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Jiang Z, Xie W, Zhou X, Pan W, Jiang S, Zhang X, Zhang M, Zhang Z, Lu Y, Wang D. A virtual biopsy study of microsatellite instability in gastric cancer based on deep learning radiomics. Insights Imaging 2023; 14:104. [PMID: 37286810 DOI: 10.1186/s13244-023-01438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/15/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES This study aims to develop and validate a virtual biopsy model to predict microsatellite instability (MSI) status in preoperative gastric cancer (GC) patients based on clinical information and the radiomics of deep learning algorithms. METHODS A total of 223 GC patients with MSI status detected by postoperative immunohistochemical staining (IHC) were retrospectively recruited and randomly assigned to the training (n = 167) and testing (n = 56) sets in a 3:1 ratio. In the training set, 982 high-throughput radiomic features were extracted from preoperative abdominal dynamic contrast-enhanced CT (CECT) and screened. According to the deep learning multilayer perceptron (MLP), 15 optimal features were optimized to establish the radiomic feature score (Rad-score), and LASSO regression was used to screen out clinically independent predictors. Based on logistic regression, the Rad-score and clinically independent predictors were integrated to build the clinical radiomics model and visualized as a nomogram and independently verified in the testing set. The performance and clinical applicability of hybrid model in identifying MSI status were evaluated by the area under the receiver operating characteristic (AUC) curve, calibration curve, and decision curve (DCA). RESULTS The AUCs of the clinical image model in training set and testing set were 0.883 [95% CI: 0.822-0.945] and 0.802 [95% CI: 0.666-0.937], respectively. This hybrid model showed good consistency in the calibration curve and clinical applicability in the DCA curve, respectively. CONCLUSIONS Using preoperative imaging and clinical information, we developed a deep-learning-based radiomics model for the non-invasive evaluation of MSI in GC patients. This model maybe can potentially support clinical treatment decision making for GC patients.
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Affiliation(s)
- Zinian Jiang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Wentao Xie
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China
| | - Xiaoming Zhou
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenjun Pan
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Sheng Jiang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Xianxiang Zhang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China
| | - Maoshen Zhang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China
| | - Zhenqi Zhang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yun Lu
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China.
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China.
- Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, Qingdao, Shandong, China.
| | - Dongsheng Wang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China.
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China.
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Bai H, Xia S, Zhu L, Dong Y, Liu C, Li N, Liu H, Xiao J. Altered polymerase theta expression promotes chromosomal instability in salivary adenoid cystic carcinoma. J Cell Mol Med 2022; 26:3931-3949. [PMID: 35726713 PMCID: PMC9279586 DOI: 10.1111/jcmm.17429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/10/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022] Open
Abstract
Genomic instability (GIN) plays a key role in cancer progression. The disorders of polymerase theta (POLQ) were reported to contribute to GIN and progression in many cancers. Here, we found that POLQ over‐expression was related to salivary adenoid cystic carcinoma (SACC) progression and poor prognosis. Then, we investigated the role and mechanism of POLQ in the GIN in SACC. GIN was assessed by chromosome staining with DAPI and Giemsa, as well as qRT‐PCR of the mitosis‐related gene expression. Meanwhile, PCR‐SSCP was used to evaluate microsatellite instability. Modulation of POLQ expression increased chromosomal instability and enhanced the sensitivity to etoposide without impacting microsatellite stability. Mechanistically, POLQ regulated genome stability by promoting the expression of the error‐prone alt‐NHEJ‐related protein PARP1, and down‐regulating c‐NHEJ‐ and HR‐related proteins KU70 and RAD51. In vitro CCK, Transwell assays and in vivo murine xenograft models indicated that the PARP inhibitor olaparib suppressed SACC growth in the case of etoposide‐induced DNA damage. Bioinformatic analysis identified CEBPB as a potential POLQ‐regulating transcription factor. In summary, our research provides new insights into the mechanisms of SACC chromosomal instability and identifies new potential targets for SACC treatment.
