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JNCI Journal of the National Cancer Institute 2000 92(2):148-153; doi:10.1093/jnci/92.2.148
© 2000 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 92, No. 2, 148-153, January 19, 2000
© 2000 Oxford University Press


REPORTS

Ser-249 p53 Mutations in Plasma DNA of Patients With Hepatocellular Carcinoma From The Gambia

Gregory D. Kirk, Anne-Marie Camus-Randon, Maimuna Mendy, James J. Goedert, Philippe Merle, Christian Trépo, Christian Bréchot, Pierre Hainaut, Ruggero Montesano

Affiliations of authors: G. D. Kirk, International Agency for Research on Cancer, Banjul, The Gambia, and Lyon, France, and Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; A.-M. Camus-Randon, P. Hainaut, R. Montesano, International Agency for Research on Cancer, Banjul and Lyon; M. Mendy, Medical Research Council Laboratories, Banjul; J. J. Goedert, Viral Epidemiology Branch, National Cancer Institute; P. Merle, C. Trépo, INSERM Unité 271, Lyon; C. Bréchot, Hepatology Unit, Necker Hospital, Paris, France.

Correspondence to: Ruggero Montesano, M.D., Ph.D., Unit of Mechanisms of Carcinogenesis, International Agency for Research on Cancer, 150 cours Albert-Thomas, 69372 Lyon Cedex 08, France (e-mail: montesano{at}iarc.fr).

BACKGROUND: A selective mutation, an arginine-to-serine substitution in codon 249, of the p53 gene has been identified as a "hotspot" mutation in hepatocellular carcinoma (HCC). This mutation occurs in populations that are exposed to aflatoxins and have a high prevalence of hepatitis B virus carriers. We evaluated whether this mutation could be detected in cell-free DNA isolated from the plasma of subjects from The Gambia to detect this mutation that is strongly associated with HCC. METHODS: Fifty-three patients with HCC, 13 patients with cirrhosis, and 53 control subjects were prospectively recruited from The Gambia. Sixty patients, of non-African origin, with various liver pathologies were also selected from France. DNA was extracted and purified from 200-µL aliquots of plasma. The Ser-249 p53 mutation was detected by restriction endonuclease digestion of polymerase chain reaction products from exon 7 and was confirmed by direct sequencing of the amplified DNA. RESULTS: The Ser-249 p53 mutation was detected in plasma DNA from 19 (36%) of the 53 patients with HCC, two (15%) of the 13 patients with cirrhosis, and three (6%) of the 53 control subjects. This mutation was not detected in any plasma DNA from the European patients. The adjusted odds ratio for having the mutation was 16.4 (95% confidence interval = 3.0-90.5) for patients with HCC compared with the control subjects. CONCLUSION: The Ser-249 p53 mutation in plasma DNA is strongly associated with HCC in Gambian patients. This mutation was also detected at a much lower prevalence in plasma DNA from Gambian patients with cirrhosis and in Gambian control subjects, findings that may lead to the earlier detection of HCC. Use of the Ser-249 p53 mutation should facilitate further molecular epidemiologic studies on the development of HCC.



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