BMC Cancer | |
Prognostic impact of MGMT promoter methylation and MGMT and CD133 expression in colorectal adenocarcinoma | |
Jaime Antonio Oliver3  Raúl Ortiz2  Consolación Melguizo4  Pablo Juan Álvarez2  Jaime Gómez-Millán1  Jose Prados4  | |
[1] Radiation Oncology Department, Hospital Clinico Universitario Virgen de la Victoria, Málaga 29010, Spain | |
[2] Biosanitary Institute of Granada (ibs.GRANADA), SAS-Universidad de Granada, Granada, Spain | |
[3] Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Granada 18100, Spain | |
[4] Department of Anatomy and Embryology, University of Granada, Granada 18012, Spain | |
关键词: Disease free-survival; Overall survival; Biomarker; Methylation status; CD133; MGMT; Colorectal cancer; | |
Others : 856545 DOI : 10.1186/1471-2407-14-511 |
|
received in 2014-05-08, accepted in 2014-07-07, 发布年份 2014 | |
【 摘 要 】
Background
New biomarkers are needed for the prognosis of advanced colorectal cancer, which remains incurable by conventional treatments. O6-methylguanine DNA methyltransferase (MGMT) methylation and protein expression have been related to colorectal cancer treatment failure and tumor progression. Moreover, the presence in these tumors of cancer stem cells, which are characterized by CD133 expression, has been associated with chemoresistance, radioresistance, metastasis, and local recurrence. The objective of this study was to determine the prognostic value of CD133 and MGMT and their possible interaction in colorectal cancer patients.
Methods
MGMT and CD133 expression was analyzed by immunohistochemistry in 123 paraffin-embedded colorectal adenocarcinoma samples, obtaining the percentage staining and intensity. MGMT promoter methylation status was obtained by using bisulfite modification and methylation-specific PCR (MSP). These values were correlated with clinical data, including overall survival (OS), disease-free survival (DFS), tumor stage, and differentiation grade.
Results
Low MGMT expression intensity was significantly correlated with shorter OS and was a prognostic factor independently of treatment and histopathological variables. High percentage of CD133 expression was significantly correlated with shorter DFS but was not an independent factor. Patients with low-intensity MGMT expression and ≥50% CD133 expression had the poorest DFS and OS outcomes.
Conclusions
Our results support the hypothesis that MGMT expression may be an OS biomarker as useful as tumor stage or differentiation grade and that CD133 expression may be a predictive biomarker of DFS. Thus, MGMT and CD133 may both be useful for determining the prognosis of colorectal cancer patients and to identify those requiring more aggressive adjuvant therapies. Future studies will be necessary to determine its clinical utility.
【 授权许可】
2014 Oliver et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140723030723246.pdf | 2507KB | download | |
248KB | Image | download | |
90KB | Image | download | |
222KB | Image | download | |
100KB | Image | download |
【 图 表 】
【 参考文献 】
- [1]Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F: GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC cancer base no. 11. http://globocan.iarc.fr/Default.aspx
- [2]Van Cutsem E, Köhne CH, Hitre E, Zaluski J, Chang Chien CR, Makhson A, D’Haens G, Pintér T, Lim R, Bodoky G, Roh JK, Folprecht G, Ruff P, Stroh C, Tejpar S, Schlichting M, Nippgen J, Rougier P: Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 2009, 360:1408-1417.
- [3]Labianca R, Merelli B: Screening and diagnosis for colorectal cancer: present and future. Tumori 2010, 96:889-901.
- [4]American Cancer Society: Cancer facts and figures 2013. Atlanta, Ga: American Cancer Society; 2013.
- [5]Peng Y, Wang L, Gu J: Elevated preoperative carcinoembryonic antigen (CEA) and Ki67 is predictor of decreased survival in IIA stage colon cancer. World J Surg 2013, 37:208-213.
