Document Detail

Clinicopathologic and molecular characteristics of synchronous colorectal cancers: heterogeneity of clinical outcome depending on microsatellite instability status of individual tumors.
MedLine Citation:
PMID:  22228162     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The contribution of chromosomal instability, microsatellite instability, and epigenetic instability to the development of synchronous colorectal carcinomas is controversial.
OBJECTIVE: This study aimed to investigate the relative roles of microsatellite instability and epigenetic instability in the development of synchronous colorectal cancers.
DESIGN: This was a retrospective study of medical records with histologic, immunohistochemical, and molecular examination of stored tissue samples.
SETTING: The study took place at Seoul National University Hospital, Korea.
PATIENTS: A total of 46 patients with synchronous colorectal cancers and 105 patients with solitary colorectal cancers were included.
MAIN OUTCOME MEASURES: Clinicopathologic and molecular characteristics including microsatellite instability, mismatch repair gene expression, CpG island methylator phenotype, and mutation of KRAS and BRAF were analyzed.
RESULTS: Patients with synchronous tumors were more likely to be men than those with solitary tumors and had a tendency toward colocalization of individual tumors in the left or right colon. MSI-deficient cancers were more frequent in synchronous than in solitary cancers. The frequencies of CpG island methylator phenotype-high and KRAS and BRAF mutations were not different between synchronous and solitary cancers. No differences between synchronous cancers and solitary cancers were observed in overall survival or progression-free survival. Within the synchronous cancer group, patients with individual tumors discordant for microsatellite instability status had the worst clinical outcome, whereas those with individual tumors concordant for microsatellite instability-deficient status had the best clinical outcome.
LIMITATIONS: The study was limited by its retrospective nature. Molecular analysis was performed only on cancerous lesions.
CONCLUSIONS: Our findings suggest that microsatellite instability plays a more important role than does epigenetic instability in the development of synchronous colorectal cancers, and that information regarding concordant or discordant microsatellite instability status between individual tumors might help to predict clinical outcome of synchronous colorectal cancers.
Jeong M Bae; Nam-Yun Cho; Tae-You Kim; Gyeong H Kang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  55     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-09     Completed Date:  2012-03-07     Revised Date:  2012-06-21    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-90     Citation Subset:  IM    
Department of Pathology, Seoul National University College of Medicine, 28 Yongon-dong, Songno-gu, Seoul, Korea.
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MeSH Terms
Aged, 80 and over
Colorectal Neoplasms / genetics*,  mortality,  pathology
CpG Islands / genetics
DNA Methylation
DNA Mismatch Repair / genetics
Epigenesis, Genetic*
Microsatellite Instability*
Middle Aged
Neoplasms, Multiple Primary / genetics*,  mortality,  pathology
Proto-Oncogene Proteins / genetics
Proto-Oncogene Proteins B-raf / genetics
Retrospective Studies
Survival Analysis
Tumor Markers, Biological / genetics*
ras Proteins / genetics
Reg. No./Substance:
0/KRAS protein, human; 0/Proto-Oncogene Proteins; 0/Tumor Markers, Biological; EC protein, human; EC Proteins B-raf; EC Proteins

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