Gut Liver.
2016 Mar;10(2):228-236. 10.5009/gnl14472.
Risk Factors for Metachronous Gastric Neoplasms in Patients Who Underwent Endoscopic Resection of a Gastric Neoplasm
- Affiliations
-
- 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. nayoungkim49@empas.com
- 2Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.
- 4Department of Pathology, Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- 5Department of Microbiology, Hanyang University College of Medicine, Seoul, Korea.
- KMID: 2363967
- DOI: http://doi.org/10.5009/gnl14472
Abstract
- BACKGROUND/AIMS
To identify the risk factors for metachronous gastric neoplasms in patients who underwent an endoscopic resection of a gastric neoplasm.
METHODS
We prospectively collected clinicopathologic data and measured the methylation levels of HAND1, THBD, APC, and MOS in the gastric mucosa by methylation-specific real-time polymerase chain reaction in patients who underwent endoscopic resection of gastric neoplasms.
RESULTS
A total of 257 patients with gastric neoplasms (113 low-grade dysplasias, 25 high-grade dysplasias, and 119 early gastric cancers) were enrolled. Metachronous gastric neoplasm developed in 7.4% of patients during a mean follow-up of 52 months. The 5-year cumulative incidence of metachronous gastric neoplasm was 4.8%. Multivariate analysis showed that moderate/severe corpus intestinal metaplasia and family history of gastric cancer were independent risk factors for metachronous gastric neoplasm development; the hazard ratios were 4.12 (95% confidence interval [CI], 1.23 to 13.87; p=0.022) and 3.52 (95% CI, 1.09 to 11.40; p=0.036), respectively. The methylation level of MOS was significantly elevated in patients with metachronous gastric neoplasms compared age- and sex-matched patients without metachronous gastric neoplasms (p=0.020).
CONCLUSIONS
In patients who underwent endoscopic resection of gastric neoplasms, moderate/severe corpus intestinal metaplasia and a family history of gastric cancer were independent risk factors for metachronous gastric neoplasm, and MOS was significantly hypermethylated in patients with metachronous gastric neoplasms.
Keyword
MeSH Terms
-
Aged
Basic Helix-Loop-Helix Transcription Factors/genetics
DNA Methylation
Female
Gastrectomy/methods
Genes, APC/physiology
Genes, mos/genetics
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Neoplasms, Second Primary/epidemiology/*genetics/pathology
Proportional Hazards Models
Risk Factors
Stomach Neoplasms/genetics/*pathology/surgery
Thrombomodulin/genetics
Basic Helix-Loop-Helix Transcription Factors
Thrombomodulin
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- The Effect of Helicobacter pylori Eradication on the Metachronous Neoplasm after Endoscopic Resection for Gastric Dysplasia
- Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of a Gastric Neoplasm
- Metachronous Gastric Cancer Occurring after Endoscopic Resection of Early Gastric Cancer
- Utility of Surgical Resection in the Management of Metachronous Krukenberg's Tumors of Gastric Origin
- Effectiveness of Helicobacter pylori Eradication before Endoscopic Resection