- [6]McKeown E, Nelson DW, Johnson EK, Maykel JA, Stojadinovic A, Nissan A, Avital I, Brücher BL, Steele SR: Current approaches and challenges for monitoring treatment response in colon and rectal cancer. J Cancer 2014, 5:31-43.
- [7]Duffy MJ, van Dalen A, Haglund C, Hansson L, Klapdor R, Lamerz R, Nilsson O, Sturgeon C, Topolcan O: Clinical utility of biochemical markers in colorectal cancer: European group on tumour markers (EGTM) guidelines. Eur J Cancer 2003, 39:718-727.
- [8]Pegg AE, Dolan ME, Moschel RC: Structure, function, and inhibition of O6-alkylguanine-DNA alkyltransferase. Prog Nucleic Acid Res Mol Biol 1995, 51:167-223.
- [9]Jacinto FV, Esteller M: MGMT hypermethylation: a prognostic foe, a predictive friend. DNA Repair (Amst) 2007, 6:1155-1160.
- [10]Esteller M, Risques RA, Toyota M, Capella G, Moreno V, Peinado MA, Baylin SB, Herman JG: Promoter hypermethylation of the DNA repair gene O6-methylguanine-DNA methyltransferase is associated with the presence of G: C to A:T transition mutations in p53 in human colorectal tumorigenesis. Cancer Res 2001, 61:4689-4692.
- [11]Shima K, Morikawa T, Baba Y, Nosho K, Suzuki M, Yamauchi M, Hayashi M, Giovannucci E, Fuchs CS, Ogino S: MGMT promoter methylation, loss of expression and prognosis in 855 colorectal cancers. Cancer Causes Control 2011, 22:301-309.
- [12]Esteller M, Toyota M, Sanchez-Cespedes M, Capella G, Peinado MA, Watkins DN, Issa JP, Sidransky D, Baylin SB, Herman JG: Inactivation of the DNA repair gene O6-methylguanine-DNA methyltransferase by promoter hypermethylation is associated with G to A mutations in K-ras in colorectal tumorigenesis. Cancer Res 2000, 60:2368-2371.
- [13]Qi J, Zhu YQ, Huang MF, Yang D: Hypermethylation of CpG island in O6-methylguanine-DNA methyltransferase gene was associated with K-ras G to A mutation in colorectal tumor. World J Gastroenterol 2005, 11:2022-2025.
- [14]Rosty C, Young JP, Walsh MD, Clendenning M, Sanderson K, Walters RJ, Parry S, Jenkins MA, Win AK, Southey MC, Giles GG, Williamson EJ, English DR, Buchanan DD: PIK3CA activating mutation in colorectal carcinoma: associations with molecular features and survival. PLoS One 2013, 8:e65479.
- [15]Suehiro Y, Wong CW, Chirieac LR, Kondo Y, Shen L, Webb CR, Chan YW, Chan AS, Chan TL, Wu TT, Rashid A, Hamanaka Y, Hinoda Y, Shannon RL, Wang X, Morris J, Issa JP, Yuen ST, Leung SY, Hamilton SR: Epigenetic-genetic interactions in the APC/WNT, RAS/RAF, and P53 pathways in colorectal carcinoma. Clin Cancer Res 2008, 14:2560-2569.
- [16]Ren F, Sheng WQ, Du X: CD133: a cancer stem cells marker, is used in colorectal cancers. World J Gastroenterol 2013, 19:2603-2611.
- [17]Maenhaut C, Dumont JE, Roger PP, van Staveren WC: Cancer stem cells: a reality, a myth, a fuzzy concept or a misnomer? an analysis. Carcinogenesis 2010, 31:149-158.
- [18]Puglisi MA, Tesori V, Lattanzi W, Gasbarrini GB, Gasbarrini A: Colon cancer stem cells: controversies and perspectives. World J Gastroenterol 2013, 19:2997-3006.
- [19]Irollo E, Pirozzi G: CD133: to be or not to be, is this the real question? Am J Transl Res 2013, 5:563-581.