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Affiliation(s)
- Han Bai
- College of Stomatology, Dalian Medical University, Dalian, China
| | - Shilin Xia
- Clinical Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lei Zhu
- College of Stomatology, Dalian Medical University, Dalian, China
| | - Yan Dong
- College of Stomatology, Dalian Medical University, Dalian, China
| | - Chao Liu
- College of Stomatology, Dalian Medical University, Dalian, China
| | - Nan Li
- College of Stomatology, Dalian Medical University, Dalian, China.,Liaoning Province Key Laboratory of Organism Microecology and Disease Control, Dalian, China
| | - Han Liu
- College of Stomatology, Dalian Medical University, Dalian, China.,Liaoning Province Key Laboratory of Organism Microecology and Disease Control, Dalian, China
| | - Jing Xiao
- College of Stomatology, Dalian Medical University, Dalian, China.,Liaoning Province Key Laboratory of Organism Microecology and Disease Control, Dalian, China
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Huang H, Wang Z, Li Y, Zhao Q, Niu Z. Amplification of the human epidermal growth factor receptor 2 ( HER2) gene is associated with a microsatellite stable status in Chinese gastric cancer patients. J Gastrointest Oncol 2021; 12:377-387. [PMID: 34012633 PMCID: PMC8107625 DOI: 10.21037/jgo-21-47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/04/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Gastric cancer (GC) is one of the most common cancers worldwide. However, little is known about the combination of HER2 amplification and microsatellite instability (MSI) status in GC. This study aimed to analyze the correlation of HER2 amplification with microsatellite instability (MSI) status, clinical characteristics, and the tumor mutational burden (TMB) of patients. METHODS A total of 192 gastric cancer (GC) patients were enrolled in this cohort. To analyze genomic alterations (GAs), deep sequencing was performed on 450 target cancer genes. TMB was measured by an in-house algorithm. MSI status was inferred based on the MANTIS (Microsatellite Analysis for Normal-Tumor InStability) score. RESULTS The most frequently amplified genes in the GC patients included cyclin E1 (CCNE1), human epidermal growth factor receptor 2 (HER2), fibroblast growth factor receptor 2 (FGFR2), cyclin D1 (CCND1), fibroblast growth factor 19 (FGF19), fibroblast growth factor 3 (FGF3), and fibroblast growth factor 4 (FGF4). The frequency of HER2 amplification was 9.38% (18/192). HER2 amplification was higher in females than in males (14.52% vs. 6.92%, respectively, P=0.091), however, MSI was higher in males compared to females (7.69% vs. 4.84%, respectively, P=0.46). HER2 amplification was higher in metastatic loci compared to primary lesions (23.08% vs. 8.38%, respectively, P=0.079) and was lower in patients with high TMB (TMB-H) compared to those with low TMB (TMB-L) (4.0% vs. 11.35%, respectively, P=0.12). While the frequency of MSI in metastatic foci was higher than that in primary lesions (15.38% vs. 6.15%, respectively, P=0.48), MSI status was highly associated with TMB-H (20% vs. 0%, respectively, P=3.66×10-7). Furthermore, HER2 amplification was negatively correlated with MSI status in Chinese GC patients. CONCLUSIONS HER2 amplification was negatively correlated with TMB-H and MSI status, and MSI status was significantly associated with TMB-H in Chinese GC patients. These data suggested that HER2 amplification might be a negative indicator for GC immunotherapy.
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Affiliation(s)
- He Huang
- Department of Gastrointestinal Surgery, The First Hospital of Shanxi Medical University, Shanxi, China
| | - Zhengkun Wang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yi Li
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qun Zhao
- Department of Gastrosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhaojian Niu
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Gastric cancer is associated with a high rate of microsatellite instability versus chronic gastritis: A retrospective study. REV ROMANA MED LAB 2020. [DOI: 10.2478/rrlm-2020-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Objective: Microsatellite instability (MSI) in gastric cancer contributes to genetic complexities of gastric cancer. In the current study, we employed a panel of mononucleotide and dinucleotide markers to detect MSI in 99 gastric cancer patients and 91 chronic gastritis patients and further analyzed the association of MSI with clinicopathologic variables of the study patients.
Methods: We retrospectively analyzed the clinicopathologic data of primary gastric cancer patients and chronic gastritis patients. MSI was analyzed using five microsatellite markers, including D2S12, D5S346, D17S799, BAT26, and D18S34. MSI was defined as either a band shift or the appearance of a novel band in DNA. Multivariate logistic regression analysis was used to predict risk of MSI.
Results: Seventeen (17.2%) gastric cancer patients and 7 (7.7%) chronic gastritis patients were positive for MSI (P=0.012). Multivariate analysis further showed that gastric cancer was associated with a significantly higher likelihood for MSI versus gastritis (OR 3.73; 95% CI 1.19, 11.72; P=0.024) while age, drinking or smoking was not associated with increased MSI.
