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Ben Mahmoud IT, Ben Said A, Berguiga S, Houij R, Cherif I, Hamdi A, Ben Ayed W, Limayem I. Incidence and risk factors associated with development of oxalipatin-induced acute peripheral neuropathy in colorectal cancer patients. J Oncol Pharm Pract 2023; 29:311-318. [PMID: 34918549 DOI: 10.1177/10781552211068138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Oxaliplatin utilized in colorectal neoplasms treatment could induce acute peripheral neuropathy (APN) which is a dreadful and frequent adverse event. The objective of this study is to estimate incidence of APN induced by oxaliplatin cumulative incidence in cancer patients colorectal and to describe the distribution of the APN incidence according to demographic and clinical characteristics, as well as according to oxaliplatin cumulative dose. MATERIAL AND METHODS This is a prospective descriptive study which took place from June to December 2018 at the Salah Azaiz Institute, Tunis. Demographic data, clinical data and data on oxaliplatin administration were collected from patient interview, medical files and pharmaceutical databases. RESULTS The APN (grade 1, grade 2 and grade 3) cumulative incidence during the period of six months of follow up was 86% (95% CI [0.7815-0.9132]). While 38.3% (95% CI [0.29-0.48]) of the patients had grade 2 or 3 neuropathy. The search for factors associated with the risk of grade 2 and 3 NAP revealed trend significant association with diabetes (adjusted RR = 5.7 (IC95% [0.9- 37.3]; p = 0.07). Moreover, there was significant association with oxaliplatin cumulative dose (≥421 mg/m2) to increase the risk of APN grade 2 and 3 (adjusted RR = 7.8; [2.7-22.7]; p = 0.0001). Furthermore, significant association with obesity to increase the risk of APN grade 2 and 3 (adjusted RR = 5.3 [1.1- 25.4]; p = 0.04) was found. Among the patients included, 31.1% experienced oxaliplatin dose reduction and in the majority of cases this reduction is due to neurotoxicity (90.9%). CONCLUSION The high incidence of oxaliplatin-induced APN remains an embarrassing and handicapping side effect. Our study has shown that oxaliplatin cumulative dose (≥421 mg/m2), diabetes and obesity are risk factor for the development of grade 2 and 3 APN.
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Affiliation(s)
- Imen Toukabri Ben Mahmoud
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia.,Faculty of Pharmacy, 108055University of Monastir, Monastir, Tunisia
| | - Azza Ben Said
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia.,Faculty of Pharmacy, 108055University of Monastir, Monastir, Tunisia
| | - Souad Berguiga
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia
| | - Racha Houij
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia
| | - Ines Cherif
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Adel Hamdi
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia.,Faculty of Pharmacy, 108055University of Monastir, Monastir, Tunisia
| | - Wiem Ben Ayed
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia
| | - Imen Limayem
- 59075Salah Azaiez Institute Department of Pharmacy, Tunis, Tunisia.,Faculty of Pharmacy, 108055University of Monastir, Monastir, Tunisia
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Chen L, Yin N, Ding Y, Zhang ML, Li M, Zhong JJ, Feng SM. Effects of fluoride on the proliferation and activation of osteoblasts by regulating methylation of the DNA repair genes MGMT and MLH1. Regen Ther 2022; 19:107-112. [PMID: 35155723 PMCID: PMC8814769 DOI: 10.1016/j.reth.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/15/2021] [Accepted: 01/12/2022] [Indexed: 12/29/2022] Open
Abstract
Introduction Fluoride can induce the proliferation and activation of osteoblasts, resulting in skeletal fluorosis progression; however, the specific mechanism is unclear. Methods Cell proliferation was examined using the MTT assay. Flow cytometry was performed to detect the cell cycle distribution. Alkaline phosphatase (ALP) was calculated to evaluate bone formation and turnover. Gene methylation was examined using the MSP assay. mRNA and protein expression levels were assessed using qRT-PCR and Western blot assays. Results Low-concentration NaF treatment promoted the cell cycle progression of osteoblasts to S-phase, thus accelerating cell proliferation and activation in a concentration-dependent manner. In addition, the methylation of the MGMT and MLH1 genes was increased, and their mRNA expression was reduced. Furthermore, the DNA methyltransferase inhibitor 5-AZA-dC suppressed cell viability, cell number in S-phase, ALP activity and osteogenesis-related protein levels in osteoblasts treated with low doses of NaF. Meanwhile, 5-AZA-dC suppressed the increase in MGMT and MLH1 gene methylation in osteoblasts treated with low doses of NaF, leading to enhanced expression of MGMT and MLH1 mRNA. Conclusion NaF treatment led to methylation of the DNA repair genes MGMT and MLH1 in osteoblasts, resulting in cell proliferation and activation and causing the development of skeletal fluorosis.
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Gorzo A, Galos D, Volovat SR, Lungulescu CV, Burz C, Sur D. Landscape of Immunotherapy Options for Colorectal Cancer: Current Knowledge and Future Perspectives beyond Immune Checkpoint Blockade. Life (Basel) 2022; 12:229. [PMID: 35207516 PMCID: PMC8878674 DOI: 10.3390/life12020229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022] Open
Abstract
Colorectal cancer is the third most prevalent malignancy in Western countries and a major cause of death despite recent improvements in screening programs and early detection methods. In the last decade, a growing effort has been put into better understanding how the immune system interacts with cancer cells. Even if treatments with immune checkpoint inhibitors (anti-PD1, anti-PD-L1, anti-CTLA4) were proven effective for several cancer types, the benefit for colorectal cancer patients is still limited. However, a subset of patients with deficient mismatch repair (dMMR)/microsatellite-instability-high (MSI-H) metastatic colorectal cancer has been observed to have a prolonged benefit to immune checkpoint inhibitors. As a result, pembrolizumab and nivolumab +/- ipilimumab recently obtained the Food and Drug Administration approval. This review aims to highlight the body of knowledge on immunotherapy in the colorectal cancer setting, discussing the potential mechanisms of resistance and future strategies to extend its use.
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Affiliation(s)
- Alecsandra Gorzo
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuţă”, 400015 Cluj-Napoca, Romania; (A.G.); (D.G.); (C.B.)
- Department of Medical Oncology, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania
| | - Diana Galos
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuţă”, 400015 Cluj-Napoca, Romania; (A.G.); (D.G.); (C.B.)
- Department of Medical Oncology, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania
| | - Simona Ruxandra Volovat
- Department of Medical Oncology, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700115 Iasi, Romania;
| | | | - Claudia Burz
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuţă”, 400015 Cluj-Napoca, Romania; (A.G.); (D.G.); (C.B.)
- Department of Allergology and Immunology, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania
| | - Daniel Sur
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuţă”, 400015 Cluj-Napoca, Romania; (A.G.); (D.G.); (C.B.)
- Department of Medical Oncology, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400000 Cluj-Napoca, Romania
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Detection of Microsatellite Instability by High-Resolution Melting Analysis in Colorectal Cancer. IRANIAN BIOMEDICAL JOURNAL 2022; 26:70-6. [PMID: 34923812 PMCID: PMC8784903 DOI: 10.52547/ibj.26.1.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Colorectal cancer (CRC) is the third most common cancer worldwide. microsatellite instability (MSI) is a molecular marker of a deficient mismatch repair system and happens in almost 15% of CRCs. Because of a wide frequency of MSI+ CRC in Iran compared to other parts of the world, the importance of screening for this type of cancer is highlighted. Methods : The most common MSI detection technique is a fluorescent PCR-based method in which fragments are analyzed by capillary electrophoresis (CE). This technique is very time-consuming, difficult, and expensive. We sought to develop and evaluate a proper method with high accuracy, specificity, and sensitivity to screen the MSI+ CRC. A high-resolution melting (HRM) analysis procedure is relying on the analysis of the melting curve attributes. Low cost, feasibility, high specificity, and sensitivity are outstanding attributes of HRM analysis. Results Five mononucleotide microsatellite markers, including BAT-25, BAT-26, NR-21, NR-24, and NR-27, in 25 archival CRC tumor tissue samples were compared with normal tissue adjacent using HRM method. The specificity and sensitivity of BAT-25 with HRM method were 100% compared to CE, while other markers had lower sensitivity. However, when all the markers were considered together, the sensitivity and specificity became 100%. The number of MSI+ samples was 56%, which shows a higher ratio than previous Iranian studies. The highest MSI was related to BAT-26 (52%). Conclusion The HRM method is much simpler and more cost-effective than current MSI techniques, and its sensitivity and accuracy are comparable. Therefore, it can serve as an alternative method in cases where CE is unavailable.
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Cabral LKD, Mapua CA, Natividad FF, Sukowati CHC, Cortez ER, Enriquez MLD. MutL homolog 1 methylation and microsatellite instability in sporadic colorectal tumors among Filipinos. World J Gastrointest Oncol 2021; 13:2101-2113. [PMID: 35070045 PMCID: PMC8713326 DOI: 10.4251/wjgo.v13.i12.2101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/24/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) ranks third in terms of incidence and second in mortality worldwide. In CRC, the silencing of mismatch repair genes, including the mutL homolog 1 (hMLH1) has been linked to microsatellite instability (MSI), the lengthening or shortening of microsatellite repeats. Very limited data have been presented so far on the link of hMLH1 methylation and MSI in Southeast Asia populations with sporadic CRC, and on its clinical significance.
AIM To investigate the significance of the MSI status and hMLH1 methylation in CRC Filipino patients.
METHODS Fifty-four sporadic CRC patients with complete clinical data were included in this study. Genomic DNA from CRC tumor biopsies and their normal tissue counterparts were profiled for MSI by high resolution melting (HRM) analysis using the Bethesda Panel of Markers (BAT25, BAT26, D2S123, D5S346, and D17S250). hMLH1 methylation screening was performed using bisulfite conversion and methylation specific polymerase chain reaction. Statistical analysis was conducted to calculate their associations to clinicopathological characteristics and survival relevance (Kaplan-Meier curves and the log-rank test).
RESULTS hMLH1 methylation was observed in 9% and 35% of CRC and normal samples, respectively. Higher incidence of consistently methylated hMLH1 found in both normal and CRC was noticed for relation to location of tumor (P < 0.05). As for MSI status, D2S123 the most common unstable microsatellite and MSI-high (MSI-H) was the most common MSI profile, counted for 46% and 50% of normal and CRC tissues, respectively. The presence of MSI-low (MSI-L) and microsatellite stable (MSS) was 43% and 11% for normal, and 31% and 19% for CRC samples. The mean month of patients’ survival was shorter in patients whose normal and tumor tissues had methylated compared to those with unmethylated hMLH1 and with MSI-H compared to those with MSI-L/MSS (P < 0.05). This was supported by significant difference in Kaplan-Meier with log-rank analysis. This data indicated that hMLH1 methylation and high MSI status have prognostic value.
CONCLUSION This study showed the clinical significance of hMLH1 methylation and MSI status in sporadic CRC Filipino patients, especially in the normal part of the tumor.
