Department of Medical Oncology, Gastroenterological Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
Department of Clinical Cancer Genomics, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
BMC Gastroenterol. 2023 Oct 2;23(1):339. doi: 10.1186/s12876-023-02975-1.
BACKGROUND: Fluoropyrimidine-based postoperative adjuvant chemotherapy is globally recommended for high-risk stage II and stage III colon cancer. However, adjuvant chemotherapy is often associated with severe adverse events and is not highly effective in preventing recurrence. Therefore, discovery of novel molecular biomarkers of postoperative adjuvant chemotherapy to identify patients at increased risk of recurrent colorectal cancer is warranted. Autophagy (including mitophagy) is activated under chemotherapy-induced stress and contributes to chemotherapy resistance. Expression of autophagy-related genes and their single-nucleotide polymorphisms are reported to be effective predictors of chemotherapy response in some cancers. Our goal was to evaluate the relationship between single-nucleotide variants of autophagy-related genes and recurrence rates in order to identify novel biomarkers that predict the effect of adjuvant chemotherapy in colorectal cancer. METHODS: We analyzed surgical or biopsy specimens from 84 patients who underwent radical surgery followed by fluoropyrimidine-based adjuvant chemotherapy at Saitama Medical University International Medical Center between January and December 2016. Using targeted enrichment sequencing, we identified single-nucleotide variants and insertions/deletions in 50 genes, including autophagy-related genes, and examined their association with colorectal cancer recurrence rates. RESULTS: We detected 560 single-nucleotide variants and insertions/deletions in the target region. The results of Fisher's exact test indicated that the recurrence rate of colorectal cancer after adjuvant chemotherapy was significantly lower in patients with the single-nucleotide variants (c.1018G > A [p < 0.005] or c.1562A > C [p < 0.01]) of the mitophagy-related gene PTEN-induced kinase 1. CONCLUSIONS: The two single-nucleotide variants of PINK1 gene may be biomarkers of non-recurrence in colorectal cancer patients who received postoperative adjuvant chemotherapy.
背景:氟嘧啶类术后辅助化疗在全球范围内被推荐用于高危 II 期和 III 期结肠癌。然而,辅助化疗常伴有严重的不良反应,并且在预防复发方面效果不佳。因此,有必要发现新型的术后辅助化疗分子生物标志物,以识别复发风险增加的结直肠癌患者。自噬(包括线粒体自噬)在化疗诱导的应激下被激活,并有助于化疗耐药。有报道称,自噬相关基因的表达及其单核苷酸多态性是某些癌症化疗反应的有效预测因子。我们的目标是评估自噬相关基因的单核苷酸变异与复发率之间的关系,以确定预测结直肠癌辅助化疗效果的新型生物标志物。
方法:我们分析了 2016 年 1 月至 12 月期间在埼玉医科大学国际医疗中心接受根治性手术和氟嘧啶类辅助化疗的 84 例患者的手术或活检标本。使用靶向富集测序,我们鉴定了包括自噬相关基因在内的 50 个基因中的单核苷酸变异和插入/缺失,并检查了它们与结直肠癌复发率的关系。
结果:我们在靶区检测到 560 个单核苷酸变异和插入/缺失。Fisher 精确检验的结果表明,接受辅助化疗后结直肠癌复发率在具有以下单核苷酸变异(c.1018G > A [p < 0.005]或 c.1562A > C [p < 0.01])的患者中显著降低。PTEN 诱导的激酶 1 是一种与线粒体自噬相关的基因。
结论:PINK1 基因的两个单核苷酸变异可能是接受术后辅助化疗的结直肠癌患者无复发的生物标志物。
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