Conclusion: Gastric cancer is associated with a high rate of MSI. MSI should be further explored in future studies with a larger sample size for its role in gastric cancer development and as a predictive biomarker.
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Silva-Fernandes IJDL, Oliveira ESD, Santos JC, Ribeiro ML, Ferrasi AC, Pardini MIDMC, Burbano RMR, Rabenhorst SHB. The intricate interplay between MSI and polymorphisms of DNA repair enzymes in gastric cancer H.pylori associated. Mutagenesis 2017; 32:471-478. [DOI: 10.1093/mutage/gex013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 04/24/2017] [Indexed: 12/15/2022] Open
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Kim YB, Lee SY, Kim JH, Sung IK, Park HS, Shim CS, Han HS. Microsatellite Instability of Gastric and Colorectal Cancers as a Predictor of Synchronous Gastric or Colorectal Neoplasms. Gut Liver 2016; 10:220-7. [PMID: 26087787 PMCID: PMC4780451 DOI: 10.5009/gnl14310] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/AIMS Microsatellite instability (MSI) plays a crucial role in gastrointestinal carcinogenesis. The aim of this study was to clarify whether MSI is a useful marker for predicting synchronous gastric and colorectal neoplasms. METHODS Consecutive patients who underwent both esophagogastroduodenoscopy and colonoscopy before the resection of gastric or colorectal cancers were included. MSI was analyzed using two mononucleotide and three dinucleotide markers. RESULTS In total, 434 gastric cancers (372 microsatellite stability [MSS], 21 low incidence of MSI [MSI-L], and 41 high incidence of MSI [MSI-H]) and 162 colorectal cancers (138 MSS, 9 MSI-L, and 15 MSI-H) were included. Patients with MSI gastric cancer had a higher prevalence of synchronous colorectal cancer, colorectal adenoma, and gastric adenoma than those with MSS gastric cancers (4.8% vs 0.5%, p=0.023; 11.3% vs 3.2%, p=0.011; 3.2% vs 1.2%, p=0.00, respectively). The prevalence of synchronous colorectal adenomas was highest in MSI-L gastric cancers (19.0%), compared with MSI-H (7.3%) or MSS (3.2%) gastric cancers (p=0.002). In addition, there were no significant differences in the prevalence rates of synchronous colorectal adenoma among the MSI-H (13.3%), MSI-L (11.1%), and MSS (12.3%) colorectal cancers (p=0.987). CONCLUSIONS The presence of MSI in gastric cancer may be a predictor of synchronous gastric and colorectal neoplasms, whereas MSI in colorectal cancer is not a predictor of synchronous colorectal adenoma.
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Affiliation(s)
- Young Beak Kim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Sun-Young Lee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jeong Hwan Kim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - In-Kyung Sung
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hyung Seok Park
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Chan Sup Shim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hye Seung Han
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
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Guo Y, Huang A, Hu C, Zhou Y, Zhang X, Czajkowsky DM, Li J, Cheng S, Shen R, Gu J, Liu B, Shao Z. Complex clonal mosaicism within microdissected intestinal metaplastic glands without concurrent gastric cancer. J Med Genet 2016; 53:643-6. [DOI: 10.1136/jmedgenet-2016-103872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 05/18/2016] [Indexed: 12/22/2022]
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Guo Y, Zhou J, Huang A, Li J, Yan M, Zhu Z, Zhao X, Gu J, Liu B, Shao Z. Spatially defined microsatellite analysis reveals extensive genetic mosaicism and clonal complexity in intestinal metaplastic glands. Int J Cancer 2014; 136:2973-9. [PMID: 25403721 DOI: 10.1002/ijc.29340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 11/03/2014] [Indexed: 12/18/2022]
Abstract
Intestinal metaplasia (IM) has been recognized as the first irreversible precancerous stage of intestinal-type gastric cancer at which genetic instabilities, such as microsatellite (MS) instability and loss of heterozygosity, can already be detected. However, the extent and clonal relationship of these genetic lesions in the precancerous tissues are not fully appreciated. In this work, we have used well established MS markers to analyze the relatedness of spatially separated individual metaplastic glands as well as subsegments within single glands from the same patients. We found that individual IM glands frequently show different marker lengths even for closely apposed IM glands, suggesting that these tissues have already gained the ability to independently evolve their genome regardless of whether or not they share a common origin. Furthermore, within individual IM glands, there is also significant intra-gland diversity in the MS markers. Since most of these cells are not dividing and only have a limited lifespan, this result indicates that in each IM gland, a single dominant clone is rare and new clones are constantly created by either progenitor cells or stem cells. This greatly enhanced ability to create de novo genetic alterations may underlie the importance of this stage in the eventual progression toward cancer. Given the widely observed phenotype switch in the early stages of many solid tumors, whether this associated genetic stability is also an intrinsic property of metaplastic transformation should be extensively characterized to further our understanding of cancer initiation.
