Risk Factors for Metachronous Gastric Neoplasms in Patients Who Underwent Endoscopic Resection of a Gastric Neoplasm.
- Author:
Hyuk YOON
1
;
Nayoung KIM
;
Cheol Min SHIN
;
Hye Seung LEE
;
Bo Kyoung KIM
;
Gyeong Hoon KANG
;
Jung Mogg KIM
;
Joo Sung KIM
;
Dong Ho LEE
;
Hyun Chae JUNG
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Stomach neoplasms; Metastasis; Risk factors; Therapeutics
- MeSH: 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
- From:Gut and Liver 2016;10(2):228-236
- CountryRepublic of Korea
- Language:English
- 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.
