies of the FGFR4 Gly388Arg polymorphism between GC patients and healthy controls were estimated using the χ(2) test. Binary logistic regression was used for all analysis variables to estimate risk as the ORs with 95%CIs. The relationships between the FGFR4 genotype and clinicopathological parameters were tested with the χ(2) test. The Kaplan-Meier product-limit method, the log-rank test, and the Cox regression model were applied to evaluate the effect of the FGFR4 genotype on the overall survival of patients with GC.
In the present GC cohort, 118 patients (38.8%) were homozygous for the Gly388 allele, 124 patients (40.8%) were heterozygous, and 62 patients (20.4%) were homozygous for the Arg388 allele. The frequencies of the Gly/Gly, Gly/Arg, and Arg/Arg genotypes in the healthy controls were 33.6%, 48.0%, and 18.4%, respectively. The distributions of genotypes (χ(2) = 3.589, P = 0.166) and alleles (χ(2) = 0.342, P = 0.559) of the FGFR4 Gly388Arg polymorphism were not different between the GC patients and the healthy controls. Although we observed no correlation between the FGFR4 Gly388Arg polymorphism and clinicopathological parameters or survival in the total cohort of GC patients, the presence of the Arg388 allele was associated with shorter survival time in patients with GC if the tumor was small (log rank χ(2) = 5.449, P = 0.020), well differentiated (log rank χ(2) = 12.798, P = 0.000), T1 or T2 stage (log rank χ(2) = 4.745, P = 0.029), without lymph node involvement (log rank χ(2) = 6.647, P= 0.010), and at an early clinical stage (log rank χ(2) = 4.615, P = 0.032).
Our results suggest that the FGFR4 Gly388Arg polymorphism is not a risk factor for GC cancer initiation but that it is a useful prognostic marker for GC patients when the tumor is relatively small, well differentiated, or at an early clinical stage.
探讨成纤维细胞生长因子受体 4(FGFR4)Gly388Arg 多态性作为胃癌(GC)遗传风险因素的作用,并探讨该多态性与临床病理参数和生存之间的任何关联。
从 304 例 GC 患者中收集肿瘤和匹配的癌旁非肿瘤组织,从同一民族人群中相同年龄和性别匹配的无癌症病史的 62 例 GC 患者和 392 例健康对照者中采集 5 mL 静脉血。提取 DNA,对所有样本进行 FGFR4 Gly388Arg 多态性的直接测序分析。使用 χ²检验估计 GC 患者和健康对照组 FGFR4 Gly388Arg 多态性基因型频率的差异。使用二元逻辑回归对所有分析变量进行风险估计,OR 值及其 95%CI。使用 χ²检验检验 FGFR4 基因型与临床病理参数之间的关系。应用 Kaplan-Meier 乘积限法、对数秩检验和 Cox 回归模型评估 FGFR4 基因型对 GC 患者总生存的影响。
在本 GC 队列中,118 例患者(38.8%)为 Gly388 等位基因纯合子,124 例患者(40.8%)为杂合子,62 例患者(20.4%)为 Arg388 等位基因纯合子。健康对照组中 Gly/Gly、Gly/Arg 和 Arg/Arg 基因型的频率分别为 33.6%、48.0%和 18.4%。FGFR4 Gly388Arg 多态性的基因型(χ²=3.589,P=0.166)和等位基因(χ²=0.342,P=0.559)分布在 GC 患者和健康对照组之间没有差异。尽管我们在 GC 患者的总队列中未观察到 FGFR4 Gly388Arg 多态性与临床病理参数或生存之间存在相关性,但在肿瘤较小时(log-rank χ²=5.449,P=0.020)、分化良好(log-rank χ²=12.798,P=0.000)、T1 或 T2 期(log-rank χ²=4.745,P=0.029)、无淋巴结受累(log-rank χ²=6.647,P=0.010)和早期临床阶段(log-rank χ²=4.615,P=0.032)的患者中,Arg388 等位基因与较短的生存时间相关。
我们的结果表明,FGFR4 Gly388Arg 多态性不是 GC 癌症发生的危险因素,但当肿瘤相对较小时,它是 GC 患者的有用预后标志物,分化良好或处于早期临床阶段。