Expression of plasma methylated Septin9 gene and its clinical significance in patients with gastric cancer

doi:10.19401/j.cnki.1007-3639.2023.02.009

Abstract

Abstract:

Background and purpose: Gastric cancer is one of the most common malignant tumors in our country. The diagnosis and treatment process of gastric cancer lacks of sensitive and specific biomarker. This study aimed to explore the expression of plasma methylated Septin9 gene (mSEPT9) and its clinical significance in patients with gastric cancer. Methods: From April 2020 to November 2020, 221 patients with gastric cancer and 34 patients with no evidence of disease who visited Zhongshan Hospital Fudan University were enrolled. The status of mSEPT9 was detected by polymerase chain reaction (PCR) fluorescence probe method, and relative mSEPT9 value was determined by the ΔΔCt method. Detailed clinical data including pathological characteristics (patients characteristics and pathology characteristics) and serum biomarkers [carcinoembryonic antigen (CEA), carbohydrate antigen (CA)12-5, CA19-9 and CA72-4] were collected and analyzed. Paired t test, χ² test and receiver operating characteristic (ROC) curve analysis were performed for statistical analysis. Results: The positive rate, sensitivity and specificity of plasma mSEPT9 were 35%, 35% and 100%, respectively in untreated patients with gastric cancer. The positive rate of mSEPT9 was higher in patients with blood vessel invasion, serosa invasion and lymphatic metastasis, which was 46.87% vs 12.50%, 45.16% vs 14.29%, 75.00% vs 40.00%, respectively (P<0.05). The positive rate of mSEPT9 was higher in progressive disease (PD) patients than in partial response (PR) and stable disease (SD) patients, which were 68.75% and 17.74%, the differences were statistically significant (P<0.05). mSEPT9 level before PD and at the time of PD showed statistically significance. Conclusion: Plasma mSEPT9 detection demonstrates a more satisfactory diagnostic performance in gastric cancer than traditional serum biomarkers. The biomarker can provide information regarding severity with high positive rate among PD patients. The status and level of mSEPT9 were of clinical significance in evaluating tumor burden and predicting treatment response.

Key words: Septin9 gene, Methylated, Gastric cancer, Plasma, Circulating tumor DNA

CLC Number:

R735.2

CHEN Xinning, JIANG Huiqin, YANG Yihui, YU Qian, ZHANG Chunyan, WANG Beili, PAN Baishen, GUO Wei. Expression of plasma methylated Septin9 gene and its clinical significance in patients with gastric cancer[J]. China Oncology, 2023, 33(2): 162-167.

Figures/Tables 6

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Characteristic	N	Percentage/%
Median age (range)/year	62 (30-84)
Gender	221
Male	138	62
Female	83	38
Differentiation status	177
Well	2	1
Moderately	42	24
Poorly	133	75
Lauren classification	186
Intestinal type	61	33
Diffuse type	60	32
Mixed type	65	35
HER2	180
Negative	165	92
Positive	15	8

Item	Cut-off value	AUC	Sensitivity/%	Specificity/%	SE	95% CI	P value
CEA	5	0.573 9	25.32	100.00	0.0527 6	0.470 5-0.677 3	0.214 0
CA19-9	34	0.600 1	17.95	97.06	0.0593 4	0.483 8-0.716 3	0.092 9
CA72-4	10	0.562 9	22.78	94.12	0.0559 1	0.453 3-0.672 5	0.290 1
CA12-5	25	0.711 6	16.25	100.00	0.0473 0	0.618 9-0.804 3	0.000 4
mSEPT9	-0.152 1	0.815 3	35.00	100.00	0.0414 1	0.734 2-0.896 5	<0.000 1
Joint	2.852	0.822 2	66.25	96.77	0.382 1	0.747 3-0.897 1	<0.000 1

Item	Group	mSEPT9 positive	mSEPT9 negative	P value
Blood vessel invasion	Yes	15	17	0.025 8
Blood vessel invasion	No	2	14
Perineural invasion	Yes	13	17	0.362 7
Perineural invasion	No	5	13
Depth of invasion	Serosa negative	4	24	0.012 3
Depth of invasion	Serosa positive	14	17
Lymphatic metastasis	Yes	15	18	0.014 8
Lymphatic metastasis	No	5	27

Item	PR+SD	PD	P value
mSEPT9 positive	11	11	0.000 2
mSEPT9 negative	51	5	0.000 2