Journal
BRITISH JOURNAL OF CANCER
Volume 109, Issue 4, Pages 1004-1012Publisher
SPRINGERNATURE
DOI: 10.1038/bjc.2013.430
Keywords
CpG island methylator phenotype; microsatellite instability; colorectal cancer; prognosis
Categories
Funding
- Mid-career Researcher Program through the National Research Foundation of Korea (NRF)
- Ministry of Education, Science and Technology (MEST) [2011-0015646]
- National R&D Program for Cancer Control, Ministry of Health & Welcare, Republic of Korea [0720540]
- Priority Research Centers Program through NRF
- MEST [2009-0093820]
- Korea Health Promotion Institute [0720540] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
- National Research Foundation of Korea [2011-0015646] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Background: Colorectal cancer (CRC) is usually categorised as proximal or distal CRC. Recently, many researchers have tried to determine the molecular heterogeneity of CRCs along bowel subsites. However, the differential effects of the CpG island methylator phenotype (CIMP) and microsatellite instability (MSI) on the clinical outcome according to tumour location are not well-known. Methods: We analysed clinicopathologic and molecular characteristics, including CIMP, MSI, KRAS and BRAF mutations, in 734 CRCs according to bowel subsites. And the prognostic value of CIMP and MSI was analysed according to tumour location. Results: We found a linear increase of female predominance, T, N category, stage, differentiation, absence of luminal necrosis, tumour -infiltrating lymphocytes, Crohn's-like lymphoid reaction, serration and mucin production from the rectum to caecum. CpG island methylator phenotype -high and MSI-high gradually increased from the rectum to caecum. CpG island methylator phenotype is a poor prognostic factor of overall survival (hazard ratio (HR): 4.13, 95% confidence interval (CI): 1.27-13.46) and disease-free survival (HR: 2.90, 95% CI: 1.04-8.08) in rectal cancers. Conclusion: Clinicopathologic and molecular profiles of CRCs gradually change along bowel subsites, and the prognostic implication of CIMP is different according to tumour location.
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