Momose Hirotaka, Sugimoto Kiichi, Irie Takahiro, Nomura Sachio, Ro Hisashi, Ishiyama Shun, Takahashi Makoto, Pisanic Thomas, Sakamoto Kazuhiro
Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Department of Pathology and Oncology, Juntendo University Faculty of Medicine, Tokyo, Japan.
J Surg Oncol. 2025 Feb;131(2):160-169. doi: 10.1002/jso.27824. Epub 2024 Aug 19.
Our aim in this study was to investigate the usefulness of circulating tumor (ct) DNA methylation analysis for predicting long-term outcomes after resection in Stage IV colorectal cancer (CRC).
Methylation analyses were performed on 95 plasma samples from patients with CRC who underwent surgery. The methylation status (relative methylation value: RMV) of CpG within the promoter region of three genes (CHFR, SOX11, and CDO1) was assessed to quantitative methylation-specific PCR (qMSP) analysis.
In the patients who had undergone resection of the primary tumor and metastatic organs with curative intent, the CHFR-RMV high group had significantly worse recurrence-free survival (RFS) compared with the CHFR-RMV low group (p = 0.001). Multivariate analysis revealed that CHFR-RMV was a significant independent prognostic factor (hazard ratio = 2.63 (1.29-5.36); p = 0.008). In the patients who had undergone resection of the primary tumor with metastatic organs with curative intent after neoadjuvant systemic chemotherapy, the SOX11-RMV high group had significantly worse RFS compared with the SOX11-RMV low group (p = 0.004).
The current study showed the usefulness of ctDNA methylation analysis for predicting the possibility of curative resection and long-term outcomes after resection in Stage IV CRC. A future prospective study is needed to obtain more conclusive results.
本研究的目的是探讨循环肿瘤(ct)DNA甲基化分析在预测IV期结直肠癌(CRC)切除术后长期预后中的作用。
对95例接受手术的CRC患者的血浆样本进行甲基化分析。通过定量甲基化特异性PCR(qMSP)分析评估三个基因(CHFR、SOX11和CDO1)启动子区域内CpG的甲基化状态(相对甲基化值:RMV)。
在以治愈为目的切除原发性肿瘤和转移器官的患者中,CHFR-RMV高分组的无复发生存期(RFS)明显低于CHFR-RMV低分组(p = 0.001)。多变量分析显示,CHFR-RMV是一个显著的独立预后因素(风险比= 2.63(1.29 - 5.36);p = 0.008)。在新辅助全身化疗后以治愈为目的切除原发性肿瘤和转移器官的患者中,SOX11-RMV高分组的RFS明显低于SOX11-RMV低分组(p = 0.004)。
本研究表明ctDNA甲基化分析在预测IV期CRC治愈性切除的可能性和切除术后长期预后方面具有作用。需要未来进行前瞻性研究以获得更确凿的结果。