ABSTRACT
BACKGROUND: Assuming that the entire airway is affected by the same inhaled carcinogen, similar molecular alterations may occur in the lung and oral cavity. Thus, we hypothesized that DNA methylation profiles in the oral epithelium may be a promising biomarker for lung cancer risk stratification. METHODS: A methylation-specific polymerase chain reaction was performed on oral epithelium from 16 patients with lung cancer and 32 controls without lung cancer. Genes showing aberrant methylation profiles in the oral epithelium were compared between patients and controls. RESULTS: The analysis revealed that HOXD11 and PCDHGB6 were methylated more frequently in patients than in controls ( p = 0.0055 and p = 0.0247, respectively). Combined analyses indicated that 8 of 16 (50%) patients and 3 of 32 (9.4%) controls showed DNA methylation in both genes ( p = 0.0016). Among the population limited to current and former smokers, 6 of 11 (54.5%) patients showed methylation in both genes, compared to 1 of 17 (5.9%) controls ( p = 0.0037). In a subgroup analysis limited to the population above 50-years old, 8 of 16 (50%) patients and 2 of 16 (12.5%) controls showed methylation in both genes ( p = 0.0221). CONCLUSIONS: The results of this study indicate that specific gene methylation in the oral epithelium might be a promising biomarker for lung cancer risk assessment, especially among smokers. Risk stratification through the analysis of DNA methylation profiles in the oral epithelium may be a useful and less invasive first-step approach in an efficient two-step lung cancer screening strategy.
Subject(s)
Biomarkers, Tumor/genetics , Cadherins/genetics , DNA Methylation , Epithelial Cells/chemistry , Homeodomain Proteins/genetics , Lung Neoplasms/genetics , Mouth Mucosa/chemistry , Transcriptome , Adult , Aged , Aged, 80 and over , Case-Control Studies , Early Detection of Cancer/methods , Epithelial Cells/pathology , Female , Gene Expression Profiling/methods , Genetic Predisposition to Disease , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Mouth Mucosa/pathology , Phenotype , Pilot Projects , Polymerase Chain Reaction , Predictive Value of Tests , Protocadherins , Risk Assessment , Risk Factors , Smoking/adverse effects , Smoking/geneticsABSTRACT
LEOPARD syndrome is a rare congenital disease characterized by seven features. Besides the original clinical manifestations, hypertrophic cardiomyopathy was reported as an additional laboratory finding recently. We gave general anesthesia to a child of this syndrome, and encountered ECG changes during emergence from anesthesia. The diagnosis was made in her infancy, and had been receiving beta-blocker treatment ever since. The preoperative examination showed remarkable right axis deviation in ECG, and asymmetric ventricular septal hypertrophy in echocardiography. After the operation, several kinds of arrhythmia (i.e. atrioventricular junctional rhythm, atrioventricular dissociation, etc), were observed and they continued for a few minutes. Careful planning for the perioperative management of this syndrome is mandatory. The cardiomyopathy must be examined beforehand. We made an effort to prevent the extreme changes of pre- and after-load during the general anesthesia.
