Clinical experience of application of molecular-genetic markers in gastric cancer surgery
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Clinical experience of application of molecular-genetic markers in gastric cancer surgery Andrey Andriyanov
Present study aimed at improving the outcomes in patients with gastric cancer through the application of molecular genetic methods for examination of the gastric mucosa at the preoperative stage.
The study included 156 patients: 106 patients with gastric cancer (main group) and 50 with cholelithiasis, as a comparison group with unchanged gastric mucosa. All 106 patients with gastric cancer underwent scheduled surgical intervention: in the form of gastrectomy (n=42) or gastric resection (n=64). Genetic tests of the resected tumor material and distant gastric mucosa in the main group and the comparison group were performed.
Locally advanced gastric cancer was verified in 80 (76%) patients of the main group; 58
(72.5%) of them underwent adjuvant chemotherapy with 5-fluorouracil. To assess the efficacy of 5-fluorouracil-based chemotherapy, polymorphisms of the TYMS and TP53 genes, which are detected in locally advanced gastric cancer, were studied.
Genetic tests in patients with gastric cancer reliably confirmed (p<0.01) an increase in expression of hTERT, MMP7, BIRC5 markers, as well as telomerase activity, at the same time statistically significant reduction in the surrounding mucosa located 5 cm below and above the tumor node.
When assessing the relationship of TYMS gene polymorphisms with the long-term results of combined treatment of patients with locally advanced gastric cancer: the mean relapse-free survival in patients with the 3R/2R genotype was 34.6±2.2 months, the mean relapse-free survival in patients with the 3R/3R genotype was 25.8±2.5 months. For TP 53 gene polymorphisms: mean relapse-free survival in Arg/Arg genotype is 29.1±2.2 months. Mean relapse-free survival in Arg/Pro genotype is 29.5±3.3 months. Mean relapse-free survival in Pro/Pro genotype is 20.0±3.5 months.
In patients with gastric cancer, analysis of molecular genetic markers is recommended, since the data obtained allow to assess the genetic potential of the mucosa without gross changes and reduce the extent of surgical intervention, as well as to predict the effect of 5-fluorouracil-based adjuvant chemotherapy in patients with locally advanced gastric cancer.
DOI: https://ysmu.am/v2/wp-content/uploads/2023/05/8499d459-1.pdf The New Armenian Medical Journal Vol.15 (2021), Nо 3 84-93