- [20]Pantic I: Cancer stem cell hypotheses: impact on modern molecular physiology and pharmacology research. J Biosci 2011, 36:957-961.
- [21]Peitzsch C, Kurth I, Kunz-Schughart L, Baumann M, Dubrovska A: Discovery of the cancer stem cell related determinants of radioresistance. Radiother Oncol 2013, 108:378-387.
- [22]Pilati P, Mocellin S, Bertazza L, Galdi F, Briarava M, Mammano E, Tessari E, Zavagno G, Nitti D: Prognostic value of putative circulating cancer stem cells in patients undergoing hepatic resection for colorectal liver metastasis. Ann Surg Oncol 2012, 19:402-408.
- [23]Chen KL, Pan F, Jiang H, Chen JF, Pei L, Xie FW, Liang HJ: Highly enriched CD133(+)CD44(+) stem-like cells with CD133(+)CD44(high) metastatic subset in HCT116 colon cancer cells. Clin Exp Metastasis 2011, 28:751-763.
- [24]Liu G, Yuan X, Zeng Z, Tunici P, Ng H, Abdulkadir IR, Lu L, Irvin D, Black KL, Yu JS: Analysis of gene expression and chemoresistance of CD133+ cancer stem cells in glioblastoma. Mol Cancer 2006, 5:67.
- [25]He J, Shan Z, Li L, Liu F, Liu Z, Song M, Zhu H: Expression of glioma stem cell marker CD133 and O6-methylguanine-DNA methyltransferase is associated with resistance to radiotherapy in gliomas. Oncol Rep 2011, 26:1305-1313.
- [26]Metellus P, Nanni-Metellus I, Delfino C, Colin C, Tchogandjian A, Coulibaly B, Fina F, Loundou A, Barrie M, Chinot O, Ouafik L, Figarella-Branger D: Prognostic impact of CD133 mRNA expression in 48 glioblastoma patients treated with concomitant radiochemotherapy: a prospective patient cohort at a single institution. Ann Surg Oncol 2011, 18:2937-2945.
- [27]Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A: Cancer staging handbook. 7th edition. New York: USA: Springer Publishing Company 2010; 2010.
- [28]Melguizo C, Prados J, González B, Ortiz R, Concha A, Alvarez PJ, Madeddu R, Perazzoli G, Oliver JA, López R, Rodríguez-Serrano F, Aránega A: MGMT promoter methylation status and MGMT and CD133 immunohistochemical expression as prognostic markers in glioblastoma patients treated with temozolomide plus radiotherapy. J Transl Med. 2012, 10:250.
- [29]Horst D, Kriegl L, Engel J, Kirchner T, Jung A: CD133 expression is an independent prognostic marker for low survival in colorectal cancer. Br J Cancer 2008, 99:1285-1289.
- [30]Cordeiro AT, Silva CM, Bartchewsky Júnior W, Ribeiro ML, Martinez CA: Evaluation of the expression of the MGMT gene in normal and neoplastic tissue of patients with colorectal cancer. Rev Col Bras Cir 2012, 39:48-53.
- [31]Lee KH, Lee JS, Nam JH, Choi C, Lee MC, Park CS, Juhng SW, Lee JH: Promoter methylation status of hMLH1, hMSH2, and MGMT genes in colorectal cancer associated with adenoma-carcinoma sequence. Langenbecks Arch Surg 2011, 396:1017-1026.
- [32]Psofaki V, Kalogera C, Tzambouras N, Stephanou D, Tsianos E, Seferiadis K, Kolios G: Promoter methylation status of hMLH1, MGMT, and CDKN2A/p16 in colorectal adenomas. World J Gastroenterol 2010, 16:3553-3560.
- [33]Sinha R, Hussain S, Mehrotra R, Kumar RS, Kumar K, Pande P, Doval DC, Basir SF, Bharadwaj M: Kras gene mutation and RASSF1A, FHIT and MGMT gene promoter hypermethylation: indicators of tumor staging and metastasis in adenocarcinomatous sporadic colorectal cancer in Indian population. PLoS One 2013, 8:e60142.
