Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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p16INK4a Promoter Hypermethylation in Sputum, Blood, and Tissue from Non-Small Cell Lung Cancer and Pulmonary Inflammation

비소세포폐암과 염증성 폐질환에서 가래와 혈액 및 조직에서 p16INK4a Promoter 과메틸화

  • Kim, Jeong Pyo (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Kim, Kyong Mee (Department of Pathology, College of Medicine, the Catholic University of Korea) ;
  • Kwon, Soon Seog (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Kim, Young Kyoon (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Kim, Kwan Hyoung (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Moon, Hwa Sik (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Song, Jeong Sup (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Park, Sung Hak (Department of Internal Medicine, College of Medicine, the Catholic University of Korea) ;
  • Ahn, Joong Hyun (Department of Internal Medicine, College of Medicine, the Catholic University of Korea)
  • 김정표 (가톨릭대학교 의과대학 내과학교실) ;
  • 김경미 (가톨릭대학교 의과대학 병리학교실) ;
  • 권순석 (가톨릭대학교 의과대학 내과학교실) ;
  • 김영균 (가톨릭대학교 의과대학 내과학교실) ;
  • 김관형 (가톨릭대학교 의과대학 내과학교실) ;
  • 문화식 (가톨릭대학교 의과대학 내과학교실) ;
  • 송정섭 (가톨릭대학교 의과대학 내과학교실) ;
  • 박성학 (가톨릭대학교 의과대학 내과학교실) ;
  • 안중현 (가톨릭대학교 의과대학 내과학교실)
  • Received : 2005.10.04
  • Accepted : 2006.01.19
  • Published : 2006.02.28
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Abstract

Background : The aberrant promoter hypermethylation of p16INK4a, as a tumor suppressor gene, is contributory factor to non-small cell lung cancer(NSCLC). However, its potential diagnostic impact of lung cancer is unclear. This study measured the level of $p16^{INK4a}$ promoter hypermethylation in the sputum and blood, and compared this with the level measured in the tissue obtained from NSCLC and pulmonary inflammation. Methods : Of the patients who visited the Our Lady of Mercy Hospital in Incheon, Korea for an evaluation of a lung mass and underwent blood, sputum, and tissue tests, 23patients (18 NSCLC, 5 pulmonary inflammation) were enrolled in this study. DNA was extracted from each sample and the level of p16INK4amethylation was determined using methylation-specific polymerase chain reaction. Results : $p16^{INK4a}$ methylation of the blood was observed in 88.9% (16 of 18) and 20.0% (1 of 5) of NSCLC and from pulmonary inflammation samples, respectively (P=0.008). Methylation of the sputum was observed in 83.3% (10 of 12) 80.0% (4 of 5) of NSCLC and pulmonary inflammation samples, respectively (P=1.00). Among the 8 NSCLC tissue samples, methylation changes were detected in 75.0% of samples (6 cases). Four out of seven tissue samples (57.1%) showed concordance, being methylated in both the blood and sputum. Conclusions : There was a higher level of $p16^{INK4a}$ methylation of the blood from NSCLC patients than from pulmonary inflammation. The tissue showed a high concordance with the blood in the NSCLC samples. These findings suggest that $p16^{INK4a}$ promoter hypermethylation of the blood can used to discriminate between NSCLC and pulmonary inflammation.

연구배경 : 종양억제유전자인 $p16^{INK4a}$는 promoter region의 과메틸화로 인해 비소세포폐암의 발생에 관여하는 것으로 잘 알려져 있지만 폐암의 진단 방법으로 사용할 수 있는지는 아직까지 명확하지 않다. 이에 저자들은 비소세포폐암과 염증성 폐질환 환자의 가래와 혈액 및 조직에서 $p16^{INK4a}$ 메틸화의 발현 정도와 발현 일치 정도를 알아보고자 하였다. 방 법 : 폐종양을 주소로 내원하여 혈액, 가래 및 조직 검사를 시행한 후 최종적으로 비소세포폐암(18명)과 염증성 폐질환(5명) 진단을 받은 23명을 대상으로 하였다. 각 표본에서 DNA를 추출한 후 메틸화 특이성 중합효소연쇄반응법을 이용하여 $p16^{INK4a}$ promoter region의 메틸화 양상을 비교 분석하였다. 결 과 : 혈액에서는 비소세포폐암 그룹(88.9%, 18명중 16명)이 염증성 폐질환 그룹(20.0%, 5명중 1명)보다 $p16^{INK4a}$ 메틸화 발현이 증가하였으며(P=0.008), 가래에서는 비소세포폐암 그룹(12명중 10명)과 염증성 폐질환 그룹(5명중 4명)의 발현 차이는 없었다(P=1.00). 조직은 비소세포폐암 그룹에서 8명중 6명(75.0%)이 $p16^{INK4a}$ 메틸화가 나타났다. 혈액, 가래 및 조직에서 $p16^{INK4a}$ 메틸화의 발현 일치율은 7명 중 4명이 일치한 57.1%를 보였다. 결 론 : 비소세포폐암 그룹에서 염증성 폐질환 그룹보다 혈액의 $p16^{INK4a}$ 메틸화가 증가하였고 조직과의 일치율도 높았다. 따라서 폐암이 의심되는 고 위험 인자가 있는 환자에서 혈액의$p16^{INK4a}$ 과메틸화는 비소세포폐암과 염증성 폐질환을 감별하는데 유용하게 사용될 수 있을 것으로 생각한다.

Keywords

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