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Affiliation(s)
- Yan Guo
- Bio-ID Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China; State Key Laboratory for Oncogenes & Related Genes, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Lee JH, Kim DK. Microsatellite Instability of Nuclear and Mitochondrial DNAs in Gastric Carcinogenesis. Asian Pac J Cancer Prev 2014. [DOI: 10.7314/apjcp.2014.15.19.8027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Choi HS, Lee SY, Kim JH, Sung IK, Park HS, Shim CS, Jin CJ, Han HS. Low prevalence of microsatellite instability in interval gastric cancers. Dig Dis Sci 2014; 59:322-7. [PMID: 24357187 DOI: 10.1007/s10620-013-2987-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 12/05/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIM Esophagogastroduodenoscopy (EGD) is recommended at 2-year intervals in countries with a high prevalence of gastric cancer. The aim of this study was to determine whether interval gastric cancers that develop within 2 years of a previous complete screening are associated with microsatellite instability (MSI). METHODS Newly diagnosed gastric cancer patients who had undergone gastrectomy were included. Of these 459 patients, 177 were classified as interval gastric cancer since they were diagnosed within 2 years of a previous EGD. Noninterval gastric cancer patients were subclassified into 65 patients who underwent previous EGD between the past 2 and 10 years and 217 patients without EGD during the last 10 years. Analysis for MSI was conducted using two mononucleotide and three dinucleotide markers. RESULTS MSI was found more frequently in noninterval gastric cancers than in interval gastric cancers (p = 0.009). Interval gastric cancers were associated with a higher prevalence of early gastric cancer (p = 0.006), smaller size (p < 0.001), and lower TNM stages (p = 0.006). On logistic regression analysis, noninterval gastric cancers were related to MSI (p = 0.010) and larger size (≥4 cm) (p = 0.009). Subjects with interval gastric cancer showed better survival than those with noninterval gastric cancer (p = 0.006). CONCLUSIONS During a 2-year screening interval, noninterval gastric cancers tend to be larger, more advanced, and associated with MSI. Biannual EGD screening is effective for detecting small gastric cancers at an early stage, but is not useful in detecting gastric cancers with MSI.
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Affiliation(s)
- Hong Seok Choi
- Department of Internal Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 143-729, Korea
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Park HJ, Kim HS, Kim JW, Park SY, Kim BR, Ryu HY, Lee IY, Lee YK, Cho MY. Is microsatellite instability (MSI) associated with multiplicity in early stage gastric neoplasias? Clin Res Hepatol Gastroenterol 2013; 37:400-5. [PMID: 23273496 DOI: 10.1016/j.clinre.2012.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 09/26/2012] [Accepted: 10/18/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS The aim of this study was to investigate the relationship between microsatellite instability (MSI) and clinicopathologic features including multiplicity in early stage gastric neoplasias (ESGN). METHODS From November 2004 until September 2009, 372 patients with consecutive resected gastric neoplasias were retrospectively enrolled. The gastric neoplasias were composed of 117 advanced gastric cancers (AGCs) and 255 ESGNs including 31 gastric dysplasias (including low and high grade dysplasia) and 224 early gastric cancers (EGCs). RESULTS Based on microsatellite markers, high MSI (MSI-H) was observed in 61 cases (16.4%) and low MSI (MSI-L) in 14 cases (3.8%) of 372 cases. There was a positive correlation between the presence of MSI-H and progression of gastric adenoma to gastric tumor. We compared ESGNs with microsatellite stable (MSS; 223 cases, 87.5%) and ESGNs with MSI-H (24 cases, 9.4%). The ESGNs with MSI-H were only associated with older age and female gender. There were no association with Helicobacter pylori infection, intestinal metaplasia, and distal location in contrast with EGCs with MSI-H. Furthermore, multiplicity of ESGNs was not associated with MSI status. CONCLUSIONS The clinicopatholgic features of MSI-H phenotype were different according to the progression of gastric neoplasias from ESGNs to AGCs. ESGNs with MSI-H were only associated with old age, female sex. In addition ESGNs with MSI-H were not associated with an increased risk of multifocal tumors.
