Published online Jul 15, 2022. doi: 10.4251/wjgo.v14.i7.1295
Peer-review started: January 11, 2022
First decision: March 13, 2022
Revised: March 18, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: July 15, 2022
Most gastric cancer (GC) patients are diagnosed at middle or late stage because the symptoms in early stage are obscure, which causes higher mortality rates of GC. Analyses show that aberrant DNA methylation is highly correlated with GC risk. Helicobacter pylori (H. pylori) was identified as a class I carcinogen leading to gastric adenocarcinoma, and H. pylori-induced chronic inflammation plays a direct role in the induction of aberrant DNA methylation. The median demethylation product 5-hydroxymethylcytosine (5-hmC) is considered as an activating epigenetic marker, and it plays complex roles in gene regulation of tumorigenesis.
A few small studies analyzed the association between 5-hmC levels and GC, but the evidence is lacking, especially for H. pylori-induced GC.
Exploring the association between 5-hmC level and the progression and prognosis of GC patients with or without H. pylori infection.
This was a retrospective cohort study to estimate the predicted value of 5-hmC level in the progression and prognosis of GC patients with different H. pylori infection status.
A high level of 5-hmC was an independent significant favorable predictor of overall survival in the entire GC patient cohort (hazard ratio = 0.61, 95% confidence interval: 0.38-0.98, P = 0.040), the H. pylori-negative GC subgroup (hazard ratio = 0.30, 95% confidence interval: 0.13-0.68, P = 0.004) and GC patients with early TNM stage (hazard ratio = 0.32, 95% confidence interval: 0.13-0.77, P = 0.011).
5-hmC level was a significant predictor of the prognosis of GC patients without H. pylori infection.
A large-scale GC patient cohort to assess the association between the level of 5-hmC and the prognosis of GC patients, especially for different H. pylori infection status, should be conducted.