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Affiliation(s)
- Loraine Kay D Cabral
- Research and Biotechnology Group, St. Luke's Medical Center, Quezon City 1112, Philippines
- Centro Studi Fegato, Fondazione Italiana Fegato ONLUS, Trieste 34149, Italy
| | - Cynthia A Mapua
- Research and Biotechnology Group, St. Luke's Medical Center, Quezon City 1112, Philippines
| | - Filipinas F Natividad
- Research and Biotechnology Group, St. Luke's Medical Center, Quezon City 1112, Philippines
| | | | - Edgardo R Cortez
- Department of Surgery, St. Luke's Medical Center, Quezon City 1112, Philippines
| | - Ma Luisa D Enriquez
- Research and Biotechnology Group, St. Luke's Medical Center, Quezon City 1112, Philippines
- Center for Natural Science and Environmental Research, De La Salle University, Manila 1004, Philippines
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Yari A, Samoudi A, Afzali A, Karam ZM, Karimaldini NK, Abadi MFS, Ziasistani M, Zangouey MR, Dabiri S. Mutation Status and Prognostic Value of KRAS and BRAF in Southeast Iranian Colorectal Cancer Patients: First Report from Southeast of Iran. J Gastrointest Cancer 2021; 52:557-568. [PMID: 32495109 DOI: 10.1007/s12029-020-00426-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
MAIN PURPOSE This study aimed to determine any association of KRAS and BRAF mutations in colorectal cancer with clinicopathological features and overall survival (OS) of Southeast Iranian colorectal cancer (CRC) patients. METHODS Overall, KRAS and BRAF status were assessed in 100 Iranian CRC subjects. A hundred consecutive stages I-IV CRC patients, who underwent surgical tumor resection from February 2012 to August 2015, were prospectively attained from three centers and were enrolled in the research. Direct sequencing and real-time PCR methods were used to the detection of KRAS and BRAF mutations, respectively. Logistic regression models were used to detect associations of KRAS and BRAF mutations with clinical/clinicopathological features. Kaplan-Meier model was used to estimate overall survival. RESULTS In total, KRAS and BRAF mutations were detected in 29 (29%) and 7 (7%) of 100 CRC patients, respectively. BRAF mutations that all comprised V600E and KRAS mutations were found in codon 12, 13, and 61 (72.4%, 20.7 and 6.9%), respectively. In a multivariate analysis, older age (≥ 60) was significantly associated with higher KRAS mutations rate and high BRAF mutation rate was significantly associated with older age (≥ 60) and poorly differentiated tumors. KRAS and BRAF mutant vs. wild type of KRAS and BRAF, 5-year OS was 62.1% vs. 71.8% (p value > 0.05) and 57.1% vs. 67.7% (p value > 0.05), respectively. CONCLUSION Mutations were found in both KRAS and BRAF genes in Iranian colorectal cancers patients and were associated with clinical/clinicopathologic features. Our data emphasizes the importance of these molecular features in Iranian CRC patients.
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Affiliation(s)
- Abolfazl Yari
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, 22 Bahman Blvd., Kerman, Iran
| | - Arash Samoudi
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
- Department of Immunology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Asiyeh Afzali
- Department of Medical Laboratory of Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Miri Karam
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Negin Khaje Karimaldini
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, 22 Bahman Blvd., Kerman, Iran
| | - Maryam Fekri Soofi Abadi
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, 22 Bahman Blvd., Kerman, Iran
| | - Mahsa Ziasistani
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, 22 Bahman Blvd., Kerman, Iran
| | - Mohammad Reza Zangouey
- Department of Immunology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahriar Dabiri
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, 22 Bahman Blvd., Kerman, Iran.
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7
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A systematic review and meta-analysis of the DNA methylation in colorectal cancer among Iranian population. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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8
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Yari A, Afzali A, Aalipour M, Nakheai M, Zahedi MJ. KRAS and BRAF mutations in Iranian colorectal cancer patients: A systematic review and meta-analysis. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 11:355-369. [PMID: 33680376 PMCID: PMC7911761 DOI: 10.22088/cjim.11.4.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Mutations in the EGFR signaling pathway play an important role in the development of colorectal cancer (CRC). Mutations in these genes, like KRAS and BRAF, affect the treatment strategies and associated with poor prognosis and relative resistance to anti-EGFR therapies. Our aim was to conduct a systematic and meta-analysis on all studies that have been conducted on the prevalence of these gene mutations in Iranian CRC patients. Methods: Four science citation index databases (MEDLINE, EMBASE, Web of Science and Cochrane library) and local databases were searched up to March 2018 with related keywords. Two reviewers independently screened and extracted the data. Quality of all included studies was assessed using an adapted checklist from STROBE. A random-effect model was used to calculate the total prevalence of KRAS and BRAF mutations in CRC subjects by the event rate (ER). Meta-regression was utilized to explore heterogeneity causes. Results: In total, from 573 records, 23 eligible studies (2662 patients) were included for data extraction and analysis. In 18 of 23 included studies, the prevalence of KRAS mutations was 33.9% (95% CI=30.1-37.9) with I2=65.17 (p<0.001). The occurrence of KRAS mutations in codon 12 and 13 was 76.9% (95% CI = 70.4-82.3%) with I2=84.88 (p<0.001) and 23.5% (95% CI=17.9-30.3) with I2=85.85 (p<0.001), respectively. In 9 of 23 studies, the BRAF mutation rate was 3.2% (95% CI=0.003-13.6) with I2=88.61 (p<0.001). Conclusion: The prevalence of these mutations in CRC patients shows a significant difference in the different regions of Iran, which is probably due to environmental and racial factors.
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Affiliation(s)
- Abolfazl Yari
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.,Department of Medical Genetics, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Asiyeh Afzali
- Department of Medical Laboratory of Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Aalipour
- Department of Immunology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehran Nakheai
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Javad Zahedi
- Gastroenterology and Hepatology Research Center, Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Ashktorab H, Delker D, Kanth P, Goel A, Carethers JM, Brim H. Molecular Characterization of Sessile Serrated Adenoma/Polyps From a Large African American Cohort. Gastroenterology 2019; 157:572-574. [PMID: 31004568 PMCID: PMC6980432 DOI: 10.1053/j.gastro.2019.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/09/2019] [Accepted: 04/13/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Hassan Ashktorab
- Department of Medicine and Cancer Center, Howard University College of Medicine, Washington, DC.
| | - Don Delker
- Division of Gastroenterology, University of Utah Health Care, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Priyanka Kanth
- Division of Gastroenterology, University of Utah Health Care, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Ajay Goel
- Baylor Scott & White Research Institute and Charles A. Sammons Cancer Center, Dallas, Texas
| | - John M. Carethers
- Division of Gastroenterology, Department of Internal Medicine, Department of Human Genetics, and Rogel Cancer Center, Ann Arbor, Michigan
| | - Hassan Brim
- Department of Pathology, Howard University College of Medicine, Washington DC
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Abbaszadegan MR, Moghbeli M. Genetic and molecular origins of colorectal Cancer among the Iranians: an update. Diagn Pathol 2018; 13:97. [PMID: 30579343 PMCID: PMC6303916 DOI: 10.1186/s13000-018-0774-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/05/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one the leading causes of cancer related deaths among Iranians. Despite the various progresses in new therapeutic methods, it has still a low rate of survival. This high ratio of mortality is mainly related to the late diagnosis, in which the patients refer for treatment in advanced stages of tumor. MAIN BODY: colorectal cancer progression is largely associated with molecular and genetic bases. Although Iran has a high ratio of CRC mortality, there is not an efficient genetic panel for detection and prognosis. Therefore, it is critical to introduce new diagnostic markers with ability to detect in early stages. CONCLUSION Present review summarizes all of the genetic and epigenetic factors which are reported in CRC until now among the Iranian patients to pave the way of incorporation of new ethnic specific markers into the clinical practice and development of new targeted therapeutic methods.
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Affiliation(s)
| | - Meysam Moghbeli
- Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Reverón D, López C, Gutiérrez S, Sayegh ZE, Antonia T, Dutil J, Malafa M, Coppola D. Frequency of Mismatch Repair Protein Deficiency in a Puerto Rican Population with Colonic Adenoma and Adenocarcinoma. Cancer Genomics Proteomics 2018; 15:265-271. [PMID: 29976631 DOI: 10.21873/cgp.20084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/15/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIM Microsatellite instability (MSI) results from genetic alterations involving the mismatch repair (MMR) genes MLH1, PSM2, MSH2, and MSH6. MSI has been implicated in both sporadic CRC and Lynch syndrome. The aim of the study was to assess the frequency of alterations in MMR protein expression in both primary colorectal cancer and precursor lesions among Puerto Rican patients. PATIENTS AND METHODS A retrospective study of 84 Puerto Rican patients was performed to assess the frequency of MMR protein expression alterations in both primary CRC and precursor lesions using tissue microarray and immunohistochemistry. RESULTS The loss of expression of both MLH1 and PMS2 proteins was present in 6.3% of adenomas, 9.1% of adenomas with high-grade dysplasia and 9.4% of colon adenocarcinomas. Negative nuclear staining for both MSH2 and MSH6 proteins was found in 2.4% of colon adenocarcinomas. CONCLUSION When compared to prior reports, this study suggests a lower frequency of MSI among the Puerto Rican population. The higher prevalence of MLH1 mutations correlates with previous studies of protein expression among the Hispanic community including Colombian, Uruguay and Brazilian populations.
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Affiliation(s)
- Dayana Reverón
- School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico, U.S.A
| | - Christian López
- School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico, U.S.A
| | - Sylvia Gutiérrez
- Department of Tissue Procurement Core Pathology-Tissue Collecting Facility, St. Luke's Episcopal Hospital, Ponce, Puerto Rico, U.S.A
| | - Zena E Sayegh
- Department of Anatomic Pathology, Tumor Biology and Tissue Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - Teresita Antonia
- Department of Anatomic Pathology, Tumor Biology and Tissue Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - Julie Dutil
- Department of Molecular Biology, Ponce Health Sciences University, Ponce, Puerto Rico, U.S.A
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - Domenico Coppola
- Department of Anatomic Pathology, Tumor Biology and Tissue Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A.
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Dolatkhah R, Somi MH, Shabanloei R, Farassati F, Fakhari A, Dastgiri S. Main Risk Factors Association with Proto-Oncogene Mutations in Colorectal Cancer. Asian Pac J Cancer Prev 2018; 19:2183-2190. [PMID: 30139223 PMCID: PMC6171391 DOI: 10.22034/apjcp.2018.19.8.2183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective: Although several factors have been shown to have etiological roles in colorectal cancer, few investigations
have addressed how and to what extent these factors affect the genetics and pathology of the disease. Precise relationships
with specific genetic mutations that could alter signaling pathways involved in colorectal cancer remain unknown.
We therefore aimed to investigate possible links between lifestyle, dietary habits, and socioeconomic factors and specific
mutations that are common in colorectal cancers. Methods: Data were retrieved from a baseline survey of lifestyle factors,
dietary behavior, and SES, as well as anthropometric evaluations during a physical examination, for 100 confirmed
primary sporadic colorectal cancer patients from Northwest Iran. Results: High socioeconomic status was significantly
associated with higher likelihood of a KRAS gene mutation (P < 0.05) (odds ratio: 3.01; 95% CI: 0.69–13.02). Consuming
carbohydrates and alcohol, working less, and having a sedentary lifestyle also increased the odds of having a KRAS
mutation. Conclusion: Although research has not yet described the exact relationships among genetic mutations with
different known risk factors in colorectal cancer, examples of the latter may have an impact on KRAS gene mutations.
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Affiliation(s)
- Roya Dolatkhah
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Ashktorab H, Mokarram P, Azimi H, Olumi H, Varma S, Nickerson ML, Brim H. Targeted exome sequencing reveals distinct pathogenic variants in Iranians with colorectal cancer. Oncotarget 2018; 8:7852-7866. [PMID: 28002797 PMCID: PMC5341754 DOI: 10.18632/oncotarget.13977] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/01/2016] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Next Generation Sequencing (NGS) is currently used to establish mutational profiles in many multigene diseases such as colorectal cancer (CRC), which is on the rise in many parts of the developing World including, Iran. Little is known about its genetic hallmarks in these populations. AIM To identify variants in 15 CRC-associated genes in patients of Iranian descent. RESULTS There were 51 validated variants distributed on 12 genes: 22% MSH3 (n = 11/51), 10% MSH6 (n = 5/51), 8% AMER1 (n = 4/51), 20% APC (n = 10/51), 2% BRAF (n = 1/51), 2% KRAS (n = 1/51), 12% PIK3CA (n = 6/51), 8% TGFβR2A (n = 4/51), 2% SMAD4 (n = 1/51), 4% SOX9 (n = 2/51), 6% TCF7L2 (n = 3/51), and 6% TP53 (n = 3/51). Most known and distinct variants were in mismatch repair genes (MMR, 32%) and APC (20%). Among oncogenes, PIK3CA was the top target (12%). MATERIALS AND METHODS CRC specimens from 63 Shirazi patients were used to establish the variant' profile on an Ion Torrent platform by targeted exome sequencing. To rule-out technical artifacts, the variants were validated in 13 of these samples using an Illumina NGS platform. Validated variants were annotated and compared to variants from publically available databases. An in-silico functional analysis was performed. MSI status of the analyzed samples was established. CONCLUSION These results illustrate for the first time CRC mutational profile in Iranian patients. MSH3, MSH6, APC and PIK3CA genes seem to play a bigger role in the path to cancer in this population. These findings will potentially lead to informed genetic diagnosis protocol and targeted therapeutic strategies.
