Clinicopathological and molecular profiles of sporadic microsatellite unstable colorectal cancer with or without the cpg island methylator phenotype (Cimp)

Shih Ching Chang, Anna Fen Yau Li, Pei Ching Lin, Chun Chi Lin, Hung Hsin Lin, Shen Chieh Huang, Chien Hsing Lin, Wen Yi Liang, Wei Shone Chen, Jeng Kai Jiang, Jen Kou Lin, Shung Haur Yang, Yuan Tzu Lan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: The 5'-C-phosphate-G-3' island methylator phenotype (CIMP) is a specific phenotype of colorectal cancer (CRC) associated with microsatellite instability-high (MSI-high) tumors. Methods: In this study, we determined the CIMP status using eight methylation markers in 92 MSI-high CRC patients after excluding five germline mismatch repair (MMR) gene mutations analyzed by next-generation sequencing (NGS) and confirmed by Sanger sequencing. The mutation spectra of 22 common CRC-associated genes were analyzed by NGS. Results: Of the 92 sporadic MSI-high tumors, 23 (25%) were considered CIMP-high (expressed more than 5 of 8 markers). CIMP-high tumors showed proximal colon preponderance and female predominance. The mutation profiles of CIMP-high tumors were significantly different from those of CIMP-low or CIMP-0 tumors (i.e., higher frequencies of BRAF, POLD1, MSH3, and SMAD4 mutations but lower frequencies of APC, TP53, and KRAS mutations). Multivariate analysis demonstrated that tumor, node, metastasis (TNM) stage was the independent prognostic factor affecting overall survival (OS). Among the MSI-high cases, the CIMP status did not impact the outcome of patients with MSI-high tumors. Conclusions: Only TNM stage was a statistically significant predictor of outcomes independent of CIMP profiles in MSI-high CRC patients. Sporadic MSI-high CRCs with different mechanisms of carcinogenesis have specific mutation profiles and clinicopathological features.

Original languageEnglish
Article number3487
Pages (from-to)1-16
Number of pages16
JournalCancers
Volume12
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Colorectal cancer
  • CpG island methylator phenotype
  • Microsatellite instability
  • Mutation

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