- [34]Farzanehfar M, Vossoughinia H, Jabini R, Tavassoli A, Saadatnia H, Khorashad AK, Ahadi M, Afzalaghaee M, Ghayoor Karimiani E, Mirzaei F, Ayatollahi H: Evaluation of methylation of MGMT (O6-methylguanine-DNA methyltransferase) gene promoter in sporadic colorectal cancer. DNA Cell Biol 2013, 32:371-377.
- [35]Ahlquist T, Lind GE, Costa VL, Meling GI, Vatn M, Hoff GS, Rognum TO, Skotheim RI, Thiis-Evensen E, Lothe RA: Gene methylation profiles of normal mucosa, and benign and malignant colorectal tumors identify early onset markers. Mol Cancer 2008, 7:94.
- [36]Kang YP, Cao FA, Chang WJ, Lou Z, Wang H, Wu LL, Fu CG, Cao GW: Gene methylation in stool for the screening of colorectal cancer and pre-malignant lesions. Zhonghua Wei Chang Wai Ke Za Zhi 2011, 14:52-56.
- [37]Nagasaka T, Sharp GB, Notohara K, Kambara T, Sasamoto H, Isozaki H, MacPhee DG, Jass JR, Tanaka N, Matsubara N: Hypermethylation of O6-methylguanine-DNA methyltransferase promoter may predict nonrecurrence after chemotherapy in colorectal cancer cases. Clin Cancer Res 2003, 9:5306-5312.
- [38]Nilsson TK, Löf-Öhlin ZM, Sun XF: DNA methylation of the p14ARF, RASSF1A and APC1A genes as an independent prognostic factor in colorectal cancer patients. Int J Oncol 2013, 42:127-133.
- [39]Murakami J, Lee YJ, Kokeguchi S, Tsujigiwa H, Asaumi J, Nagatsuka H, Fukui K, Kuroda M, Tanaka N, Matsubara N: Depletion of O6-methylguanine-DNA methyltransferase by O6-benzylguanine enhances 5-FU cytotoxicity in colon and oral cancer cell lines. Oncol Rep 2007, 17:1461-1417.
- [40]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 2013, 40:3851-3857.
- [41]Ishiguro K, Shyam K, Penketh PG, Baumann RP, Sartorelli AC, Rutherford TJ, Ratner ES: Expression of O6-methylguanine-DNA methyltransferase examined by alkyl-transfer assays, methylation-specific PCR and western blots in tumors and matched normal tissue. J Cancer Ther 2013, 4:919-931.
- [42]Ogino S, Hazra A, Tranah GJ, Kirkner GJ, Kawasaki T, Nosho K, Ohnishi M, Suemoto Y, Meyerhardt JA, Hunter DJ, Fuchs CS: MGMT germline polymorphism is associated with somatic MGMT promoter methylation and gene silencing in colorectal cancer. Carcinogenesis 2007, 28:1985-1990.
- [43]Hawkins NJ, Lee JH, Wong JJ, Kwok CT, Ward RL, Hitchins MP: MGMT methylation is associated primarily with the germline C > T SNP (rs16906252) in colorectal cancer and normal colonic mucosa. Mod Pathol 2009, 22:1588-1599.
- [44]Park JH, Kim NS, Park JY, Chae YS, Kim JG, Sohn SK, Moon JH, Kang BW, Ryoo HM, Bae SH, Choi GS, Jun SH: MGMT -535G > T polymorphism is associated with prognosis for patients with metastatic colorectal cancer treated with oxaliplatin-based chemotherapy. J Cancer Res Clin Oncol 2010, 136:1135-1142.
- [45]Schneider M, Huber J, Hadaschik B, Siegers GM, Fiebig HH, Schüler J: Characterization of colon cancer cells: a functional approach characterizing CD133 as a potential stem cell marker. BMC Cancer 2012, 12:96.