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Affiliation(s)
- Hassan Ashktorab
- Department of Medicine and Cancer Center, Howard University College of Medicine, Washington, DC, USA
| | - Pooneh Mokarram
- Current address: Department of Biochemistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Azimi
- Department of Medicine and Cancer Center, Howard University College of Medicine, Washington, DC, USA
| | - Hasti Olumi
- Department of Medicine and Cancer Center, Howard University College of Medicine, Washington, DC, USA
| | | | - Michael L Nickerson
- Laboratory of Translational Genomics, National Cancer Institute, Bethesda, MD, USA
| | - Hassan Brim
- Department of Pathology, Howard University College of Medicine, Washington, DC, USA
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Augustus GJ, Ellis NA. Colorectal Cancer Disparity in African Americans: Risk Factors and Carcinogenic Mechanisms. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 188:291-303. [PMID: 29128568 DOI: 10.1016/j.ajpath.2017.07.023] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/01/2017] [Accepted: 07/20/2017] [Indexed: 12/13/2022]
Abstract
African Americans have the highest incidence and mortality rates of colorectal cancer (CRC) of any ethnic group in the United States. Although some of these disparities can be explained by differences in access to care, cancer screening, and other socioeconomic factors, disparities remain after adjustment for these factors. Consequently, an examination of recent advances in the understanding of ethnicity-specific factors, including genetic and environmental factors relating to risk of CRC, the biology of CRC progression, and the changes in screening and mortality, is important for evaluating our progress toward eliminating the disparities. An overarching limitation in this field is the number and sample size of studies performed to characterize the etiological bases of CRC incidence and mortality in African Americans. Despite this limitation, significant differences in etiology are manifest in many studies. These differences need validation, and their impacts on disparities need more detailed investigation. Perhaps most heartening, improvements in CRC screening can be attributed to the smallest difference in CRC incidence between African Americans and whites since the late 1980s. Cancer mortality, however, remains a persistent difference.
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Affiliation(s)
- Gaius J Augustus
- Cancer Biology Graduate Interdisciplinary Program, University of Arizona, Tucson, Arizona.
| | - Nathan A Ellis
- University of Arizona Cancer Center, University of Arizona, Tucson, Arizona; Department of Cellular and Molecular Medicine, University of Arizona, Tucson, Arizona.
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15
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A Microbiomic Analysis in African Americans with Colonic Lesions Reveals Streptococcus sp.VT162 as a Marker of Neoplastic Transformation. Genes (Basel) 2017; 8:genes8110314. [PMID: 29120399 PMCID: PMC5704227 DOI: 10.3390/genes8110314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/19/2017] [Accepted: 10/26/2017] [Indexed: 12/26/2022] Open
Abstract
Increasing evidence suggests a role of the gut microbiota in colorectal carcinogenesis (CRC). To detect bacterial markers of colorectal cancer in African Americans a metabolomic analysis was performed on fecal water extracts. DNA from stool samples of adenoma and healthy subjects and from colon cancer and matched normal tissues was analyzed to determine the microbiota composition (using 16S rDNA) and genomic content (metagenomics). Metagenomic functions with discriminative power between healthy and neoplastic specimens were established. Quantitative Polymerase Chain Reaction (q-PCR) using primers and probes specific to Streptococcus sp. VT_162 were used to validate this bacterium association with neoplastic transformation in stool samples from two independent cohorts of African Americans and Chinese patients with colorectal lesions. The metabolomic analysis of adenomas revealed low amino acids content. The microbiota in both cancer vs. normal tissues and adenoma vs. normal stool samples were different at the 16S rRNA gene level. Cross-mapping of metagenomic data led to 9 markers with significant discriminative power between normal and diseased specimens. These markers identified with Streptococcus sp. VT_162. Q-PCR data showed a statistically significant presence of this bacterium in advanced adenoma and cancer samples in an independent cohort of CRC patients. We defined metagenomic functions from Streptococcus sp. VT_162 with discriminative power among cancers vs. matched normal and adenomas vs. healthy subjects’ stools. Streptococcus sp. VT_162 specific 16S rDNA was validated in an independent cohort. These findings might facilitate non-invasive screening for colorectal cancer.
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Staudacher JJ, Yazici C, Bul V, Zeidan J, Khalid A, Xia Y, Krett N, Jung B. Increased Frequency of KRAS Mutations in African Americans Compared with Caucasians in Sporadic Colorectal Cancer. Clin Transl Gastroenterol 2017; 8:e124. [PMID: 29048416 PMCID: PMC5666119 DOI: 10.1038/ctg.2017.48] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/05/2017] [Indexed: 12/15/2022] Open
Abstract
Objectives: The basis for over-representation of colorectal cancer (CRC) in African-American (AA) populations compared with Caucasians are multifactorial and complex. Understanding the mechanisms for this racial disparity is critical for delivery of better care. Several studies have investigated sporadic CRC for differences in somatic mutations between AAs and Caucasians, but owing to small study sizes and conflicting results to date, no definitive conclusions have been reached. Methods: Here, we present the first systematic literature review and meta-analysis investigating the mutational differences in sporadic CRC between AAs and Caucasians focused on frequent driver mutations (APC,TP53, KRAS,PI3CA, FBXW7,SMAD4, and BRAF). Publication inclusion criteria comprised sporadic CRC, human subjects, English language, information on ethnicity (AA, Caucasian, or both), total subject number >20, and information on mutation frequencies. Results: We identified 6,234 publications. Meta-analysis for APC, TP54, FBXW7, or SMAD4 was not possible owing to paucity of data. KRAS mutations were statistically less frequent in non-Hispanic Whites when compared with AAs (odds ratio, 0.640; 95% confidence interval (CI): 0.5342–0.7666; P=0.0001), while the mutational differences observed in BRAF and PI3CA did not reach statistical significance. Conclusions: Here, we report the mutational patterns for KRAS, BRAF, and PI3CA in sporadic CRC of AAs and Caucasians in a systematic meta-analysis of previously published data. We identified an increase in KRAS mutations in sporadic CRC in AAs, which may contribute to worse prognosis and increased mortality of CRC in AAs. Future studies investigating health-care disparities in CRC in AAs should control for KRAS mutational frequency.
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Affiliation(s)
- Jonas J Staudacher
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Cemal Yazici
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Vadim Bul
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Joseph Zeidan
- Transplant Hepatology, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Ahmer Khalid
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yinglin Xia
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nancy Krett
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Barbara Jung
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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17
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Zhang HF, Lu YW, Xie ZR, Wang KH. Relationship Between Human mutL Homolog 1 (hMLH1) Hypermethylation and Colorectal Cancer: A Meta-Analysis. Med Sci Monit 2017. [PMID: 28635682 PMCID: PMC6179171 DOI: 10.12659/msm.895643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Hypermethylation of CpG islands in gene promoter regions is an important mechanism of gene inactivation in cancers. Promoter hypermethylation of human mutL homolog 1 (hMLH1) has been implicated in a subset of colorectal cancers that show microsatellite instability (MSI), while the connection of the epigenetic inactivation of hMLH1 in colorectal cancers remains unknown. The aim of this study was to evaluate the relationship between the promoter hypermethylation of hMLH1 and colorectal cancers by performing a meta-analysis. Material/Methods Eligible studies were identified through searching PubMed, Cochrane Library, Web of Science, and Google Scholar databases. R Software including meta packages was used to calculate the pooled and odds ratios (ORs) with corresponding confidence intervals (CIs). Funnel plots were also performed to evaluate publication bias. Results This meta-analysis obtained 45 articles, including 4096 colorectal cancer patients, and identified a significant association between hMLH1 hypermethylation and colorectal cancer risk using the fixed-effects model (OR=8.3820; 95% CI, 6.9202~10.1527; z=21.7431; P<0.0001) and random effects model pooled (OR=10.0963; 95% CI, 6.1919~16.4626; z=9.2688; P<0.0001). The significant relationship was found in subgroup analyses. Conclusions The results of this meta-analysis show a significant association between hMLH1 hypermethylation and colorectal cancer risk.
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Affiliation(s)
- Hui-Feng Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China (mainland).,Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China (mainland).,The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - You-Wang Lu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
| | - Zhen-Rong Xie
- Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Kun-Hua Wang
- Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
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18
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Nagahashi M, Wakai T, Shimada Y, Ichikawa H, Kameyama H, Kobayashi T, Sakata J, Yagi R, Sato N, Kitagawa Y, Uetake H, Yoshida K, Oki E, Kudo SE, Izutsu H, Kodama K, Nakada M, Tse J, Russell M, Heyer J, Powers W, Sun R, Ring JE, Takabe K, Protopopov A, Ling Y, Okuda S, Lyle S. Genomic landscape of colorectal cancer in Japan: clinical implications of comprehensive genomic sequencing for precision medicine. Genome Med 2016; 8:136. [PMID: 28007036 PMCID: PMC5180401 DOI: 10.1186/s13073-016-0387-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/01/2016] [Indexed: 12/18/2022] Open
Abstract
Background Comprehensive genomic sequencing (CGS) has the potential to revolutionize precision medicine for cancer patients across the globe. However, to date large-scale genomic sequencing of cancer patients has been limited to Western populations. In order to understand possible ethnic and geographic differences and to explore the broader application of CGS to other populations, we sequenced a panel of 415 important cancer genes to characterize clinically actionable genomic driver events in 201 Japanese patients with colorectal cancer (CRC). Methods Using next-generation sequencing methods, we examined all exons of 415 known cancer genes in Japanese CRC patients (n = 201) and evaluated for concordance among independent data obtained from US patients with CRC (n = 108) and from The Cancer Genome Atlas-CRC whole exome sequencing (WES) database (n = 224). Mutation data from non-hypermutated Japanese CRC patients were extracted and clustered by gene mutation patterns. Two different sets of genes from the 415-gene panel were used for clustering: 61 genes with frequent alteration in CRC and 26 genes that are clinically actionable in CRC. Results The 415-gene panel is able to identify all of the critical mutations in tumor samples as well as WES, including identifying hypermutated tumors. Although the overall mutation spectrum of the Japanese patients is similar to that of the Western population, we found significant differences in the frequencies of mutations in ERBB2 and BRAF. We show that the 415-gene panel identifies a number of clinically actionable mutations in KRAS, NRAS, and BRAF that are not detected by hot-spot testing. We also discovered that 26% of cases have mutations in genes involved in DNA double-strand break repair pathway. Unsupervised clustering revealed that a panel of 26 genes can be used to classify the patients into eight different categories, each of which can optimally be treated with a particular combination therapy. Conclusions Use of a panel of 415 genes can reliably identify all of the critical mutations in CRC patients and this information of CGS can be used to determine the most optimal treatment for patients of all ethnicities. Electronic supplementary material The online version of this article (doi:10.1186/s13073-016-0387-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Hitoshi Kameyama
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Ryoma Yagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Nobuaki Sato
- Niigata Cancer Center Hospital, 15-3 Kawagishi-cho 2-Chome, Chuo-ku, Niigata City, Niigata, 951-8566, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Hiroyuki Uetake
- Department of Chemotherapy and Oncosurgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shin-Ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan
| | - Hiroshi Izutsu
- Diagnostics Research Department, Life innovation Research Institute, Denka innovation center, Denka Co., Ltd., 3-5-1 Asahi-Machi, Machida-City, Tokyo, 194-8560, Japan
| | - Keisuke Kodama
- Diagnostics Research Department, Life innovation Research Institute, Denka innovation center, Denka Co., Ltd., 3-5-1 Asahi-Machi, Machida-City, Tokyo, 194-8560, Japan
| | - Mitsutaka Nakada
- Diagnostics Research Department, Life innovation Research Institute, Denka innovation center, Denka Co., Ltd., 3-5-1 Asahi-Machi, Machida-City, Tokyo, 194-8560, Japan
| | - Julie Tse
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA
| | - Meaghan Russell
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA
| | - Joerg Heyer
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA
| | - Winslow Powers
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA
| | - Ruobai Sun
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA
| | - Jennifer E Ring
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA
| | - Kazuaki Takabe
- Breast Surgery, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA.,Department of Surgery, University at Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | | | - Yiwei Ling
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Shujiro Okuda
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Stephen Lyle
- KEW, Inc, 840 Memorial Drive, 4th floor, Cambridge, MA, 02139, USA. .,University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
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19
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Dolatkhah R, Somi MH, Asvadi Kermani I, Bonyadi M, Sepehri B, Boostani K, Azadbakht S, Fotouhi N, Farassati F, Dastgiri S. Association between proto-oncogene mutations and clinicopathologic characteristics and overall survival in colorectal cancer in East Azerbaijan, Iran. Onco Targets Ther 2016; 9:7385-7395. [PMID: 27994469 PMCID: PMC5153263 DOI: 10.2147/ott.s116373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Colorectal cancer (CRC) is the third-most common cancer in Iran. The increasing incidence of CRC in the past three decades has made it a major public health burden in the country. This study aimed to determine any relationship of specific mutations in CRCs with clinicopathologic aspects and outcome of patients. Materials and methods This study was conducted on 100 CRC patients by the case-only method. Polymerase chain-reaction products were analyzed by Sanger sequencing, and sequence results were compared with the significant KRAS and BRAF gene mutations in the My Cancer Genome database. Logistic regression models were used to detect associations of clinicopathologic characteristics with each of the mutations. Kaplan–Meier and Cox regression models were constructed to estimate overall survival in patients. Results A total of 26 subjects (26%) had heterozygote-mutant KRAS, and mutations were not detected in the amplified exon of BRAF in both tumor and normal tissues of the 100 CRCs. Rectal tumors had 1.53-fold higher likelihood of KRAS mutations than colon tumors, and men had 1.37-fold higher odds than women. The presence of metastasis increased the likelihood of KRAS mutations 2.36-fold over those with nonmetastatic CRCs. Compared to patients with KRAS wild-type cancers, those with KRAS mutations had significantly higher mortality (hazard ratio 3.74, 95% confidence interval 1.44–9.68; log-rank P=0.003). Conclusion Better understanding of the causality of CRC can be established by combining epidemiology and research on molecular mechanisms of the disease.