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Affiliation(s)
- Hong Jun Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Chung HW, Lee SY, Han HS, Park HS, Yang JH, Lee HH, So Y. Gastric cancers with microsatellite instability exhibit high fluorodeoxyglucose uptake on positron emission tomography. Gastric Cancer 2013; 16:185-92. [PMID: 22692466 DOI: 10.1007/s10120-012-0165-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 05/11/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastric cancers exhibit various degrees of (18)F-fluorodeoxyglucose (FDG) uptakes on positron emission tomography/computed tomography (PET/CT) imaging. The aim of this study was to evaluate whether FDG uptake in gastric cancer varies according to the microsatellite instability (MSI) status. METHODS Consecutive gastric cancer patients who underwent PET/CT imaging and MSI analysis were included in the study. The maximum standardized uptake value (SUVmax) of gastric cancer was assessed using PET/CT imaging. RESULTS Of 131 gastric cancers, 16 exhibited a high incidence of MSI (MSI-H) and 3 exhibited a low incidence of MSI (MSI-L). In 29 subjects who showed no uptake on PET/CT imaging the gastric cancers were all microsatellite stable (MSS). Gastric cancers with MSI were related to age older than 60 years (p = 0.002), cancer volume larger than 10 cm(3) (p = 0.015), and the presence of FDG uptake on PET/CT imaging (p = 0.001). A higher SUVmax of gastric cancer was linked to the presence of MSI (p < 0.001). CONCLUSION The presence of MSI is related to FDG uptake in gastric cancer. Care should be taken with MSS gastric cancers, because they show lower SUVmax on PET/CT imaging than MSI gastric cancers.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Korea
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An JY, Kim H, Cheong JH, Hyung WJ, Kim H, Noh SH. Microsatellite instability in sporadic gastric cancer: its prognostic role and guidance for 5-FU based chemotherapy after R0 resection. Int J Cancer 2011; 131:505-11. [PMID: 21898388 DOI: 10.1002/ijc.26399] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 08/04/2011] [Indexed: 12/17/2022]
Abstract
This study investigated whether MSI status can be used as a prognostic biomarker and whether it is helpful for predicting which patients will benefit from 5-FU based adjuvant chemotherapy. Between 2005 and 2008, an MSI status examination was performed in 1,990 gastric cancer patients who had undergone curative gastrectomy for gastric adenocarcinoma. MSI was analyzed by PCR amplification with fluorescent dye-labeled primers of mononucleotide markers (BAT25 and BAT26) and dinucleotide markers (D5S346, D2S123 and D17S250) specific to the microsatellite loci. Patients with MSI-H tumors accounted for 8.5% (n = 170) of the total study population. They tended to be older and female and to have distal tumor location, lower tumor stage, intestinal type of Lauren classification and differentiated histological type. The disease-free survival curves showed no significant differences between MSS/MSI-L and MSI-H patients at each stage of I, II, III and IV. In gastric cancer patients with stage II and III, 5-FU-based adjuvant chemotherapy showed better disease-free survival in the MSS/MSI-L group, but showed no benefits in the MSI-H group. By multivariate analysis, patients with MSS/MSI-L tumors benefited from 5-FU-based adjuvant chemotherapy in terms of tumor disease-free survival. MSI status in gastric cancer is not itself a prognostic indicator. However, it appears to be a possible guidance for the use of 5-FU-based chemotherapy in stage II and III gastric cancers after R0 resection.
