title: p16INK4A gene alterations are not a prognostic indicator for survival in patients with hepatocellular carcinoma undergoing curative hepatectomy.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is a common malignancy worldwide that is highly associated with chronic hepatitis B or C infection and cirrhosis. The tumor suppressor gene p16INK4A is an important component of the cell cycle and inactivation of the gene has been found in a variety of human cancers. The present study was performed to determine genetic and epigenetic alterations in the p16INK4A tumor suppressor gene and the effect of these on HCC progression.
  
  
  METHODS
  The status of p16INK4A was evaluated in 117 HCC tumoral nodules and 110 corresponding peritumoral tissues by loss of heterozigosity (LOH) at the 9p21-22 region, homozygous deletions, single-strand conformation polymorphism-polymerase chain reaction (PCR) mutational analysis and methylation specific PCR.
  
  
  RESULTS
  The most frequent inactivation mechanism was hypermethylation of the promoter region, which was found in 63.2% of the tumor samples and in 28.2% of the peritumoral samples. Loss of heterozygosity at the 9p21 region was detected in 27.3% and 10% of tumor and peritumoral tissues, respectively. Homozygous deletions and mutations were less common events in hepatocarcinogenesis. The authors found 5.9% of the tumor cases with exon 2 homozygous deletions and 8.6% with mutations. Two polymorphisms were detected, one at codon 148 (GCG --> ACG, Ala --> Thr) in three cases and the other in exon 3 at 540 bp (34.2% of the samples). No association was found between inactivation of p16INK4A and clinicopathological characteristics or prognosis.
  
  
  CONCLUSIONS
  p16INK4A is altered frequently and early in HCC, being the predominant mechanism of inactivation promoter hypermethylation. The present results suggest that the p16INK4A gene plays an important role in the pathogenesis of HCC.
authors.affiliation: Department of Z and Cellular Dynamics, Faculty of Pharmacy, University of the Basque Country, Vitoria, Spain.
authors.forename: Monica
authors.initials: M
authors.lastname: Anzola
authors.forename: Nerea
authors.initials: N
authors.lastname: Cuevas
authors.forename: Monica
authors.initials: M
authors.lastname: Lopez-Martinez
authors.forename: Marian
authors.initials: M
authors.lastname: Martinez de Pancorbo
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Burgos
mesh_terms: D001483:Base Sequence; D006528:Carcinoma, Hepatocellular / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019175:DNA Methylation; D004252:DNA Mutational Analysis; D005260:Female; D017353:Gene Deletion; D020868:Gene Silencing; D019942:Genes, p16; D006498:Hepatectomy; D006720:Homozygote; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019656:Loss of Heterozygosity; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D011401:Promoter Regions, Genetic / Q000235:genetics; D016019:Survival Analysis