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Affiliation(s)
- Roya Dolatkhah
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Iraj Asvadi Kermani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Bonyadi
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Bita Sepehri
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Boostani
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saleh Azadbakht
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nikou Fotouhi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faris Farassati
- Molecular Medicine Laboratory, University of Kansas Medical School, Kansas City, KS, USA
| | - Saeed Dastgiri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Tabriz Health Services Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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Abstract
Genome-wide studies are increasingly becoming a must, especially for complex diseases such as cancer where multiple genes and diverse molecular mechanisms are known to be involved in genes' function alteration. In this review, we report our latest genomic and epigenomic findings in African-American colorectal cancer patients. This population suffers a higher burden of the disease and most investigators in this field are looking for the underlying genetic and epigenetic targets that might be responsible for this disparity. We here report genome-wide copy number variations, single nucleotide mutations and DNA methylation findings that might be specific to this population.
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Affiliation(s)
- Hassan Brim
- Pathology Department, Howard University College of Medicine, Gastroenterology Division and Cancer Center, Washington DC, USA
| | - Hassan Ashktorab
- Howard University College of Medicine, Department of Medicine and Cancer Center, 2041 Georgia Avenue, Washington, DC, 20060, USA
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21
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Berera S, Koru-Sengul T, Miao F, Carrasquillo O, Nadji M, Zhang Y, Hosein PJ, McCauley JL, Abreu MT, Sussman DA. Colorectal Tumors From Different Racial and Ethnic Minorities Have Similar Rates of Mismatch Repair Deficiency. Clin Gastroenterol Hepatol 2016; 14:1163-71. [PMID: 27046481 DOI: 10.1016/j.cgh.2016.03.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 02/18/2016] [Accepted: 03/13/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Microsatellite instability (MSI) in colorectal cancer cells results from deficient mismatch repair (MMR) protein function, either acquired or from germline alterations such as in patients with Lynch syndrome. Universal screening initiatives for Lynch syndrome have been encouraged. However, little is known about the true prevalence of MMR deficiency and MSI in colorectal tumors among individuals from different racial and ethnic subgroups or their clinical effects in these populations. METHODS We performed a retrospective analysis of 253 surgically resected, primary colorectal adenocarcinoma specimens identified from the University of Miami tumor registry from 2005 through 2010. We collected clinical data, including overall survival (OS), the proportion of patients alive at specific intervals, from non-Hispanic white, Hispanic, and black patients matched by stage. We performed immunohistochemical staining to detect MMR proteins in all specimens and polymerase chain reaction analysis of 51 tumors to detect MSI. RESULTS We detected MMR deficiency in 28 of 253 cases (11.1%), evenly distributed among blacks (9.6%), non-Hispanic whites (10.4%), and Hispanics (12.6%) (P = .79). Combined deficiencies in MLH1 and PMS2 were found in 23 of 28 MMR-deficient samples (82.1%); MSH2 and MSH6 were most frequently absent in tumor samples from Hispanics (P = .03). Eleven of 51 tumor samples (21.6%) had high levels of MSI, and we observed a high level of concordance between MMR and MSI (κ = .81). OS was significantly better in patients whose tumors had deficient MMR (hazard ratio for patients with MMR-deficient tumors vs MMR proteins intact = 0.37; 95% confidence interval, 0.15-0.91; P = .03). Race and ethnicity were not significant predictors of OS. CONCLUSIONS MMR deficiency in colorectal tumors occurs with similar rates among patients of different racial and ethnic groups, which is based on immunohistochemical analysis of 253 primary tumor specimens. This finding indicates the potential value of universal testing of colorectal cancer by immunohistochemistry in minority populations and confirms the benefit of MMR deficiency to OS.
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Affiliation(s)
- Shivali Berera
- Division of Gastroenterology, Department of Internal Medicine, University of Miami Leonard Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Tulay Koru-Sengul
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Feng Miao
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Olveen Carrasquillo
- Division of General Internal Medicine, Department of Internal Medicine, University of Miami Leonard Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Mehrdad Nadji
- Department of Pathology, University of Miami Leonard Miller School of Medicine, Miami, Florida
| | - Yaxia Zhang
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
| | - Peter J Hosein
- Division of Hematology and Oncology, Department of Internal Medicine, University of Kentucky, Lexington, Kentucky/Sylvester Comprehensive Cancer Center, Lexington, Kentucky
| | - Jacob L McCauley
- Center for Genome Technology, John P. Hussman Institute for Human Genomics, University of Miami Leonard Miller School of Medicine, Miami, Florida
| | - Maria T Abreu
- Division of Gastroenterology, Department of Internal Medicine, University of Miami Leonard Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Daniel A Sussman
- Division of Gastroenterology, Department of Internal Medicine, University of Miami Leonard Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida.
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22
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Mojarad EN, Kashfi SMH, Mirtalebi H, Taleghani MY, Azimzadeh P, Savabkar S, Pourhoseingholi MA, Jalaeikhoo H, Asadzadeh Aghdaei H, Kuppen PJK, Zali MR. Low Level of Microsatellite Instability Correlates with Poor Clinical Prognosis in Stage II Colorectal Cancer Patients. JOURNAL OF ONCOLOGY 2016; 2016:2196703. [PMID: 27429617 PMCID: PMC4939356 DOI: 10.1155/2016/2196703] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/19/2016] [Indexed: 01/19/2023]
Abstract
The influence of microsatellite instability (MSI) on the prognosis of colorectal cancer (CRC) requires more investigation. We assessed the role of MSI status in survival of individuals diagnosed with primary colorectal cancer. In this retrospective cross-sectional study the MSI status was determined in 158 formalin-fixed paraffin-embedded tumors and their matched normal tissues from patients who underwent curative surgery. Cox proportional hazard modeling was performed to assess the clinical prognostic significance. In this study we found that MSI-H tumors were predominantly located in the colon versus rectum (p = 0.03), associated with poorer differentiation (p = 0.003) and TNM stage II/III of tumors (p = 0.02). In CRC patients with stage II, MSI-L cases showed significantly poorer survival compared with patients who had MSI-H or MSS tumors (p = 0.04). This study indicates that MSI-L tumors correlate with poorer clinical outcome in patients with stage II tumors (p = 0.04) or in tumors located in the colon (p = 0.02). MSI-L characterizes a distinct subgroup of CRC patients who have a poorer outcome. This study suggests that MSI status in CRC, as a clinical prognostic marker, is dependent on other factors, such as tumor stage and location.
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Affiliation(s)
- Ehsan Nazemalhosseini Mojarad
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Hossein Kashfi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Mirtalebi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Yaghoob Taleghani
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Azimzadeh
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sanaz Savabkar
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hasan Jalaeikhoo
- AJA Cancer Research Center (ACRC), AJA University of Medical Sciences, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peter J. K. Kuppen
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Muliira JK, D'Souza MS, Ahmed SM. Contrasts in Practices and Perceived Barriers to Colorectal Cancer Screening by Nurses and Physicians Working in Primary Care Settings in Oman. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:15-25. [PMID: 25739678 DOI: 10.1007/s13187-015-0806-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) is the fourth most common type of cancer worldwide and it is responsible for 610,000 deaths annually, despite availability of screening tests that ensure early detection. Predictions specific to the Middle East show that this region will experience a significant increase in cancer mortality over the next 15 years. This study explored the practices and perceived barriers to CRC screening from the perspective of health care providers (HCPs) working in primary care settings in Muscat, Oman. A cross-sectional design and self-administered questionnaires were used to collect data from 142 HCPs. The HCPs were nurses (57.7 %) and physicians (42.3 %) with average age and clinical experience of 32.5 and 9.5 years, respectively. The majority of the HCPs (64.8 %) rarely ordered, referred, health educated, or recommended CRC screening to eligible patients. The only major patient-related barrier to CRC screening reported by HCPs was lack of awareness about CRC tests (63.7 %). There were significant differences between nurses' and physicians' rating of patient-related barriers such as fear of cancer diagnosis (p = 0.037), belief that screening is not effective (p = 0.036), embarrassment or anxiety about screening tests (p = 0.022), and culture (p = 0.001). The major system barriers to CRC screening were lack of hospital policy or protocols, lack of trained HCPs, lack of CRC screening services, and timely appointments to get CRC screening. The findings indicate a need for interventions to enhance patient awareness, HCPs CRC screening practices, and strategies to ameliorate patient and system barriers to CRC screening.
