Association of angiotensin-converting enzyme insertion/deletion polymorphism with serum level and development of pulmonary complications following esophagectomy

Jang-Ming Lee, An-Chi Lo, Shi-Yi Yang, Huei-Shian Tsau, Robert J Chen, Yung-Chie Lee

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Pulmonary complications remain the major cause of postoperative mortality in patients with esophageal cancer undergoing esophagectomy. It was unclear whether this dismal complication has a genetic predisposition. We therefore investigated the role of an angiotensin-converting enzyme (ACE) insertion/deletion polymorphism in developing these complications.

METHODS: We conducted a prospective study including 152 patients with esophageal cancer who underwent esophagectomy in National Taiwan University Hospital between 1996 and 2002. The ACE genotype was determined by polymerase chain reaction amplification of leukocyte DNA obtained before surgery. The serum ACE concentration was determined by enzyme-linked immunosorbent assay.

RESULTS: Thirty-five patients (23%) developed pulmonary complications following esophagectomy. As compared with patients with the I/I and I/D genotypes, those with the D/D genotype had a higher risk for pulmonary complications (adjusted odds ratio [OR], 3.12; 95% confidence interval [CI], 1.01-9.65). The risk was additively enhanced by combination of the ACE D/D genotype with other clinical risk factors (old age, hypoalbuminemia, and poor pulmonary function). The circulating ACE level was also dose-dependently with the presence of ACE D allele. As compared with the patients with circulating ACE less than 200 ng/mL, the patients with circulating ACE of 200 to 400 ng/mL and over 400 ng/mL had ORs (95% CI) of 2.75 (1.12-6.67) and 15.00 (4.3-52.34) to present with ACE D allele, respectively.

CONCLUSIONS: An ACE insertion/deletion polymorphism might modulate the function of ACE gene and play a role in affecting individual susceptibility to pulmonary injury following esophagectomy in patients of esophageal cancer.

Original languageEnglish
Pages (from-to)659-65
Number of pages7
JournalAnnals of Surgery
Volume241
Issue number4
Publication statusPublished - Apr 2005
Externally publishedYes

Fingerprint

Esophagectomy
Peptidyl-Dipeptidase A
Lung
Serum
Esophageal Neoplasms
Genotype
Alleles
Confidence Intervals
Hypoalbuminemia
Lung Injury
Genetic Predisposition to Disease
Taiwan
Leukocytes
Enzyme-Linked Immunosorbent Assay
Odds Ratio
Prospective Studies

Keywords

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell/genetics
  • Esophageal Neoplasms/genetics
  • Esophagectomy/adverse effects
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Incidence
  • Logistic Models
  • Lung Diseases/genetics
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peptidyl-Dipeptidase A/genetics
  • Polymorphism, Genetic
  • Postoperative Complications/mortality
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Sex Distribution
  • Survival Analysis

Cite this

Association of angiotensin-converting enzyme insertion/deletion polymorphism with serum level and development of pulmonary complications following esophagectomy. / Lee, Jang-Ming; Lo, An-Chi; Yang, Shi-Yi; Tsau, Huei-Shian; Chen, Robert J; Lee, Yung-Chie.

In: Annals of Surgery, Vol. 241, No. 4, 04.2005, p. 659-65.

Research output: Contribution to journalArticle

Lee, Jang-Ming ; Lo, An-Chi ; Yang, Shi-Yi ; Tsau, Huei-Shian ; Chen, Robert J ; Lee, Yung-Chie. / Association of angiotensin-converting enzyme insertion/deletion polymorphism with serum level and development of pulmonary complications following esophagectomy. In: Annals of Surgery. 2005 ; Vol. 241, No. 4. pp. 659-65.
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abstract = "BACKGROUND: Pulmonary complications remain the major cause of postoperative mortality in patients with esophageal cancer undergoing esophagectomy. It was unclear whether this dismal complication has a genetic predisposition. We therefore investigated the role of an angiotensin-converting enzyme (ACE) insertion/deletion polymorphism in developing these complications.METHODS: We conducted a prospective study including 152 patients with esophageal cancer who underwent esophagectomy in National Taiwan University Hospital between 1996 and 2002. The ACE genotype was determined by polymerase chain reaction amplification of leukocyte DNA obtained before surgery. The serum ACE concentration was determined by enzyme-linked immunosorbent assay.RESULTS: Thirty-five patients (23{\%}) developed pulmonary complications following esophagectomy. As compared with patients with the I/I and I/D genotypes, those with the D/D genotype had a higher risk for pulmonary complications (adjusted odds ratio [OR], 3.12; 95{\%} confidence interval [CI], 1.01-9.65). The risk was additively enhanced by combination of the ACE D/D genotype with other clinical risk factors (old age, hypoalbuminemia, and poor pulmonary function). The circulating ACE level was also dose-dependently with the presence of ACE D allele. As compared with the patients with circulating ACE less than 200 ng/mL, the patients with circulating ACE of 200 to 400 ng/mL and over 400 ng/mL had ORs (95{\%} CI) of 2.75 (1.12-6.67) and 15.00 (4.3-52.34) to present with ACE D allele, respectively.CONCLUSIONS: An ACE insertion/deletion polymorphism might modulate the function of ACE gene and play a role in affecting individual susceptibility to pulmonary injury following esophagectomy in patients of esophageal cancer.",
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author = "Jang-Ming Lee and An-Chi Lo and Shi-Yi Yang and Huei-Shian Tsau and Chen, {Robert J} and Yung-Chie Lee",
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TY - JOUR