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Affiliation(s)
- Ji Yeong An
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Ahmadi L, Kamkari S, Mokarram P, Lankarani KB, Tabibi N, Ashktorab H, Vasei M. HER-2/neu and E-cadherin Expression and Microsatellite Instability in Gastric Dysplasia. Middle East J Dig Dis 2011; 3:20-7. [PMID: 25197528 PMCID: PMC4154924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 02/10/2011] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Gastric dysplasia (GD) is a precursor lesion of gastric adenocarcinoma. Intestinal type gastric carcinoma commonly shows microsatellite instability (MSI) and the diffuse type is associated with down regulation of E-cadherin. HER-2/neu is over-expressed in some cases of gastric cancer. In this study, MSI and expression rates of HER-2/neu and E-cadherin in GD were evaluated. METHODS Paraffin blocks of 21 cases of low grade dysplasia (LD), 11 cases of high grade dysplasia (HD) and 25 cases of indefinite for dysplasia (ID) were collected. After deparaffinization and antigen retrieval, the sections were incubated with antibodies against E-cadherin, hMLH1, hMSH2 and HER-2/neu. The streptavidin-biotin complex method was used followed by peroxidase enzyme development with diaminobenzidine. RESULTS HER-2/neu was positive in six cases of HD (50%), four LD (21%) and two ID (9%). E-cadherin was absent in two cases of LD and showed normal expression in all HD and ID cases. hMLH1 expression was absent or markedly decreased only in the zones of dysplasia in HD (3/11), LD (3/21) and ID (4/25). Absence or diminished expression of hMSH2 was seen in HD (3/11), LD (2/21) and ID (3/25) cases. HER-2/neu expression showed close association with diminished expression of hMLH1 or hMSH2 (p < 0.05). CONCLUSION Stepwise increase in the expression rate of HER-2/neu was seen in ID, LD and HD cases implying its role in cancer evolution. The absence of hMLH1 and hMSH2 in GD may predispose individuals to over-expression of other oncogenes such as HER-2/neu. Abnormal expression of E-cadherin is not a frequent finding in GD.
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Affiliation(s)
- L Ahmadi
- 1Department of Pathology, Shiraz Institute of Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Kamkari
- 1Department of Pathology, Shiraz Institute of Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - P Mokarram
- 2Department of Biochemistry, Shiraz University, Medical Sciences, Shiraz Iran
| | - K Bagheri Lankarani
- 3Department of Internal Medicine, Center for Health Research, Shiraz University ofMedical Sciences, Shiraz, Iran
| | - N Tabibi
- 1Department of Pathology, Shiraz Institute of Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - H Ashktorab
- 4Department of Medicine, Howard University College of Medicine, 2041 Georgia avenue, N.W., Washington, DC 20060.
| | - M Vasei
- 5Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
,Corresponding Author: Mohammad Vasei, MD Department of Pathology, Tehran University of Medical Sciences Fax: + 98 21 82415400 Tehran, Iran Tel: + 98 21 84902205
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15
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Borges BDN, Burbano RR, Harada ML. Survivin -31C/G polymorphism and gastric cancer risk in a Brazilian population. Clin Exp Med 2010. [PMID: 21161671 DOI: 10.1007/s10238-010- 0122-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Gastric cancer, despite its decline in incidence, remains a public health problem worldwide, especially in Brazil, where higher incidence indexes are still described. The Survivin gene codifies a multifunctional protein involved in the regulation of the cell cycle and inhibition of the apoptotic pathway, and a polymorphism (-31C/G) located in its promoter region is associated with gene regulation. In order to evaluate the correlation of this polymorphism with gastric cancer risk in a northern Brazil population, we sequenced a fragment containing the polymorphism in individuals with gastric cancer and controls. We observed no differences of alleles and genotype frequencies between cases and controls. However, G carriers of the tumor group had an increased relative risk of developing tumors of diffuse type (OR: 2.22-IC 95%: 0.4835-10.2137), localized in the antrum (OR: 2.16-IC 95%: 0.4811-9.6971) and in younger patients (<50 years-old) (OR: 3.65-IC 95%: 0.4012-33.2429), although with no statistical significance. Nevertheless, C carriers with a high D17S250 microsatellite instability (TP53 gene) show a higher risk to develop gastric tumors (P = 0.0453; OR: 4.1556-IC95%: 0.9716-17.7728), suggesting that the mutate TP53 gene may fail in control and inhibition of Survivin expression, favoring the gastric carcinogenesis. The present result suggests that the presence of the C allele of -31C/G Survivin promoter polymorphism in combination with D17S250 instability may be used as a risk factor for gastric cancer in our population. However, other studies based on a larger sample size are required to properly assess such hypothesis.
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Affiliation(s)
- Bárbara do Nascimento Borges
- Laboratório de Biologia Molecular "Francisco Mauro Salzano", Instituto de Ciências Biológicas, Universidade Federal do Pará, Cidade Universitária Belém, Pará, Brazil.