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Affiliation(s)
- Joshua Kanaabi Muliira
- College of Nursing, Department of Adult Health and Critical Care, Sultan Qaboos University, P. O. Box 66, 123, Al Khod, Muscat, Oman.
| | - Melba Sheila D'Souza
- College of Nursing, Department of Adult Health and Critical Care, Sultan Qaboos University, P. O. Box 66, 123, Al Khod, Muscat, Oman
| | - Samira Maroof Ahmed
- College of Nursing, Department of Community Health and Psychiatric Mental Health, Sultan Qaboos University, P. O. Box 66, 123, Al Khod, Muscat, Oman
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Molaei M, Kishani Farahani R, Maftouh M, Taleghani MY, Vahdatinia M, Khatami F, Nazemalhosseini- Mojarad E, Asadzadeh Aghdae H, Aboutorabi A, Zali MR. Lack of BRAFV600E mutation in stage I and II of colorectal cancer. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2016; 9:94-9. [PMID: 27099668 PMCID: PMC4833847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM We aimed to explore the frequency of BRAFV600E mutation in Iranian patients with colorectal cancer (CRC) as well as its association with clinic pathological characteristic of patients. BACKGROUND CRC is the third leading cause of cancer related death. There is a growing body of data showing the association of BRAFV600E mutation with malignant transformation and clinical outcome of different tumors, including CRC. These findings suggest that BRAFV600E mutation can be used as diagnostic and/or prognostic biomarker for management of cancer patients. PATIENTS AND METHODS A total of 85 patients with sporadic tumor were recruited. BRAFV600E mutation was investigated using sequencing of extracted DNAs from formalin-fixed paraffin-embedded (FFPE) tumor tissues. Electropherograms were analyzed using Laser-gene 6 software. RESULTS More than 95% of patients were in stage I and II and none of them were in stage IV. Patients were mostly below 55 years old and tumors were dominantly located in the distal colon. Of note, no BRAFV600E mutations were detected in our population. CONCLUSION Our results showed no V600E mutation in the BRAF gene in stage I and II of CRC patients. Further studies in multi-center settings are warranted to examine the prognostic and/or predictive value of this marker in different stages of colorectal cancer patients.
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Affiliation(s)
- Mahsa Molaei
- Gastroenterology and Liver Disease Research center, Research Institute for Gastroenterology and liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Roya Kishani Farahani
- Basic and molecular epidemiology of Gastrointestinal disorders Research center, Research Institute for Gastroenterology and liver disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Maftouh
- Gastroenterology and Liver Disease Research center, Research Institute for Gastroenterology and liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Yaghoob Taleghani
- Basic and molecular epidemiology of Gastrointestinal disorders Research center, Research Institute for Gastroenterology and liver disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Vahdatinia
- Gastroenterology and Liver Disease Research center, Research Institute for Gastroenterology and liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Khatami
- Basic and molecular epidemiology of Gastrointestinal disorders Research center, Research Institute for Gastroenterology and liver disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Nazemalhosseini- Mojarad
- Gastroenterology and Liver Disease Research center, Research Institute for Gastroenterology and liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hamid Asadzadeh Aghdae
- Basic and molecular epidemiology of Gastrointestinal disorders Research center, Research Institute for Gastroenterology and liver disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Aboutorabi
- Student Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Disease Research center, Research Institute for Gastroenterology and liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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25
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Muliira JK, D'Souza MS, Ahmed SM, Al-Dhahli SN, Al-Jahwari FRM. Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians. Asia Pac J Oncol Nurs 2016; 3:98-107. [PMID: 27981145 PMCID: PMC5123546 DOI: 10.4103/2347-5625.177391] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective: Healthcare providers (HCPs) play a critical role in reducing colorectal cancer (CRC) related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening. Methods: A total of 142 HCPs (57.7% nurses and 42.3% physicians) participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13), regularly taking care of adults eligible for CRC screening (62%) and had positive attitudes toward CRC screening (83.1%). Most participants (57%) had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50). The participants were most knowledgeable about the recommended age for initiating screening (62.7%) and the procedures not recommended for screening (90.8%). Results: More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses’ and physicians’ attitudes and knowledge. The participants’ perceptions about professional training (odds ratio [OR] = 2.17, P = 0.003), colonoscopy (OR = 2.60, P = 0.014), and double-contrast barium enema (OR = 0.53, P = 0.041), were significantly associated with knowledge about CRC screening. Conclusions: The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.
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Affiliation(s)
- Joshua Kanaabi Muliira
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Samira Maroof Ahmed
- Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
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26
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Geramizadeh B. Molecular Biomarkers of Colorectal Cancer: A Review of Published Articles From Iran. ACTA ACUST UNITED AC 2015. [DOI: 10.17795/acr-30100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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27
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Yoon HH, Shi Q, Alberts SR, Goldberg RM, Thibodeau SN, Sargent DJ, Sinicrope FA. Racial Differences in BRAF/KRAS Mutation Rates and Survival in Stage III Colon Cancer Patients. J Natl Cancer Inst 2015; 107:djv186. [PMID: 26160882 PMCID: PMC5758035 DOI: 10.1093/jnci/djv186] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 04/28/2015] [Accepted: 06/19/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND It is unknown if, after controlling for clinicopathologic variables and treatment, racial disparities in colon cancer outcomes persist. Molecular marker analysis in North American patients comparing Asians with other races has not been reported. METHODS BRAF (V600E) and KRAS mutations were analyzed in node-positive colon cancer patients (n = 3305) treated with FOLFOX-based chemotherapy in an adjuvant trial (Alliance N0147). Race categories included Asian, black, or white. Cox models were used to estimate disease-free survival (DFS) and time to recurrence (TTR). All statistical tests were two-sided. RESULTS BRAF mutation frequency in tumors from whites (13.9%) was twice that of tumors from Asians or blacks. KRAS mutation rates were highest in tumors from blacks (44.1%). KRAS/BRAF wild-type tumors were most common among Asians (66.7%) (P overall < .001). The prognostic impact of race differed by age and N stage (both P interaction < .02). Compared with whites, blacks had shorter DFS among patients younger than age 50 years (hazard ratio [HR] = 2.84, 95% confidence interval [CI] = 1.73 to 4.66) or with N1 disease (HR = 1.54, 95% CI = 1.04 to 2.29), independent of BRAF, KRAS, and other covariates. Findings were consistent using TTR as the outcome. Asians had longer DFS among N2 tumors that was partly mediated by less frequent BRAF mutation. CONCLUSIONS Colon cancers from Asians have a lower rate of BRAF and KRAS mutations than blacks or whites. We report a novel interaction of race with age and N stage in node-positive disease, indicating that racial disparities in survival persist despite uniform stage and treatment in a phase III trial.
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Affiliation(s)
- Harry H Yoon
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG).
| | - Qian Shi
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG)
| | - Steven R Alberts
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG)
| | - Richard M Goldberg
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG)
| | - Stephen N Thibodeau
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG)
| | - Daniel J Sargent
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG)
| | - Frank A Sinicrope
- Mayo Clinic, Rochester, MN (HHY, SRA, SNT, FAS); Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN (QS, DJS); Division of Medical Oncology, The Ohio State University, Columbus, OH (RMG).
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28
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Aslam MI, Venkatesh J, Jameson JS, West K, Pringle JH, Singh B. Identification of high-risk Dukes B colorectal cancer by microRNA expression profiling: a preliminary study. Colorectal Dis 2015; 17:578-88. [PMID: 25557290 DOI: 10.1111/codi.12886] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/19/2014] [Indexed: 02/08/2023]
Abstract
AIM MicroRNAs (miRNAs) from tumour tissue and common gene mutations were studied to determine whether they predict the development of metastasis in patients with Dukes B colorectal cancer. METHOD Patients who underwent curative resection for Dukes B colorectal cancer who subsequently developed distant metastatic disease at some stage in the following 5 years ('high-risk B') were compared with case-matched controls of Dukes A, Dukes B (no metastases, 'low-risk B') and Dukes C patients without any detectable metastasis at 5 years of follow-up. MiRNAs from tumour and adjacent normal tissue and common gene mutations (KRAS, BRAF, PIK3CA) in primary cancer tissue were analysed to identify prognostic tissue markers for the development of metastasis in patients with Dukes B colorectal cancer. RESULTS Expression of miR-15b and miR-135b was significantly downregulated (P < 0.001) in 'high-risk B' tumours compared with Dukes A, 'low-risk B' and C without metastasis. No significant differences were noted for mutation status and the development of metastasis. CONCLUSION The study suggests that the development of metastasis in Dukes B tumours may be predictable based on the miRNA expression of miR-15b and miR-135b. This requires further study on a much larger cohort.
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Affiliation(s)
- M I Aslam
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK.,Department of Colorectal Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - J Venkatesh
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - J S Jameson
- Department of Colorectal Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - K West
- Department of Histopathology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - J H Pringle
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - B Singh
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK.,Department of Colorectal Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
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29
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Zeinalian M, Hashemzadeh-Chaleshtori M, Salehi R, Kazemi M, Emami MH. Tumor microsatellite instability and clinicopathologic features in Iranian colorectal cancer patients at risk for Lynch syndrome. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2015; 20:154-60. [PMID: 25983768 PMCID: PMC4400710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 11/12/2014] [Accepted: 01/07/2015] [Indexed: 10/25/2022]
Abstract
BACKGROUND Microsatellite instability (MSI) is a mutational signature that is the hallmark of Lynch syndrome, and MSI testing is a cost-effective method to screen the disease. Since there is no enough data about MSI status and associated clinicopathologic features of hereditary nonpolyposis colorectal cancer (HNPCC) in Iran, our study is a new trial to describe them in center of Iran (Isfahan). MATERIALS AND METHODS It is a descriptive retrospective study to screen HNPCC families using Amsterdam II criteria in Central Iran within 2000-2013. For MSI testing, we used a commercially available kit evaluating mononucleotide markers (BAT-25, BAT-26, MON0-27, NR-21 and NR-24). After a fluorescent multiplex polymerase chain reaction amplification of the markers, samples were sequenced to fragment analysis. Data analysis was performed using SPSS 16 software (SPSS Inc., Chicago, IL, USA). RESULTS Overall, 31 of 45 screened HNPCC families were eventually included to MSI testing. Totally, 9/31 patients (29.0%) showed MSI in their tumor tissues. BAT-26 was the most instable marker with instability in 7/24 MSI tumors (29.2%). The mean age at diagnosis in microsatellite stable (MSS), MSI-Low (MSI-L), and MSI-High (MSI-H) probands was respectively 44.7 (standard deviation [SD] = 11.83), 51.7 (SD = 16.17), and 36.0 (SD = 3.41) years. The most common tumor sites in MSS, MSI-L, and MSI-H probands were rectosigmoid (∼72.8%), rectum (66.7%) and right colon (50.0%), respectively. Of 186 cancer patients among 31 HNPCC families, 86 patients (46.2%) had colorectal cancer (CRC) and 100 patients (53.8%) had extracolonic cancers. The average of CRC affected members among MSS, MSI-L, and MSI-H groups of our HNPCC families was 2.2 (SD = 1.30), 3.3 (SD = 3.21), and 4.7 (SD = 2.42) patients per family, respectively. Stomach with 18.3% and 26.7% of all extracolonic cancers were most common involved organ in MSS and MSI-H families, respectively. CONCLUSION Our different molecular results could be suggested to describe HNPCC families based on some new molecular mechanisms leading to MSS HNPCC phenotypes. Meanwhile, more evaluations within our population are recommended.
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Affiliation(s)
- Mehrdad Zeinalian
- Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran,Clinic of Gastrointestinal Diseases, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Rasoul Salehi
- Clinic of Gastrointestinal Diseases, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Kazemi
- Clinic of Gastrointestinal Diseases, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Emami
- Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran,Clinic of Gastrointestinal Diseases, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Mohammad Hassan Emami, Poursina Hakim Research Center, Sheykh Mofid St., Isfahan, Iran. E-mail:
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30
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Dolatkhah R, Somi MH, Bonyadi MJ, Asvadi Kermani I, Farassati F, Dastgiri S. Colorectal cancer in iran: molecular epidemiology and screening strategies. J Cancer Epidemiol 2015; 2015:643020. [PMID: 25685149 PMCID: PMC4312646 DOI: 10.1155/2015/643020] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 12/05/2014] [Accepted: 12/15/2014] [Indexed: 12/22/2022] Open
Abstract
Purpose. The increasing incidence of colorectal cancer (CRC) in the past three decades in Iran has made it a major public health burden. This study aimed to report its epidemiologic features, molecular genetic aspects, survival, heredity, and screening pattern in Iran. Methods. A comprehensive literature review was conducted to identify the relevant published articles. We used medical subject headings, including colorectal cancer, molecular genetics, KRAS and BRAF mutations, screening, survival, epidemiologic study, and Iran. Results. Age standardized incidence rate of Iranian CRCs was 11.6 and 10.5 for men and women, respectively. Overall five-year survival rate was 41%, and the proportion of CRC among the younger age group was higher than that of western countries. Depending on ethnicity, geographical region, dietary, and genetic predisposition, mutation genes were considerably diverse and distinct among CRCs across Iran. The high occurrence of CRC in records of relatives of CRC patients showed that family history of CRC was more common among young CRCs. Conclusion. Appropriate screening strategies for CRC which is amenable to early detection through screening, especially in relatives of CRCs, should be considered as the first step in CRC screening programs.
