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Updated: Jun 20, 2026
Genome-Wide Analysis of DNA Methylation in Gastrointestinal Cancer
Published on: September 18, 2020
Lymph node metastasis risk in submucosal invasive gastric cancer based on C-reactive protein gene polymorphism
Kotaro Honda1, Kohei Taniguchi2, Kazumasa Komura3
1Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
Background:
The 1846C > T polymorphism of the C-reactive protein (CRP) gene is associated with an increased risk of lymph node metastasis in various cancers. This study aimed to examine its association with lymph node metastasis in gastric cancer.
Methods:
A retrospective analysis of the 1846C > T CRP polymorphism was conducted in patients with submucosal (SM) gastric cancer from April 2011 to March 2022. Genotyping was performed using polymerase chain reaction fragment length polymorphisms. Patients were categorized into differentiated and undifferentiated groups and then subdivided into C/C + C/T and T/T genotypes. We assessed correlations between polymorphisms, lymph node metastasis, and lymphatic and venous invasion. Two sub-analyses were conducted in the differentiated gastric cancer group.
Results:
Among 111 patients with SM gastric cancer, 81 had differentiated tumors, whereas 30 had undifferentiated tumors. In the differentiated group, 4.5% of C/C and C/T genotypes and 18.9% of T/T genotypes exhibited lymph node metastasis, with a 95% negative predictive value. Excluding pT1b1 and tumors ≤ 3 cm, lymph node metastasis occurred in 5.3% of C/C and C/T genotypes and 20.6% of T/T genotypes, with a negative predictive value of 94.7%. For cT1bN0 cases, lymph node metastasis was 0% in C/C and C/T genotypes and 15.8% in T/T genotypes, with a negative predictive value of 100%.
Conclusions:
In this exploratory study, the 1846C > T CRP polymorphism suggests that patients with differentiated SM gastric cancer carrying the C/C or C/T genotype have reduced risk of lymph node metastasis, potentially minimizing the need for additional surgery after endoscopic submucosal dissection.
