CpG island methylator phenotype is an independent predictor of survival after curative resection for colorectal cancer: A prospective cohort study
CpG island methylator phenotype is an independent predictor of survival after curative resection for colorectal cancer: A prospective cohort study
复制标题
DOI：
10.1111/jgh.13734
复制
发表时间：
2017-08-01
影响因子：
4.1
通讯作者：
Kim, Young Jin
中科院分区：
文献类型：
--
作者：
Kim, Chang Hyun;Huh, Jung Wook;Kim, Young Jin
背景和目的：在大约30%的结直肠癌（CRC）病例中发现了CpG岛甲基化表型（CIMP）。然而，CIMP状态在预测肿瘤学结果在根治性切除CRC的作用尚不清楚。研究：2006年1月至2006年12月，我们回顾性分析了157例连续的患者接受根治性手术CRC。结果：50例（31.8%）CIMP高表达（H），107例（68.2%）CIMP无/低表达（N/L）。CIMP-H肿瘤与女性性别、结肠位置、低/粘液组织学类型、较高T分类、神经周围浸润和MSI高状态显著相关（P = 0.001）。在中位64.5个月内，47例（29.9%）患者发生肿瘤复发。CIMP-H组和CIMP-N/L组5年无瘤生存率分别为61.4%和76.3%（P = 0.018）。此外，多因素分析显示CIMP-H也是一个有意义的预后因素（P = 0.042）。当根据解剖位置进行分析时，结肠癌患者（P = 0.026）比直肠癌患者（P = 0.210）观察到更显著的生存差异。同样，CIMP状态作为预后指标的作用在I/II期患者（P = 0.006）中比III/IV期CRC患者（P = 0.65）更为突出。结论：DNA甲基化状态可以被认为是CRC手术后生存的有用预测因子，特别是对于I/II期疾病或结肠癌患者。
Background and Aims: 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.Study: 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.Results: 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).Conclusions: 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.