Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
J Gastric Cancer. 2013 Sep;13(3):157-63. doi: 10.5230/jgc.2013.13.3.157. Epub 2013 Sep 30.
The aim of this study was to assess clinical correlations with postoperative alteration of p16 DNA methylation, and to clarify whether postoperative changes in the serum DNA methylation status of p16 could be used as a reliable prognostic factor for gastric cancer.
Fifty-three consecutive gastric adenocarcinoma patients who underwent gastric resection (Chung-Ang University Hospital, Seoul, Korea) were included. DNA methylation of p16 was evaluated by methylation-specific polymerase chain reaction using serum DNA preoperatively and at the 10th postoperative day. The correlation between changes in methylation status and patients' prognosis was analyzed.
p16 was methylated in 79.2% of preoperative serum DNA and in 54.7% of postoperative serum DNA, respectively. Methylation in p16 disappeared more frequently in patients who underwent standard D2 lymphadenectomy compared to those who underwent modified D1+ lymphadenectomy (P=0.016). Whereas methylation of preoperative serum DNA was not correlated with survival, patients with postoperative disappearance of p16 methylation showed longer survival than those without postoperative disappearance of p16 methylation in the patients who had gastric cancer with lymph node metastasis (P=0.042).
Postoperative disappearance of p16 methylation could be an available prognostic factor for node-positive gastric cancer.
本研究旨在评估术后 p16DNA 甲基化改变的临床相关性,并阐明术后 p16 血清 DNA 甲基化状态的变化是否可作为胃癌的可靠预后因素。
纳入 53 例连续接受胃癌切除术(韩国忠南大学医院)的胃腺癌患者。术前及术后第 10 天采用甲基化特异性聚合酶链反应检测血清 DNA 中 p16 的甲基化状态。分析甲基化状态变化与患者预后的相关性。
术前血清 DNA 中 p16 的甲基化率为 79.2%,术后为 54.7%。标准 D2 淋巴结清扫术患者 p16 甲基化消失的频率明显高于改良 D1+淋巴结清扫术患者(P=0.016)。术前血清 DNA 甲基化与生存无关,但在有淋巴结转移的胃癌患者中,p16 甲基化消失的患者术后生存时间长于 p16 甲基化未消失的患者(P=0.042)。
术后 p16 甲基化的消失可能是淋巴结阳性胃癌的一个有效的预后因素。