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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2013

01-06-2013 | Gastrointestinal Oncology

Evaluation of the Risk of Lymph Node Metastasis Using CRP 1846C>T Genetic Polymorphism in Submucosal Thoracic Esophageal Squamous Cell Carcinoma

Authors: Satoru Motoyama, MD, PhD, Kazuhiko Mori, MD, PhD, Takashi Kamei, MD, PhD, Masatomo Miura, PhD, Yudai Hinai, Yusuke Sato, MD, PhD, Kei Yoshino, MD, PhD, Tomohiko Sasaki, MD, PhD, Go Miyata, MD, PhD, Yasuyuki Seto, MD, PhD, Jun-ichi Ogawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2013

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Abstract

Background

More than 40 % of patients with submucosal esophageal squamous cell carcinoma (ESCC) have lymph node metastasis. Furthermore, the potential presence of undetectable metastasis before treatment prompts surgeons to be aggressive with respect to lymph node dissection. Extending the indication for endoscopic resection, a minimally invasive treatment, to superficial ESCCs will require more accurate and individualized evaluation of lymph node metastasis.

Methods

The study participants were 121 esophageal cancer patients who underwent curative surgery for thoracic submucosal ESCC at three Japanese hospitals. DNA was extracted from blood samples, and the C-reactive protein (CRP) 1846C>T genetic polymorphism (rs1205) was investigated using polymerase chain reaction-restriction fragment length polymorphism. We then evaluated the value of CRP 1846C>T polymorphism for diagnosis of lymph node metastasis.

Results

Forty-nine (40 %) patients had lymph node metastasis. The CRP 1846 C/T genotype was C/C in 19 patients, C/T in 57 patients, and T/T in 45 patients. Fisher’s exact analysis of the CRP 1846C>T polymorphism showed a significantly higher frequency of lymph node involvement with the T/T genotype. Univariate and multivariate logistic regression models revealed that patients carrying the 1846 T/T genotype had a significantly greater likelihood of developing lymph node metastasis (odds ratio >2.6). Combining the CRP 1846 C/T genotype with clinical diagnosis, mainly using CT, brought a negative predictive value of 80 % to diagnosing lymph node involvement.

Conclusions

CRP genetic polymorphism may be a novel predictor of risk of lymph node metastasis in ESCC, which could enable better evaluation of the necessity for lymph node dissection.
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Metadata
Title
Evaluation of the Risk of Lymph Node Metastasis Using CRP 1846C>T Genetic Polymorphism in Submucosal Thoracic Esophageal Squamous Cell Carcinoma
Authors
Satoru Motoyama, MD, PhD
Kazuhiko Mori, MD, PhD
Takashi Kamei, MD, PhD
Masatomo Miura, PhD
Yudai Hinai
Yusuke Sato, MD, PhD
Kei Yoshino, MD, PhD
Tomohiko Sasaki, MD, PhD
Go Miyata, MD, PhD
Yasuyuki Seto, MD, PhD
Jun-ichi Ogawa, MD, PhD
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2765-9

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