Hypermethylated APC DNA in plasma and prognosis of patients with esophageal adenocarcinoma Journal Article


Authors: Kawakami, K.; Brabender, J.; Lord, R. V.; Groshen, S.; Greenwald, B. D.; Krasna, M. J.; Yin, J.; Fleisher, A. S.; Abraham, J. M.; Beer, D. G.; Sidransky, D.; Huss, H. T.; Demeester, T. R.; Eads, C.; Laird, P. W.; Ilson, D. H.; Kelsen, D. P.; Harpole, D.; Moore, M. B.; Danenberg, K. D.; Danenberg, P. V.; Meltzer, S. J.
Article Title: Hypermethylated APC DNA in plasma and prognosis of patients with esophageal adenocarcinoma
Abstract: Background: The adenomatous polyposis coli (APC) locus on chromosome 5q21-22 shows frequent loss of heterozygosity (LOH) in esophageal carcinomas. However, the prevalence of truncating mutations in the APC gene in esophageal carcinomas is low. Because hypermethylation of promoter regions is known to affect several other tumor suppressor genes, we investigated whether the APC promoter region is hypermethylated in esophageal cancer patients and whether this abnormality could serve as a prognostic plasma biomarker. Methods: We assayed DNA from tumor tissue and matched plasma from esophageal cancer patients for hypermethylation of the promoter region of the APC gene. We used the maximal chi-square statistic to identify a discriminatory cutoff value for hypermethylated APC DNA levels in plasma and used bootstrap-like simulations to determine the P value to test for the strength of this association. This cutoff value was used to generate Kaplan-Meier survival curves. All P values were based on two-sided tests. Results: Hypermethylation of the promoter region of the APC gene occurred in abnormal esophageal tissue in 48 (92%) of 52 patients with esophageal adenocarcinoma, in 16 (50%) of 32 patients with esophageal squamous cell carcinoma, and in 17 (39.5%) of 43 patients with Barrett's metaplasia but not in matching normal esophageal tissues. Hypermethylated APC DNA was observed in the plasma of 13 (25%) of 52 adenocarcinoma patients and in two (6.3%) of 32 squamous carcinoma patients. High plasma levels of methylated APC DNA were statistically significantly associated with reduced patient survival (P = .016). Conclusion: The APC promoter region was hypermethylated in tumors of the majority of patients with primary esophageal adenocarcinomas. Levels of hypermethylated APC gene DNA in the plasma may be a useful biomarker of biologically aggressive disease in esophageal adenocarcinoma patients and should be evaluated as a potential biomarker in additional tumor types.
Keywords: cancer survival; human tissue; survival analysis; human cell; major clinical study; methylation; promoter region; carcinoma, squamous cell; polymerase chain reaction; adenocarcinoma; tumor markers, biological; tumor marker; statistical analysis; dna; dna, neoplasm; chi-square distribution; heterozygosity loss; loss of heterozygosity; esophagus carcinoma; esophageal neoplasms; precancerous conditions; barrett esophagus; chromosome 5q; chromosomes, human, pair 5; adenomatous polyposis coli; promoter regions (genetics); colon polyposis; gastric mucosa; humans; prognosis; human; priority journal; article
Journal Title: JNCI: Journal of the National Cancer Institute
Volume: 92
Issue: 22
ISSN: 0027-8874
Publisher: Oxford University Press  
Date Published: 2000-11-15
Start Page: 1805
End Page: 1811
Language: English
PUBMED: 11078757
PROVIDER: scopus
DOI: 10.1093/jnci/92.22.1805
DOI/URL:
Notes: Export Date: 18 November 2015 -- Source: Scopus
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  1. David H Ilson
    434 Ilson
  2. David P Kelsen
    537 Kelsen
  3. Harold T Huss
    1 Huss