T1 - Association of angiotensin-converting enzyme insertion/deletion polymorphism with serum level and development of pulmonary complications following esophagectomy

AU - Lee, Jang-Ming

AU - Lo, An-Chi

AU - Yang, Shi-Yi

AU - Tsau, Huei-Shian

AU - Chen, Robert J

AU - Lee, Yung-Chie

PY - 2005/4

Y1 - 2005/4

N2 - BACKGROUND: Pulmonary complications remain the major cause of postoperative mortality in patients with esophageal cancer undergoing esophagectomy. It was unclear whether this dismal complication has a genetic predisposition. We therefore investigated the role of an angiotensin-converting enzyme (ACE) insertion/deletion polymorphism in developing these complications.METHODS: We conducted a prospective study including 152 patients with esophageal cancer who underwent esophagectomy in National Taiwan University Hospital between 1996 and 2002. The ACE genotype was determined by polymerase chain reaction amplification of leukocyte DNA obtained before surgery. The serum ACE concentration was determined by enzyme-linked immunosorbent assay.RESULTS: Thirty-five patients (23%) developed pulmonary complications following esophagectomy. As compared with patients with the I/I and I/D genotypes, those with the D/D genotype had a higher risk for pulmonary complications (adjusted odds ratio [OR], 3.12; 95% confidence interval [CI], 1.01-9.65). The risk was additively enhanced by combination of the ACE D/D genotype with other clinical risk factors (old age, hypoalbuminemia, and poor pulmonary function). The circulating ACE level was also dose-dependently with the presence of ACE D allele. As compared with the patients with circulating ACE less than 200 ng/mL, the patients with circulating ACE of 200 to 400 ng/mL and over 400 ng/mL had ORs (95% CI) of 2.75 (1.12-6.67) and 15.00 (4.3-52.34) to present with ACE D allele, respectively.CONCLUSIONS: An ACE insertion/deletion polymorphism might modulate the function of ACE gene and play a role in affecting individual susceptibility to pulmonary injury following esophagectomy in patients of esophageal cancer.

AB - BACKGROUND: Pulmonary complications remain the major cause of postoperative mortality in patients with esophageal cancer undergoing esophagectomy. It was unclear whether this dismal complication has a genetic predisposition. We therefore investigated the role of an angiotensin-converting enzyme (ACE) insertion/deletion polymorphism in developing these complications.METHODS: We conducted a prospective study including 152 patients with esophageal cancer who underwent esophagectomy in National Taiwan University Hospital between 1996 and 2002. The ACE genotype was determined by polymerase chain reaction amplification of leukocyte DNA obtained before surgery. The serum ACE concentration was determined by enzyme-linked immunosorbent assay.RESULTS: Thirty-five patients (23%) developed pulmonary complications following esophagectomy. As compared with patients with the I/I and I/D genotypes, those with the D/D genotype had a higher risk for pulmonary complications (adjusted odds ratio [OR], 3.12; 95% confidence interval [CI], 1.01-9.65). The risk was additively enhanced by combination of the ACE D/D genotype with other clinical risk factors (old age, hypoalbuminemia, and poor pulmonary function). The circulating ACE level was also dose-dependently with the presence of ACE D allele. As compared with the patients with circulating ACE less than 200 ng/mL, the patients with circulating ACE of 200 to 400 ng/mL and over 400 ng/mL had ORs (95% CI) of 2.75 (1.12-6.67) and 15.00 (4.3-52.34) to present with ACE D allele, respectively.CONCLUSIONS: An ACE insertion/deletion polymorphism might modulate the function of ACE gene and play a role in affecting individual susceptibility to pulmonary injury following esophagectomy in patients of esophageal cancer.

KW - Adult

KW - Age Distribution

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma, Squamous Cell/genetics

KW - Esophageal Neoplasms/genetics

KW - Esophagectomy/adverse effects

KW - Female

KW - Genetic Predisposition to Disease

KW - Humans

KW - Incidence

KW - Logistic Models

KW - Lung Diseases/genetics

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Peptidyl-Dipeptidase A/genetics

KW - Polymorphism, Genetic

KW - Postoperative Complications/mortality

KW - Prognosis

KW - Prospective Studies

KW - Risk Assessment

KW - Sex Distribution

KW - Survival Analysis

UR - https://www.ncbi.nlm.nih.gov/pubmed/15798469

M3 - Article

C2 - 15798469

VL - 241

SP - 659

EP - 665

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 4

ER -