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目的检测胃癌患者Six1基因启动子低甲基化并研究其在病情及预后评估中的价值。方法采用甲基化特异性PCR(Methylation specific PCR,MSP)法检测胃癌患者(GAC组)肿瘤组织和胃炎患者(CON组)胃组织Six1基因启动子甲基化,比较其差异并分析与临床病理因素的关系,对比GAC组中Six1基因启动子甲基化患者和未甲基化患者手术切除、3年死亡率和PFS的差异。结果 GAC组胃癌患者癌组织Six1基因启动子甲基化率(24.0%)显著低于CON组(95.0%)(均P<0.05)。GAC组胃癌患者癌组织中Six1基因启动子甲基化在Lauren’s分型、分化程度、肿瘤最大径、淋巴结转移、远处转移和TNM分期方面差异均有统计学意义(均P<0.05),Six1基因启动子甲基化患者的D2根治性手术率(100.0%)、切缘阴性率(100.0%)及PFS(23.6±3.5月)均显著高于未甲基化患者[分别为57.9%、47.4%、47.4%、(16.2±2.7)月](均P<0.05),3年死亡率显著低于未甲基化患者(均P<0.05)。结论胃癌患者Six1基因启动子处于低甲基化状态,作为胃癌病情及预后评估的标志物。
Objective To detect the promoter hypermethylation of Six1 gene in patients with gastric cancer and to study its value in the evaluation of disease and prognosis. Methods Methylation specific PCR (MSP) was used to detect the promoter methylation of Six1 gene in gastric tissue of patients with gastric cancer (GAC group) and gastritis patients (CON group). The differences were analyzed and compared with clinicopathological features The relationship between Sixi gene promoter methylation and unmethylation patients in the GAC group was compared between the surgical resection, 3-year mortality and PFS. Results The promoter methylation rate of Six1 gene in gastric cancer patients with GAC was significantly lower than that in CON patients (95.0%, P <0.05). The methylation of Six1 gene promoter in GAC group was statistically significant in Lauren’s classification, differentiation degree, maximum diameter of tumor, lymph node metastasis, distant metastasis and TNM staging (all P <0.05), Six1 The rate of D2 radical surgery (100.0%), negative margin rate (100.0%) and PFS (23.6 ± 3.5) in patients with methylation of gene promoter were significantly higher than those in unmethylated patients (57.9% and 47.4% respectively) %, 47.4%, (16.2 ± 2.7) months respectively (all P <0.05). The 3-year mortality was significantly lower than that of unmethylated patients (all P <0.05). Conclusion The promoter of Six1 gene in gastric cancer patients is in a hypomethylated state as a marker of disease status and prognosis of gastric cancer.