Kim Chang Hyun, Huh Jung Wook, Kim Hyeong Rok, Kim Young Jin
Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Gwangju, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2017 Aug;32(8):1469-1474. doi: 10.1111/jgh.13734.
The CpG island methylator phenotype (CIMP) is found in approximately 30% of colorectal cancer (CRC) cases. However, the role of CIMP status in predicting oncologic outcomes in curatively resected CRC is still unclear.
Between January 2006 and December 2006, we retrospectively reviewed 157 consecutive patients who underwent curative surgery for CRC. Prognostic significance of CIMP status was evaluated using reverse transcriptase-polymerase chain reaction.
CIMP-high (H) and CIMP-none/low (N/L) tumors were found in 50 cases (31.8%) and 107 cases (68.2%), respectively. CIMP-H tumors were significantly associated with female sex, colonic location, poorly/mucinous histologic type, higher T category, perineural invasion, and MSI-high status (P = 0.001). During a median of 64.5 months, tumor recurrence developed in 47 (29.9%) patients. The 5-year disease-free survival for CIMP-H and CIMP-N/L was 61.4% and 76.3% (P = 0.018). In addition, multivariate analysis showed that CIMP-H was also a significant prognostic factor (P = 0.042). When analysis was performed according to anatomical location, more marked survival differences were observed in patients with colon cancer (P = 0.026) than in patients with rectal cancer (P = 0.210). Similarly, the role of CIMP status as a prognostic indicator was more prominent in patients with stage I/II (P = 0.006) than in patients with stage III/IV CRC (P = 0.65).
DNA methylation status can be considered as a useful predictor of survival after CRC surgery, particularly for patients with stage I/II disease or colon cancer.
约30%的结直肠癌（CRC）病例存在CpG岛甲基化表型（CIMP）。然而，CIMP状态在预测接受根治性切除的CRC患者肿瘤学结局中的作用仍不明确。
2006年1月至2006年12月，我们回顾性分析了157例连续接受CRC根治性手术的患者。采用逆转录聚合酶链反应评估CIMP状态的预后意义。
分别在50例（31.8%）和107例（68.2%）患者中发现CIMP高（H）和CIMP无/低（N/L）肿瘤。CIMP-H肿瘤与女性、结肠部位、低分化/黏液组织学类型、较高的T分期、神经周围侵犯和微卫星高度不稳定状态显著相关（P = 0.001）。在中位64.5个月的随访期内，47例（29.9%）患者出现肿瘤复发。CIMP-H和CIMP-N/L患者的5年无病生存率分别为61.4%和76.3%（P = 0.018）。此外，多因素分析显示CIMP-H也是一个显著的预后因素（P = 0.042）。按解剖部位进行分析时，结肠癌患者（P = 0.026）的生存差异比直肠癌患者（P = 0.210）更明显。同样，CIMP状态作为预后指标在I/II期患者（P = 0.006）中比在III/IV期CRC患者（P = 0.65）中更突出。
DNA甲基化状态可被视为CRC手术后生存的有用预测指标，特别是对于I/II期疾病或结肠癌患者。