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Affiliation(s)
- Roya Dolatkhah
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Iraj Asvadi Kermani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faris Farassati
- Department of Medicine, The University of Kansas Medical School, Molecular Medicine Laboratory, KUMC, Kansas City, KS, USA
| | - Saeed Dastgiri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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31
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Ashktorab H, Daremipouran M, Devaney J, Varma S, Rahi H, Lee E, Shokrani B, Schwartz R, Nickerson ML, Brim H. Identification of novel mutations by exome sequencing in African American colorectal cancer patients. Cancer 2014; 121:34-42. [PMID: 25250560 DOI: 10.1002/cncr.28922] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/29/2014] [Accepted: 05/16/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND The purpose of this study was to identify genome-wide single nucleotide variants and mutations in African American patients with colorectal cancer (CRC). There is a need of such studies in African Americans, because they display a higher incidence of aggressive CRC tumors. METHODS We performed whole exome sequencing (WES) on DNA from 12 normal/tumor pairs of African American CRC patient tissues. Data analysis was performed using the software package GATK (Genome Analysis Tool Kit). Normative population databases (eg, 1000 Genomes SNP database, dbSNP, and HapMap) were used for comparison. Variants were annotated using analysis of variance and were validated via Sanger sequencing. RESULTS We identified somatic mutations in genes that are known targets in CRC such as APC, BRAF, KRAS, and PIK3CA. We detected novel alterations in the Wnt pathway gene, APC, within its exon 15, of which mutations are highly associated with CRC. CONCLUSIONS This WES study in African American patients with CRC provides insight into the identification of novel somatic mutations in APC. Our data suggest an association between specific mutations in the Wnt signaling pathway and an increased risk of CRC. The analysis of the pathogenicity of these novel variants may shed light on the aggressive nature of CRC in African Americans.
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Affiliation(s)
- Hassan Ashktorab
- Department of Medicine and Cancer Center, Howard University College of Medicine, Washington, DC
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32
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Kang M, Shen XJ, Kim S, Araujo-Perez F, Galanko JA, Martin CF, Sandler RS, Keku TO. Somatic gene mutations in African Americans may predict worse outcomes in colorectal cancer. Cancer Biomark 2014; 13:359-66. [PMID: 24440976 DOI: 10.3233/cbm-130366] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE African Americans have worse outcomes in colorectal cancer (CRC) than Caucasians. We sought to determine if KRAS, BRAF and PIK3CA mutations might contribute to the racial differences in CRC outcome. METHODS DNA was extracted from tissue microarrays made from CRC samples from 67 African Americans and 237 Caucasians. Mutations in KRAS, BRAF, and PIK3CA were evaluated by PCR sequencing. We also examined microsatellite instability (MSI) status. Associations of mutation status with tumor stage and grade were examined using a logistic regression model. Cox proportional hazards models were used to estimate the all-cause mortality associated with mutational status, race and other clinicopathologic features. RESULTS KRAS mutations were more common in African Americans than among Caucasians (37% vs 21%, p=0.01) and were associated with advanced stage (unadjusted odds ratio (OR)=3.31, 95% confidence interval (CI) 1.03-10.61) and grade (unadjusted OR=5.60, 95% CI 1.01-31.95) among African Americans. Presence of BRAF mutations was also positively associated with advanced tumor stage (adjusted OR=3.99, 95%CI 1.43-11.12) and grade (adjusted OR=3.93, 95%CI 1.05-14.69). PIK3CA mutations showed a trend toward an association with an increased risk of death compared to absence of those mutations (adjusted for age, sex and CRC site HR=1.89, 95% CI 0.98-3.65). Among African Americans, the association was more evident (adjusted for age, sex and CRC site HR=3.92, 95% CI 1.03-14.93) and remained significant after adjustment for MSI-H status and combined education-income level, with HR of 12.22 (95%CI 1.32-121.38). CONCLUSIONS Our results suggest that African Americans may have different frequencies of somatic genetic alterations that may partially explain the worse prognosis among African Americans with CRC compared to whites.
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Affiliation(s)
- Melissa Kang
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | - Xiang J Shen
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | - Sangmi Kim
- Georgia Regents University Cancer Center, Section of Hematology/Oncology, Department of Medicine, Medical College of Georgia, Augusta, GA, USA
| | - Felix Araujo-Perez
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | - Joseph A Galanko
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | - Chris F Martin
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | - Robert S Sandler
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | - Temitope O Keku
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
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Kim B, Park SJ, Cheon JH, Kim TI, Kim WH, Hong SP. Clinical meaning of BRAF mutation in Korean patients with advanced colorectal cancer. World J Gastroenterol 2014; 20:4370-4376. [PMID: 24764675 PMCID: PMC3989973 DOI: 10.3748/wjg.v20.i15.4370] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/04/2013] [Accepted: 01/08/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the clinicopathological features of colorectal cancer (CRC) with a v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) mutation and its molecular interaction with microsatellite instability (MSI) and v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) in patients with advanced CRCs.
METHODS: From October 2009 to December 2011, 141 patients with stage III (n = 51) or IV (n = 90) CRCs who were tested for the BRAF mutation at Severance Hospital were included. Among 141 patients, five were excluded due to follow-up loss. Therefore, 136 patients were included in the study. The clinicopathological data, MSI status, and KRAS/BRAF mutation status were reviewed retrospectively. In addition, to evaluating the value of BRAF mutation status, progression-free survival and overall survival in all patients were collected and compared between the BRAF wild-type group and BRAF mutation group.
RESULTS: Of 136 patients, 80 (58.8%) were male and the mean age was 59 years. BRAF and KRAS mutations were detected in 9.6% and 35.3% of patients, respectively. Only 4.3% of patients had MSI-high tumors and there were no MSI-high in tumors with a BRAF mutation. BRAF mutations tended to be more frequent in stage IV than in stage III (11.76% vs 5.88%, P = 0.370). Patients with a BRAF mutation had a lower incidence of KRAS mutation than those without (7.69% vs 38.21%, P = 0.033). Overall survival was significantly shorter in the BRAF mutation group than in the BRAF wild-type group both by univariate analysis (P = 0.041) and multivariate analysis (HR = 2.195; 95%CI: 1.039-4.640; P = 0.039), while progression-free survival was not different according to BRAF mutation status.
CONCLUSION: CRCs with a BRAF mutation have distinct molecular features and resulted in a poor prognosis in Korean patients with advanced CRC.
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An integrative CGH, MSI and candidate genes methylation analysis of colorectal tumors. PLoS One 2014; 9:e82185. [PMID: 24475022 PMCID: PMC3903472 DOI: 10.1371/journal.pone.0082185] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 10/21/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Different DNA aberrations processes can cause colorectal cancer (CRC). Herein, we conducted a comprehensive molecular characterization of 27 CRCs from Iranian patients. MATERIALS AND METHODS Array CGH was performed. The MSI phenotype and the methylation status of 15 genes was established using MSP. The CGH data was compared to two established lists of 41 and 68 cancer genes, respectively, and to CGH data from African Americans. A maximum parsimony cladogram based on global aberrations was established. RESULTS The number of aberrations seem to depend on the MSI status. MSI-H tumors displayed the lowest number of aberrations. MSP revealed that most markers were methylated, except RNF182 gene. P16 and MLH1 genes were primarily methylated in MSI-H tumors. Seven markers with moderate to high frequency of methylation (SYNE1, MMP2, CD109, EVL, RET, LGR and PTPRD) had very low levels of chromosomal aberrations. All chromosomes were targeted by aberrations with deletions more frequent than amplifications. The most amplified markers were CD248, ERCC6, ERGIC3, GNAS, MMP2, NF1, P2RX7, SFRS6, SLC29A1 and TBX22. Most deletions were noted for ADAM29, CHL1, CSMD3, FBXW7, GALNS, MMP2, NF1, PRKD1, SMAD4 and TP53. Aberrations targeting chromosome X were primarily amplifications in male patients and deletions in female patients. A finding similar to what we reported for African American CRC patients. CONCLUSION This first comprehensive analysis of CRC Iranian tumors reveals a high MSI rate. The MSI tumors displayed the lowest level of chromosomal aberrations but high frequency of methylation. The MSI-L were predominantly targeted with chromosomal instability in a way similar to the MSS tumors. The global chromosomal aberration profiles showed many similarities with other populations but also differences that might allow a better understanding of CRC's clinico-pathological specifics in this population.
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Mokarram P, Rismanchi M, Alizadeh Naeeni M, Mirab Samiee S, Paryan M, Alipour A, Honardar Z, Kavousipour S, Naghibalhossaini F, Mostafavi-Pour Z, Monabati A, Hosseni SV, Shamsdin SA. Microsatellite instability typing in serum and tissue of patients with colorectal cancer: comparing real time PCR with hybridization probe and high-performance liquid chromatography. Mol Biol Rep 2014; 41:2835-44. [DOI: 10.1007/s11033-014-3138-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 01/11/2014] [Indexed: 01/06/2023]
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Brim H, Yooseph S, Zoetendal EG, Lee E, Torralbo M, Laiyemo AO, Shokrani B, Nelson K, Ashktorab H. Microbiome analysis of stool samples from African Americans with colon polyps. PLoS One 2013; 8:e81352. [PMID: 24376500 PMCID: PMC3869648 DOI: 10.1371/journal.pone.0081352] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 10/11/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Colonic polyps are common tumors occurring in ~50% of Western populations with ~10% risk of malignant progression. Dietary agents have been considered the primary environmental exposure to promote colorectal cancer (CRC) development. However, the colonic mucosa is permanently in contact with the microbiota and its metabolic products including toxins that also have the potential to trigger oncogenic transformation. AIM To analyze fecal DNA for microbiota composition and functional potential in African Americans with pre-neoplastic lesions. MATERIALS & METHODS We analyzed the bacterial composition of stool samples from 6 healthy individuals and 6 patients with colon polyps using 16S ribosomal RNA-based phylogenetic microarray; the Human intestinal Tract Chip (HITChip) and 16S rRNA gene barcoded 454 pyrosequencing. The functional potential was determined by sequence-based metagenomics using 454 pyrosequencing. RESULTS Fecal microbiota profiling of samples from the healthy and polyp patients using both a phylogenetic microarraying (HITChip) and barcoded 454 pyrosequencing generated similar results. A distinction between both sets of samples was only obtained when the analysis was performed at the sub-genus level. Most of the species leading to the dissociation were from the Bacteroides group. The metagenomic analysis did not reveal major differences in bacterial gene prevalence/abundances between the two groups even when the analysis and comparisons were restricted to available Bacteroides genomes. CONCLUSION This study reveals that at the pre-neoplastic stages, there is a trend showing microbiota changes between healthy and colon polyp patients at the sub-genus level. These differences were not reflected at the genome/functions levels. Bacteria and associated functions within the Bacteroides group need to be further analyzed and dissected to pinpoint potential actors in the early colon oncogenic transformation in a large sample size.