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16
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Borges BDN, Burbano RR, Harada ML. Survivin -31C/G polymorphism and gastric cancer risk in a Brazilian population. Clin Exp Med 2010; 11:189-93. [PMID: 21161671 DOI: 10.1007/s10238-010-0122-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 11/03/2010] [Indexed: 12/27/2022]
Abstract
Gastric cancer, despite its decline in incidence, remains a public health problem worldwide, especially in Brazil, where higher incidence indexes are still described. The Survivin gene codifies a multifunctional protein involved in the regulation of the cell cycle and inhibition of the apoptotic pathway, and a polymorphism (-31C/G) located in its promoter region is associated with gene regulation. In order to evaluate the correlation of this polymorphism with gastric cancer risk in a northern Brazil population, we sequenced a fragment containing the polymorphism in individuals with gastric cancer and controls. We observed no differences of alleles and genotype frequencies between cases and controls. However, G carriers of the tumor group had an increased relative risk of developing tumors of diffuse type (OR: 2.22-IC 95%: 0.4835-10.2137), localized in the antrum (OR: 2.16-IC 95%: 0.4811-9.6971) and in younger patients (<50 years-old) (OR: 3.65-IC 95%: 0.4012-33.2429), although with no statistical significance. Nevertheless, C carriers with a high D17S250 microsatellite instability (TP53 gene) show a higher risk to develop gastric tumors (P = 0.0453; OR: 4.1556-IC95%: 0.9716-17.7728), suggesting that the mutate TP53 gene may fail in control and inhibition of Survivin expression, favoring the gastric carcinogenesis. The present result suggests that the presence of the C allele of -31C/G Survivin promoter polymorphism in combination with D17S250 instability may be used as a risk factor for gastric cancer in our population. However, other studies based on a larger sample size are required to properly assess such hypothesis.
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Affiliation(s)
- Bárbara do Nascimento Borges
- Laboratório de Biologia Molecular "Francisco Mauro Salzano", Instituto de Ciências Biológicas, Universidade Federal do Pará, Cidade Universitária Belém, Pará, Brazil.
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17
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Jeong CW, Lee JH, Sohn SS, Ryu SW, Kim DK. Mitochondrial microsatellite instability in gastric cancer and gastric epithelial dysplasia as a precancerous lesion. Cancer Epidemiol 2010; 34:323-7. [PMID: 20409774 DOI: 10.1016/j.canep.2010.03.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 02/25/2010] [Accepted: 03/24/2010] [Indexed: 12/16/2022]
Abstract
BACKGROUND Genetic instability in gastric cancer represents a key molecular step that occurs early in the carcinogenesis process. To clarify the role of genetic instability in the progression from gastric dysplasia to gastric cancer, mitochondrial microsatellite instability (mtMSI) was studied in gastric cancer and gastric dysplasia. METHODS DNA was isolated from paired normal and tumoral tissues in 24 patients with gastric dysplasia (low grade) and 49 patients with gastric cancer. mtMSI was analyzed using eight microsatellite markers. mtMSI in gastric dysplasia was studied prospectively to elucidate the relation between mtMSI and gastric carcinogenesis. RESULTS mtMSI was found in 5 (10.2%) of 49 gastric cancer patients. The mtMSI phenotype was not associated with age, gender, and Helicobacter pylori infection. However, all of the mtMSI was found in intestinal-type gastric cancer (20.8%, p=0.02). In gastric dysplasia, mtMSI was detected in 3 (12.5%) of 24 patients with gastric dysplasia. mtMSI-positive gastric dysplasia showed a poor prognosis statistically compared to mtMSI negative through progression to high-grade dysplasia or gastric cancer. CONCLUSIONS These data suggest that mtMSI may be an early and important event in the progression of gastric carcinogenesis, especially in intestinal-type gastric cancer.
