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Inamura K, Yamauchi M, Nishihara R, Lochhead P, Qian ZR, Kuchiba A, Kim SA, Mima K, Sukawa Y, Jung S, Zhang X, Wu K, Cho E, Chan AT, Meyerhardt JA, Harris CC, Fuchs CS, Ogino S. Tumor LINE-1 methylation level and microsatellite instability in relation to colorectal cancer prognosis. J Natl Cancer Inst 2014; 106:dju195. [PMID: 25190725 DOI: 10.1093/jnci/dju195] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hypomethylation in long interspersed nucleotide element-1 (LINE-1) and high-degree microsatellite instability (MSI-high) in colorectal cancer (CRC) have been associated with inferior and superior survival, respectively; however, it remains uncertain whether the prognostic association of LINE-1 hypomethylation differs by MSI status. We hypothesized that the adverse prognostic association of LINE-1 hypomethylation might be stronger in MSI-high CRCs than in microsatellite stable (MSS) CRCs. METHODS Utilizing 1211 CRCs in the Nurses' Health Study and the Health Professionals Follow-up Study, we examined patient survival according to LINE-1 hypomethylation status in strata of MSI status. A Cox proportional hazards model was used to compute multivariable CRC-specific mortality hazard ratios (HRs) for a 10% decrease in LINE-1 methylation level (range = 23.1-93.1%), adjusting for potential confounders, including CpG island methylator phenotype, and KRAS, BRAF, and PIK3CA mutations. Statistical tests (log-rank test, chi-square test, and likelihood ratio test) were two-sided. RESULTS In MSI-high cancers, the association of LINE-1 hypomethylation with higher mortality (HR = 2.45, 95% confidence interval [CI] = 1.64 to 3.66, P < .001) was stronger than that in MSS cancers (HR = 1.10, 95% CI = 0.98 to 1.24, P = .11) (P interaction < .001, between LINE-1 and MSI statuses). In MSI-high cases with CRC family history, the association of LINE-1 hypomethylation with higher mortality (HR = 5.13, 95% CI = 1.99 to 13.2; P < .001) was stronger than that in MSI-high cases without CRC family history (HR = 1.62, 95% CI = 0.89 to 2.94, P = .11) (P interaction = .02, between LINE-1 and CRC family history statuses). CONCLUSIONS The association of LINE-1 hypomethylation with inferior survival is stronger in MSI-high CRCs than in MSS CRCs. Tumor LINE-1 methylation level may be a useful prognostic biomarker to identify aggressive carcinomas among MSI-high CRCs.
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Affiliation(s)
- Kentaro Inamura
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Mai Yamauchi
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Reiko Nishihara
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Paul Lochhead
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Zhi Rong Qian
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Aya Kuchiba
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Sun A Kim
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Kosuke Mima
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Yasutaka Sukawa
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Seungyoun Jung
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Xuehong Zhang
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Kana Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Eunyoung Cho
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Andrew T Chan
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Curtis C Harris
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Charles S Fuchs
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
| | - Shuji Ogino
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA (KI, MY, RN, PL, ZRQ, AK, SAK, KM, YS, JAM, CSF, SO); Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD (KI, CCH); Department of Nutrition, Harvard School of Public Health, Boston, MA (RN, AK, KW); Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK (PL); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SJ, XZ, EC, ATC, CSF); Department of Dermatology, The Warren Alpert Medical School of Brown University, Province, RI (EC); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (SO)
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