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Affiliation(s)
- Hassan Brim
- Department of Pathology, Department of Medicine and Cancer Center, Howard University, College of Medicine, Washington, District of Columbia, United States of America
- * E-mail:
| | - Shibu Yooseph
- JCVI, San Diego, California, United States of America
| | - Erwin G. Zoetendal
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Edward Lee
- Department of Pathology, Department of Medicine and Cancer Center, Howard University, College of Medicine, Washington, District of Columbia, United States of America
| | | | - Adeyinka O. Laiyemo
- Department of Pathology, Department of Medicine and Cancer Center, Howard University, College of Medicine, Washington, District of Columbia, United States of America
| | - Babak Shokrani
- Department of Pathology, Department of Medicine and Cancer Center, Howard University, College of Medicine, Washington, District of Columbia, United States of America
| | - Karen Nelson
- JCVI, Rockville, Maryland, United States of America
| | - Hassan Ashktorab
- Department of Pathology, Department of Medicine and Cancer Center, Howard University, College of Medicine, Washington, District of Columbia, United States of America
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Tutticci NJ, Hewett DG, Leggett BA. Prevalence of serrated polyps: implications for significance as colorectal cancer precursors. COLORECTAL CANCER 2013. [DOI: 10.2217/crc.13.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Roland CL, Schwarz RE, Tong L, Ahn C, Balch GC, Yopp AC, Anthony T, Mansour JC. Is timing to delivery of treatment a reliable measure of quality of care for patients with colorectal adenocarcinoma? Surgery 2013; 154:421-8. [PMID: 23972647 DOI: 10.1016/j.surg.2013.04.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/24/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Among patients with colorectal adenocarcinoma, patient race has been associated with differences in colorectal cancer survival. Survival disparities between ethnic groups may be related to treatment delays, treating hospital, or other patient factors. We hypothesized that prolonged interval to delivery of cancer therapy negatively impacts survival. STUDY DESIGN We designed a retrospective cohort study using tumor registry and clinical database information from two academically affiliated hospitals. We examined factors associated with interval to treatment and associations between interval and overall survival. RESULTS Among 592 patients treated by a cohort of physicians, we found no differences in cancer stage related to race or treating hospital. Interval to treatment differed between different hospitals (29 vs. 16 days; P < .0001); yet, there were no differences in overall survival related to treatment interval, treating hospital, race, or insurance status. Tumor grade and tumor stage were associated with decreased overall survival. CONCLUSION Differences exist related to the timing of definitive care for patients in this series; however, these differences do not translate directly into differences in overall survival. We must deliver quality health care in an efficient and timely manner; however, the metric of interval to treatment may not measure reliably the quality of care received.
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Affiliation(s)
- Christina L Roland
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center at Dallas, TX 75390-9155, USA
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Chen CW, Zhu Z, Dong J. Hereditary nonpolyposis colorectal cancer. Shijie Huaren Xiaohua Zazhi 2013; 21:2963-2968. [DOI: 10.11569/wcjd.v21.i28.2963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, is a class of autosomal dominant genetic disease. Main clinical characteristics of HNPCC include early onset age, more common in the right colon, and concomitant with simultaneous or metachronous extracolonic cancers, including endometrial cancer, stomach cancer, and ovarian cancer. However, the prognosis of HNPCC is better than sporadic colorectal cancer. Screening and intervention for HNPCC among high-risk pedigree population can effectively reduce the cancer incidence and mortality. In this article we will review the pathogenesis, epidemiology, diagnosis, screening, prevention and treatment of HNPCC.
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Raskin L, Dakubo JCB, Palaski N, Greenson JK, Gruber SB. Distinct molecular features of colorectal cancer in Ghana. Cancer Epidemiol 2013; 37:556-61. [PMID: 23962701 DOI: 10.1016/j.canep.2013.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/12/2013] [Accepted: 07/15/2013] [Indexed: 01/03/2023]
Abstract
OBJECTIVES While colorectal cancer (CRC) is common, its incidence significantly varies around the globe. The incidence of CRC in West Africa is relatively low, but it has a distinctive clinical pattern and its molecular characteristics have not been studied. This study is one of the first attempts to analyze molecular, genetic, and pathological characteristics of colorectal cancer in Ghana. METHODS DNA was extracted from microdissected tumor and adjacent normal tissue of 90 paraffin blocks of CRC cases (1997-2007) collected at the University of Ghana. Microsatellite instability (MSI) was determined using fragment analysis of ten microsatellite markers. We analyzed expression of mismatch repair (MMR) proteins by immunohistochemistry and sequenced exons 2 and 3 of KRAS and exon 15 of BRAF. RESULTS MSI analysis showed 41% (29/70) MSI-High, 20% (14/70) MSI-Low, and 39% (27/70) microsatellite-stable (MSS) tumors. Sequencing of KRAS exons 2 and 3 identified activating mutations in 32% (24/75) of tumors, and sequencing of BRAF exon 15, the location of the common activating mutation (V600), did not show mutations at codons 599 and 600 in 88 tumors. CONCLUSIONS Our study found a high frequency of MSI-High colorectal tumors (41%) in Ghana. While the frequency of KRAS mutations is comparable with other populations, absence of BRAF mutations is intriguing and would require further analysis of the molecular epidemiology of CRC in West Africa.
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Affiliation(s)
- Leon Raskin
- Division of Epidemiology, Department of Medicine, Vanderbilt University, Nashville, TN, United States.
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Yanus GA, Belyaeva AV, Ivantsov AO, Kuligina ES, Suspitsin EN, Mitiushkina NV, Aleksakhina SN, Iyevleva AG, Zaitseva OA, Yatsuk OS, Gorodnova TV, Strelkova TN, Efremova SA, Lepenchuk AY, Ochir-Garyaev AN, Paneyah MB, Matsko DE, Togo AV, Imyanitov EN. Pattern of clinically relevant mutations in consecutive series of Russian colorectal cancer patients. Med Oncol 2013; 30:686. [PMID: 23943423 DOI: 10.1007/s12032-013-0686-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 07/31/2013] [Indexed: 12/18/2022]
Abstract
One hundred and ninety-five consecutive surgically treated Russian colorectal cancer (CRC) patients were retrospectively analyzed for the presence of mutations in KRAS, NRAS, BRAF and PIK3CA genes as well as for the microsatellite instability status. Comparison between high-resolution melting analysis, co-amplification at lower denaturation temperature PCR, DNA sequencing and allele-specific PCR for the detection of KRAS codon 12/13 mutations revealed that none of these methods alone provided satisfactory results in 100 % of the analyzed cases; this experience supports the use of more than one mutation-detecting technique at least in some circumstances. KRAS codon 12/13 substitutions were detected in 70 (35.9 %) CRC cases. Other mutations in the RAS/RAF genes occurred in 22 (11.3 %) cases and included rare KRAS (n = 6), NRAS (n = 8) and BRAF (n = 8) alterations. 5 BRAF mutations affected codon 600, while the remaining 3 potentially functional substitutions were located in the position 594. Twenty-four (12.3 %) CRC cases carried mutations in the PIK3CA, and 18 of these tumors also contained activating alteration in the RAS/RAF genes (p = 0.007). Only 3 (1.5 %) CRC cases showed high-level microsatellite instability (MSI-H) as determined by a panel of mononucleotide markers. Overall, the distribution of potentially predictive mutations in Russian CRC cases is similar to the one observed in other patient series of European descent. Noticeable occurrence of D594G mutation in BRAF oncogene and low frequency of MSI-H may deserve specific attention.
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Affiliation(s)
- Grigoriy A Yanus
- Laboratory of Molecular Oncology, N.N. Petrov Institute of Oncology, St.-Petersburg, Russia
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Mokarram P, Zamani M, Kavousipour S, Naghibalhossaini F, Irajie C, Moradi Sarabi M, Hosseini SV. Different patterns of DNA methylation of the two distinct O6-methylguanine-DNA methyltransferase (O6-MGMT) promoter regions in colorectal cancer. Mol Biol Rep 2012; 40:3851-7. [PMID: 23271133 DOI: 10.1007/s11033-012-2465-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 12/18/2012] [Indexed: 12/13/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer worldwide. Colorectal cancer incidence differs widely among different geographic regions. In addition to mutational changes, epigenetic mechanisms also play important roles in the pathogenesis of CRCs. O6-methylguanine-DNA methyltransferase (O(6)-MGMT) is a DNA repair protein and in the absence of MGMT activity, G-to-A transition may accumulate in the specific genes such as K-ras and p53. To identify which CpG sites are critical for its downregulation, we analyzed the methylation status of the MGMT gene promoter in two sites in CRC patients. Then we compared the frequency of their methylation changes with the results of our previously reported K-ras gene mutation, APC2 and p16 methylation. MGMT methylation was examined in 92 tumor samples. A methylation specific PCR (MSP) method was performed for two loci of MGMT gene which described as MGMT-A and MGMT-B. The prevalence of MGMT-A, and MGMT-B methylation was 49/91 (53.8%), and 83/92 (90.2%), respectively. We detected high frequency of MGMT-B but not MGMT-A methylation in tumor tissues with APC2 methylation. Our results showed that MGMT-B methylation is significantly associated with K-ras gene mutation rather than MGMT-A (p = 0.04). Simultaneously, an inverse correlation was found between p16 and MGMT-B methylation simultaneously (p = 0.02). Our study indicated that hypermethylation of the specific locus near the MGMT start codon is critical for cancer progression. MGMT-B assessment that is associated with K-ras mutation can have a prognostic value in patients with CRC.
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Affiliation(s)
- P Mokarram
- Department of Biochemistry, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran.
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Genomic aberrations in an African American colorectal cancer cohort reveals a MSI-specific profile and chromosome X amplification in male patients. PLoS One 2012; 7:e40392. [PMID: 22879877 PMCID: PMC3412863 DOI: 10.1371/journal.pone.0040392] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 06/06/2012] [Indexed: 02/06/2023] Open
Abstract
Objective DNA aberrations that cause colorectal cancer (CRC) occur in multiple steps that involve microsatellite instability (MSI) and chromosomal instability (CIN). Herein, we studied CRCs from AA patients for their CIN and MSI status. Experimental Design Array CGH was performed on 30 AA colon tumors. The MSI status was established. The CGH data from AA were compared to published lists of 41 TSG and oncogenes in Caucasians and 68 cancer genes, proposed via systematic sequencing for somatic mutations in colon and breast tumors. The patient-by-patient CGH profiles were organized into a maximum parsimony cladogram to give insights into the tumors' aberrations lineage. Results The CGH analysis revealed that CIN was independent of age, gender, stage or location. However, both the number and nature of aberrations seem to depend on the MSI status. MSI-H tumors clustered together in the cladogram. The chromosomes with the highest rates of CGH aberrations were 3, 5, 7, 8, 20 and X. Chromosome X was primarily amplified in male patients. A comparison with Caucasians revealed an overall similar aberration profile with few exceptions for the following genes; THRB, RAF1, LPL, DCC, XIST, PCNT, STS and genes on the 20q12-q13 cytoband. Among the 68 CAN genes, all showed some level of alteration in our cohort. Conclusion Chromosome X amplification in male patients with CRC merits follow-up. The observed CIN may play a distinctive role in CRC in AAs. The clustering of MSI-H tumors in global CGH data analysis suggests that chromosomal aberrations are not random.
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Gnosa S, Shen YM, Wang CJ, Zhang H, Stratmann J, Arbman G, Sun XF. Expression of AEG-1 mRNA and protein in colorectal cancer patients and colon cancer cell lines. J Transl Med 2012; 10:109. [PMID: 22643064 PMCID: PMC3464714 DOI: 10.1186/1479-5876-10-109] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 05/29/2012] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Astrocyte elevated gene 1 (AEG-1), an important oncogene, has been shown to be overexpressed in several types of cancers. In colorectal cancer (CRC), the protein level of AEG-1 is up-regulated in tumour tissue compared to normal mucosa, showing prognostic significance. Since little is known about the transcriptional level of AEG-1 expression and its biological pathway in CRC the aim of the present study was to examine the relationship of AEG-1 mRNA expression, the protein level and clinicopathological variables as well as its biology pathway in CRC. MATERIAL AND METHODS The mRNA expression of AEG-1 was analysed by qPCR in fresh frozen patient samples including 156 primary tumours, along with the corresponding normal mucosa, and in five colon cancer cell lines, SW480, SW620, KM12C, KM12SM and KM12L4a. AEG-1 protein expression was investigated by immunohistochemistry in paraffin-embedded materials from 74 distant normal mucosa, 107 adjacent mucosa, 158 primary tumour, 35 lymph node metastasis and 9 liver metastasis samples. In addition, the AEG-1 protein expression was elucidated in the cell lines by Western blot. RESULTS The lymph node metastatic cell line SW620 had a significantly higher AEG-1 mRNA (0.27 ± 0.02) expression compared to the primary tumour cell line SW480 (0.17 ± 0.04, p = 0.026). AEG-1 expression at the mRNA level and/or the protein level was significantly up-regulated gradually from normal mucosa to primary CRC, and then to lymph node metastasis and finally to liver metastasis (p < 0.05). There were significant associations of AEG-1 mRNA expression with tumour location (p = 0.047), as well as mRNA and protein expression with the tumour stage (p < 0.03). Furthermore AEG-1 protein expression was positively related to biological variables including NF-κB, p73, Rad50 and apoptosis (p < 0.05). CONCLUSION AEG-1 is up-regulated, at the mRNA and the protein level, during CRC development and aggressiveness, and is related to tumour location and stage. It may play its role in CRC through the NF-κB signaling pathway.
