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Published in: Annals of Surgical Oncology 11/2012

01-10-2012 | Colorectal Cancer

Clinical Outcomes of Patients with Microsatellite-Unstable Colorectal Carcinomas Depend on L1 Methylation Level

Authors: Ye-Young Rhee, MD, Mi Jung Kim, MD, Jeong Mo Bae, MD, Jae Moon Koh, MD, Nam-Yun Cho, MSc, Yong-Sung Juhnn, MD, Donguk Kim, PhD, Gyeong Hoon Kang, MD

Published in: Annals of Surgical Oncology | Issue 11/2012

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Abstract

Background

The prognostic significance of microsatellite instability (MSI) in colorectal cancers (CRCs) has been addressed in many studies since the initial description of better survival rates in MSI-positive (MSI+) tumors than in MSI-negative (MSI−) tumors. Recent studies have demonstrated that a higher degree of hypomethylation of long interspersed nuclear element-1 (L1) is related to poor prognosis of CRCs and that a wide variation of L1 methylation levels exist within MSI+ CRCs. Our aim was to identify whether L1 and Alu methylation status could predict clinical outcomes within MSI+ CRCs.

Methods

We analyzed 207 MSI+ CRCs for their methylation levels in L1 and Alu repetitive DNA elements using pyrosequencing and correlated them with clinicopathological information including survival data.

Results

Univariate survival analysis showed that low Alu methylation status (<18.60 %) and low L1 methylation status (<53.00 %) were significantly associated with shorter overall survival time (log-rank test, P = 0.009 and P < 0.001, respectively). Multivariate analysis using nine parameters (Alu methylation status, L1 methylation status, patient’s age, disease stage [tumor, node, metastasis staging system], differentiation, Crohn-like lymphoid reaction, KRAS/BRAF mutation status, CpG island methylator phenotype [CIMP] status, and peritumoral lymphocytic infiltration), which were significantly prognostic in MSI+ CRCs, revealed that low L1 methylation status was an independent prognostic factor of MSI+ CRCs (P = 0.009), whereas low Alu methylation status was not.

Conclusions

Clinical outcomes of MSI+ CRCs depend on L1 methylation status, suggesting that lower L1 methylation status serves as a significant prognostic parameter of adverse prognosis in MSI+ CRCs.
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Metadata
Title
Clinical Outcomes of Patients with Microsatellite-Unstable Colorectal Carcinomas Depend on L1 Methylation Level
Authors
Ye-Young Rhee, MD
Mi Jung Kim, MD
Jeong Mo Bae, MD
Jae Moon Koh, MD
Nam-Yun Cho, MSc
Yong-Sung Juhnn, MD
Donguk Kim, PhD
Gyeong Hoon Kang, MD
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2410-7

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