CDKN2A (p16)启动子超甲基化影响年轻肺癌患者的预后。

Dawn P Bradly, Paolo Gattuso, Mark Pool, Sanjib Basu, Michael Liptay, Philip Bonomi, Lela Buckingham
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引用次数: 26

摘要

目的:非小细胞肺癌(NSCLC)最常见于60岁以上的人群。目前,尚未发现与年轻患者(30 ~ 60岁)NSCLC相关的生物学指标。为了探索表观遗传学的影响,我们分析了30岁至87岁的早期NSCLC患者中选定肿瘤抑制基因的启动子甲基化。实验设计:对193例手术治疗的非小细胞肺癌患者(127例,年龄大于60岁;66岁,60岁及以下)。p16、MGMT、DAPK、RASSF1、CDH1、LET7-3-a、NORE1(RASSF5)和PTEN启动子的甲基化通过磷酸测序进行定量。免疫组化(IHC)检测p16蛋白表达。通过Kaplan-Meier分析评估以复发时间和总生存期定义的结局。结果:60岁以上患者的启动子甲基化水平普遍高于60岁或60岁以下诊断的患者。在测试的基因中,p16启动子的甲基化水平显示出与年龄相关的差异。尽管p16启动子甲基化在50岁或以下和40岁或以下的切割点显著降低(P分别=0.001至0.012),但p16蛋白表达随着年龄的增长而增加。60岁及以下p16启动子超甲基化患者的复发时间明显缩短(P=0.002),生存时间明显缩短(P=0.011)。p16高甲基化对60岁以上患者无影响。结论:p16启动子高甲基化与诊断年龄在60岁或以下的患者预后较差相关,但与60岁以上年龄组的预后无关。总的来说,这些数据支持甲基化依赖性和甲基化非依赖性年龄相关的p16表达调控对早期NSCLC手术切除后的预后有不同的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CDKN2A (p16) promoter hypermethylation influences the outcome in young lung cancer patients.

Purpose: Non-small cell lung cancer (NSCLC) occurs most frequently in individuals older than 60 years of age. Currently, no biological indicators associated with NSCLC in younger patients (30 to 60 y) have been identified. To explore epigenetic influences, promoter methylation of selected tumor suppressor genes was analyzed in early-stage NSCLC patients ranging in age from 30 to 87 years at diagnosis.

Experimental design: The analysis was performed on formalin-fixed tumor tissue from 193 surgically treated NSCLC patients (127, older than 60 y; 66, 60 y and younger). Methylation was quantified in p16, MGMT, DAPK, RASSF1, CDH1, LET7-3-a, NORE1(RASSF5), and PTEN promoters by pyrosequencing. p16 protein expression was assessed by immunohistochemistry (IHC). Outcome, defined by time to recurrence and overall survival, was evaluated by Kaplan-Meier analysis.

Results: Promoter methylation levels were generally higher in patients older than 60 years of age than in patients 60 years or younger at diagnosis. Of the genes tested, methylation levels of the p16 promoter showed age-related differences. Although p16 promoter methylation was significantly lower using cut-points of 50 years or younger and 40 years or younger (P=0.001 to 0.012, respectively), p16 protein expression increased with age. Patients 60 years or younger with p16 promoter hypermethylation had a significantly shortened time to recurrence (P=0.002) and a shortened survival time (P=0.011). No effect of p16 hypermethylation was seen in patients older than 60 years.

Conclusions: p16 promoter hypermethylation was associated with a worse outcome in patients with age at diagnosis of 60 years or younger, but was not associated with the outcome in the older than 60-year age group. Overall, these data support methylation-dependent and methylation-independent age-related regulation of p16 expression with differential effects on the outcome after surgical resection for early-stage NSCLC.

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期刊介绍: Diagnostic Molecular Pathology focuses on providing clinical and academic pathologists with coverage of the latest molecular technologies, timely reviews of established techniques, and papers on the applications of these methods to all aspects of surgical pathology and laboratory medicine. It publishes original, peer-reviewed contributions on molecular probes for diagnosis, such as tumor suppressor genes, oncogenes, the polymerase chain reaction (PCR), and in situ hybridization. Articles demonstrate how these highly sensitive techniques can be applied for more accurate diagnosis.
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