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Affiliation(s)
- Sebastian Gnosa
- Division of Oncology, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
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Neumann J, Horst D, Kriegl L, Maatz S, Engel J, Jung A, Kirchner T. A simple immunohistochemical algorithm predicts the risk of distant metastases in right-sided colon cancer. Histopathology 2012; 60:416-26. [PMID: 22276605 DOI: 10.1111/j.1365-2559.2011.04126.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS A test predicting distant metastases would be valuable for prognostication in colon cancer (CC). In previous studies, CC with microsatellite instability (MSI) showed a reduced risk of distant metastases. High expression of CD133 and β-catenin, both related to cancer stem cell phenotypes, might be predictive markers for metastasis. The aim of this study was to develop a simple and robust test for risk assessment of distant metastases in CC. METHODS AND RESULTS In a case-control study, 57 cases of right-sided CC specimens with synchronous distant metastases were matched with 57 CC without distant metastases. Immunohistochemistry for MLH1, CD133 and nuclear β-catenin was carried out. To define the diagnostic algorithm the tumours were first stratified according to their MLH1 expression. Loss of MLH1 expression was correlated significantly with a very low risk of distant metastases (5.3%; P = 0.00003). In MLH1-positive cases, combined high scores of CD133 and β-catenin were associated with a very high rate of distant metastases (94.4%), whereas the risk was intermediate for carcinomas with either low CD133 and/or low β-catenin expression (P = 0.0007). A validation study using an independent set of 68 right-sided CC specimens showed a clear trend towards risk stratification according to the algorithm; however, sample sizes were small, and associations were not statistically significant. CONCLUSIONS By the use of three markers, this algorithm allowed identification of subgroups of right-sided CC patients with extremely high and extremely low risk of distant metastases.
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Affiliation(s)
- Jens Neumann
- Pathologisches Institut der Ludwig-Maximilians-Universität München, Germany.
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Zhang R, Qin W, Xu GL, Zeng FF, Li CX. A meta-analysis of the prevalence of somatic mutations in the hMLH1 and hMSH2 genes in colorectal cancer. Colorectal Dis 2012; 14:e80-9. [PMID: 21988782 DOI: 10.1111/j.1463-1318.2011.02858.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM The study aimed to understand better the somatic mutations in the human MutL Homolog 1 (hMLH1) and human MutS Homolog 2 (hMSH2) genes in colorectal cancer (CRC) and to investigate the differences derived from ethnicity, family history, detection method and microsatellite instability (MSI). METHOD The terms 'hMSH2' or 'hMLH1' and 'colorectal cancer' 'colorectal carcinoma' or 'colorectal tumour' were searched in the PubMed, Springer, Lippincott, Williams & Wilkins and HighWire Press databases for the publication period December 1993 to September 2010. The Comprehensive Meta Analysis V2 software (Biostat Inc.) was used to explore the prevalence and 95% confidence intervals. RESULTS The prevalence of somatic mutations in the hMLH1 and hMSH2 genes in CRC was 0.15 (95% CI 0.10-0.22) and 0.10 (95% CI 0.07-0.16), respectively. A higher prevalence of somatic mutations in hMSH2 was found in hereditary non-polyposis CRC than in sporadic CRC: 0.36 (95% CI 0.14-0.67) and 0.10 (95% CI 0.07-0.13) respectively. In addition, a higher prevalence of somatic mutations in the hMLH1 gene was observed relative to hMSH2 in the European group. The prevalence was higher in the high-level instability (MSI-H) group than in both the low-level instability (MSI-L) and the microsatellite stable (MSS) groups. CONCLUSION Somatic mutations in the hMLH1 and hMSH2 genes play a vital role in CRC and a high prevalence was found in this meta-analysis. Furthermore, more studies are needed which focus on somatic mutations in the American population and in patients with MSI-L and MSS.
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Affiliation(s)
- R Zhang
- State Key Laboratory of Oncology in South China, Cancer Centre, Guangzhou, China
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Abstract
Cancer disparities in incidence and death rates exist among various racial and ethnic groups. These disparities are thought to be due to socioeconomic status, culture, diet, stress, the environment, and biology. Biological functions, such as epigenetic processes, are affected by all these causal factors and extend throughout the life course. Epigenetic processes, in particular DNA methylation, may play a role in the induction of phenotypes with increased cancer risk due to exposure to these multiple factors. DNA methylation is known to cause changes in gene expression of key regulatory genes in cancer. There are limited studies in which epigenetic changes have been explored to address cancer disparities in various racial and ethnic populations. These few studies have reported significant epigenetic differences in various racial and ethnic groups that could account for the differences seen in tumor initiation, progression, aggressiveness, and outcome of these cancers. Genes differentially methylated among these racially and ethnically diverse populations were involved in important cellular functions, such as tumor growth, tumor suppression, hormone receptors, and genes involved in tumor metastasis. Epigenetic research with the advancement in technology has helped identify biomarkers, therapeutic targets, and understand cancer causation in the general population. Unfortunately, these advances in technology have not been applied to explore the basis for cancer health disparities. More research in epigenetics is needed that will enhance our understanding of the determinants of cancer across various diverse populations and ultimately reduce cancer health disparities.
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Affiliation(s)
- Sulma I Mohammed
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA
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Sylvester BE, Huo D, Khramtsov A, Zhang J, Smalling RV, Olugbile S, Polite BN, Olopade OI. Molecular analysis of colorectal tumors within a diverse patient cohort at a single institution. Clin Cancer Res 2011; 18:350-9. [PMID: 22114137 DOI: 10.1158/1078-0432.ccr-11-1397] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE African American colorectal cancer patients have worse survival outcomes than Caucasian patients. To determine whether differences exist in the molecular mechanisms driving colorectal cancer between African Americans and Caucasians, we characterized patient tumors from a single institution by assessing genetic alterations involved in colorectal cancer progression and response to treatment. EXPERIMENTAL DESIGN We retrospectively examined 448 African Americans and Caucasians diagnosed with colorectal cancer at The University of Chicago Medical Center between 1992 and 2002. Microsatellite instability (MSI) status was determined by genotyping the BAT25, BAT26, BAT40, D5S346, and BAX loci. Mutations in KRAS codons 12 and 13 and BRAF codon 600 were identified by direct sequencing. MSI and detected mutations were correlated with clinicopathologic features. RESULTS Overall, no difference existed in MSI or BRAF mutation frequencies between African Americans and Caucasians. However, African Americans with microsatellite stable (MSS)/MSI-low (MSI-L) tumors had a higher proportion of KRAS mutations than Caucasians (34% vs. 23%, P = 0.048) that was isolated to proximal colon cancers and primarily driven by mutations in codon 13. There was no racial difference in receipt of chemotherapy, but African Americans with MSS/MSI-L tumors had a 73% increased risk of death over Caucasians that could not be explained by known prognostic factors. CONCLUSIONS The significantly higher risk of death among African Americans with MSS/MSI-L tumors may be related to differences in the distribution of factors influencing response to standard therapies. These data underscore the need for further research into the molecular mechanisms driving colorectal cancer progression in underserved and understudied populations.
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Affiliation(s)
- Brooke E Sylvester
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
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Wang Z, Yuan X, Jiao N, Zhu H, Zhang Y, Tong J. CDH13 and FLBN3 gene methylation are associated with poor prognosis in colorectal cancer. Pathol Oncol Res 2011; 18:263-70. [PMID: 21796503 DOI: 10.1007/s12253-011-9437-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/07/2011] [Indexed: 12/17/2022]
Abstract
The aim of this study was to identify potential epigenetic prognostic biomarkers for colorectal cancer (CRC) in the Chinese population. The methylation status of five tumor suppressor genes (CDH13, DLEC1, FBLN3, hMHL1 and RUNX3) was determined using manual microdissection followed by methylation-specific PCR in 85 paired CRC specimens and adjacent normal tissue. The results showed that methylation frequencies in cancerous tissues were 31.8% for CDH13, 37.6% for DLEC1, 38.8% for FBLN3, 22.4% for hMHL1 and 27.1% for RUNX3, all of which were significantly higher than in corresponding normal tissue. Furthermore, CDH13 methylation was associated with poor differentiation (P = 0.019) and tended to be predominant in advanced stages (P = 0.084); FBLN3 methylation was associated with advanced stages (P = 0.027) and lymph node metastasis (P = 0.029). Accordingly, the methylation status of CDH13 (P = 0.022), FBLN3 (P = 0.008), CDH13 and/or FBLN3 (P = 0.001) predicted adverse overall survival in CRC, while hMHL1 methylation showed a protective role in survival (P = 0.046). Cox proportional hazard models further indicated that CDH13 and/or FBLN3 methylation, but not that of hMHL1, was an independent prognostic factor for CRC. In conclusion, we found CDH13 and FBLN3 gene methylation are potential biomarkers for poor prognosis in CRC.
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Affiliation(s)
- Zhu Wang
- Department of Oncology, Yangzhou No.1 People's Hospital, The second Clinical School of Yangzhou University, Number 368, Mid Hanjiang Road, Yangzhou, 225009, China.
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Brim H, Kumar K, Nazarian J, Hathout Y, Jafarian A, Lee E, Green W, Smoot D, Park J, Nouraie M, Ashktorab H. SLC5A8 gene, a transporter of butyrate: a gut flora metabolite, is frequently methylated in African American colon adenomas. PLoS One 2011; 6:e20216. [PMID: 21687703 PMCID: PMC3110579 DOI: 10.1371/journal.pone.0020216] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 04/15/2011] [Indexed: 02/06/2023] Open
Abstract
Background Colon cancer is one of the leading causes of cancer related deaths. Its impact on African Americans (AAs) is higher than in the general population both in the incidence and mortality from the disease. Colon cancer aggressiveness in AAs as well as non-frequent check-ups and follow up in this population have been proposed as ways to explain the observed discrepancies. These facts made the detection of early carcinogenesis markers in this population a priority. Materials and Methods Here, we analyzed 50 colon adenomas from AA patients for both microsatellite instability (MSI) and the methylation status of SLC5A8 gene. This gene's product is involved in the transport of butyrate that has anti-proliferative properties through its effects on histone acetylation and gene expression. A proteomic analysis to check the expressed histones in adenoma and normal tissues was also performed. Results The analyzed samples displayed 82% (n = 41) methylation level of SLC5A8 gene in adenomas. The MSI-H (high) adenoma were about 18% (n = 9) while the rest were mostly MSS (microsatellite stable) with few MSI-L (Low). No association was found between SLC5A8 methylation and the MSI status. Also, there was no association between SLC5A8 methylation and the sex and age of the patients. However, there were more right sided adenomas with SLC5A8 methylation than the left sided ones. The proteomic analysis revealed distinct histone expression profiles between normal and adenoma tissues. Conclusion SLC5A8 is highly methylated in AA colon adenomas which points to its potential use as a marker for early detection. The MSI rate is similar to that found in colon cancer tumors in AAs. These findings suggest that both processes stem from the same epigenetic and genetic events occurring at an early stage in colon carcinogenesis in AAs.
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Affiliation(s)
- Hassan Brim
- Department of Medicine and Cancer Center, Howard University, College of Medicine, Washington, DC, United States of America.
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