Background:
Human mutL homolog 1 (hMLH1) is the most important member of Mismatch repair (MMR) genes encoding a number of DNA repair enzymes and thus cooperating to recognize and repair DNA mismatches [1]. DNA methylation of hMLH1 has been found in ovarian and colorectal cancer cell lines for resistance to cisplatin[2,3]. Our previous study also demonstrated that DNA methylation of hMLH1 is involved in determining sensitivity to cisplatin in NSCLC A549/DDP cell line, and cisplatin resistance could be reversed by the demethylating agent 5-zaz-2’-deoxycytidine (5-Aza-dc) in vitro [4].
Aim:
To determine whether DNA methylation of hMLH1 affects the prognosis of non-small cell lung cancer patients who received cisplatin-based adjuvant chemotherapy.
Methods:
Methylation status of hMLH1 was examined by using nested methylation-specific PCR (nested MSP) in 84 archived non-small cell lung cancer (NSCLC) surgically resected tissue specimens from patients receiving cisplatin-based adjuvant chemotherapy. Univariate and multivariate analysis were used to investigate the relationship between hMLH1 methylation status and the clinical prognosis of the patients mentioned above.
Results:
In the cohort of 84 NSCLC cases, 80 tissue samples were successfully amplified by nested MSP. Among them, 36 samples (45%) were identified to be methylated. Moreover, hMLH1 methylation was not associated with age, gender, smoking status, T stage, histology and differentiation, but correlated with lymphatic metastasis (p=0.021). Multivariate logistic regression analysis showed that hMLH1 methylation may function as a significant independent prognostic factor for tumor recurrence in NSCLC patients treated with adjuvant cisplatin (HR 3.114, 95% CI 1.032-9.399; p= 0.044). However, Kaplan-Meier method (p=0.093) and multivariate Cox regression analysis (p=0.598) revealed that hMLH1 methylation was not associated with the survival of these patients.
Conclusions:
The cisplatin-based adjuvant chemotherapy is more beneficial for NSCLC patients without hMLH1 methylation. hMLH1 methylation may have a potential to become a biomarker of individualized therapy for NSCLC patients.