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Affiliation(s)
- Chang-Wook Jeong
- Department of Surgery, Keimyung University College of Medicine, 2800 Dalgubeoldaero, Dalseo-Gu, Daegu, Republic of Korea
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18
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Do we need colonoscopy in patients with gastric adenomas? The risk of colorectal adenoma in patients with gastric adenomas. Gastrointest Endosc 2010; 71:774-81. [PMID: 20363417 DOI: 10.1016/j.gie.2009.11.042] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 11/19/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Gastric polyps are found frequently in various colonic polyposis syndromes. Genetic alterations of several genes occur in gastric adenomas and colorectal adenomas. However, it is unknown whether patients with gastric adenomas are at higher risk for colorectal adenomas. OBJECTIVE To investigate the prevalence rate of colorectal adenoma in patients with gastric adenomas and to determine the association between the presence of gastric adenomas and synchronous colorectal adenomas. DESIGN A retrospective, cross-sectional, case-control study. SETTING Single center: Center for Health Promotion of Samsung Medical Center. PATIENTS This study involved 87 patients with gastric adenomas and 174 sex-matched and age-matched controls among 19,019 participants who underwent EGD and colonoscopy simultaneously or within 6 months of each other from January 2001 to December 2008 at the Center for Health Promotion of Samsung Medical Center. INTERVENTION EGD and colonoscopy. MAIN OUTCOME MEASUREMENTS The prevalence rate of colorectal adenoma in patients with gastric adenomas. RESULTS The 87 gastric adenoma patients included 72 men and 15 women. Colorectal adenomas were identified in 42 (48.3%) of 87 cases and in 58 (33.3%) of 174 controls (P = .022). The prevalence of colorectal adenoma was significantly higher in the gastric adenoma group than in the control group. The mean size and number of colorectal adenomas were not significantly different between the two groups. The majority of colorectal adenomas were located in distal colonic segments in the gastric adenoma group in contrast with proximal colonic segments in the control group. Multivariate logistic regression analysis revealed that independent risk factors for colorectal adenoma were the presence of gastric adenomas (odds ratio [OR], .915; 95% confidence interval [CI], 1.044-3.513) and increasing age over 55 years (OR, 2.943; 95% CI, 1.558-5.560). LIMITATIONS Lack of data on previous colorectal adenomas and possible confounding factors such as hyperlipidemia or diabetes mellitus. CONCLUSION The risk of colorectal adenoma increases significantly in patients with gastric adenomas and in patients over age 55. A screening colonoscopy may be necessary for patients with gastric adenomas to detect colorectal adenomas.
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Kwon J, Lee JH, Jee YS, Park DJ, Kim HH, Lee HJ, Yang HK, Lee KU, Lee HS. Overexpression of p53, Mutation of hMLH1and Microsatellite Instability in Gastric Carcinomas: Clinicopathologic Implications and Prognosis. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2010. [DOI: 10.4174/jkss.2010.79.2.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Junsik Kwon
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ju-Hee Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ye Seob Jee
- Department of Surgery, Dankook University Hospital, Seoul, Korea
| | - Do-Jung Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyung-Ho Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Kwang Yang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kuhn Uk Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Seung Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
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20
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Ottini L, Falchetti M, Lupi R, Rizzolo P, Agnese V, Colucci G, Bazan V, Russo A. Patterns of genomic instability in gastric cancer: clinical implications and perspectives. Ann Oncol 2008; 17 Suppl 7:vii97-102. [PMID: 16760303 DOI: 10.1093/annonc/mdl960] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In gastric cancer (GC) the loss of genomic stability represents a key molecular step that occurs early in the carcinogenesis process and creates a permissive environment for the accumulation of genetic and epigenetic alterations in tumor suppressor genes and oncogenes. It is widely accepted that GC can follow at least two major genomic instability pathways, microsatellite instability (MSI) and chromosome instability (CIN). MSI is responsible for a well-defined subset of GCs. CIN represents a more common pathway comprising heterogeneous subsets of GC. In addition to MSI and CIN, the CpG islands methylator phenotype (CIMP) plays an important role in gastric carcinogenesis. CIMP may lead to the transcriptional silencing of various genes in gastric carcinogenesis. Intriguingly, more recently in addition to CpG island hypermethylation, a global DNA demethylation, that precedes genomic damage, has been observed in GC. Thus, epigenetic alterations may play a relevant role in gastric carcinogenesis as alternative mechanisms. Evidence suggests that although MSI, CIN and CIMP phenotypes can be distinguished from one another, there might be some degree of overlap. This review describes our current knowledge of the instability pathways in gastric carcinogenesis and the potential clinical applications for different forms of genomic instability in GC.
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Affiliation(s)
- L Ottini
- Department of Experimental Medicine and Pathology, University La Sapienza, Rome
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