- [46]Yang ZL, Zheng Q, Yan J, Pan Y, Wang ZG: Upregulated CD133 expression in tumorigenesis of colon cancer cells. World J Gastroenterol 2011, 17:932-937.
- [47]Shmelkov SV, Butler JM, Hooper AT, Hormigo A, Kushner J, Milde T, St Clair R, Baljevic M, White I, Jin DK, Chadburn A, Murphy AJ, Valenzuela DM, Gale NW, Thurston G, Yancopoulos GD, D’Angelica M, Kemeny N, Lyden D, Rafii S: CD133 expression is not restricted to stem cells, and both CD133+ and CD133- metastatic colon cancer cells initiate tumors. J Clin Invest 2008, 118:2111-2120.
- [48]Handra-Luca A, Taconet S: CD133 expression in colorectal adenomas. J Clin Pathol 2013, 66:1097-1098.
- [49]Coco C, Zannoni GF, Caredda E, Sioletic S, Boninsegna A, Migaldi M, Rizzo G, Bonetti LR, Genovese G, Stigliano E, Cittadini A, Sgambato A: Increased expression of CD133 and reduced dystroglycan expression are strong predictors of poor outcome in colon cancer patients. J Exp Clin Cancer Res 2012, 31:71.
- [50]Reggiani Bonetti L, Migaldi M, Caredda E, Boninsegna A, Ponz De Leon M, Di Gregorio C, Barresi V, Scannone D, Danese S, Cittadini A, Sgambato A: Increased expression of CD133 is a strong predictor of poor outcome in stage I colorectal cancer patients. Scand J Gastroenterol 2012, 47:1211-1217.
- [51]Jao SW, Chen SF, Lin YS, Chang YC, Lee TY, Wu CC, Jin JS, Nieh S: Cytoplasmic CD133 expression is a reliable prognostic indicator of tumor regression after neoadjuvant concurrent chemoradiotherapy in patients with rectal cancer. Ann Surg Oncol 2012, 19:3432-3440.
- [52]Choi D, Lee HW, Hur KY, Kim JJ, Park GS, Jang SH, Song YS, Jang KS, Paik SS: Cancer stem cell markers CD133 and CD24 correlate with invasiveness and differentiation in colorectal adenocarcinoma. World J Gastroenterol 2009, 15:2258-2264.
- [53]Kojima M, Ishii G, Atsumi N, Fujii S, Saito N, Ochiai A: Immunohistochemical detection of CD133 expression in colorectal cancer: a clinicopathological study. Cancer Sci 2008, 99:1578-1583.
- [54]Xi HQ, Zhao P: Clinicopathological significance and prognostic value of EphA3 and CD133 expression in colorectal carcinoma. J Clin Pathol 2011, 64:498-503.
- [55]Saigusa S, Tanaka K, Toiyama Y, Yokoe T, Okugawa Y, Ioue Y, Miki C, Kusunoki M: Correlation of CD133, OCT4, and SOX2 in rectal cancer and their association with distant recurrence after chemoradiotherapy. Ann SurgOncol 2009, 16:3488-98.
- [56]Kawamoto A, Tanaka K, Saigusa S, Toiyama Y, Morimoto Y, Fujikawa H, Iwata T, Matsushita K, Yokoe T, Yasuda H, Inoue Y, Miki C, Kusunoki M: Clinical significance of radiation-induced CD133 expression in residual rectal cancer cells after chemoradiotherapy. Exp Ther Med 2012, 3:403-409.
- [57]Yasuda H, Tanaka K, Saigusa S, Toiyama Y, Koike Y, Okugawa Y, Yokoe T, Kawamoto A, Inoue Y, Miki C, Kusunoki M: Elevated CD133, but not VEGF or EGFR, as a predictive marker of distant recurrence after preoperative chemoradiotherapy in rectal cancer. Oncol Rep 2009, 22:709-17.
- [58]Hermansen SK, Christensen KG, Jensen SS, Kristensen BW: Inconsistent immunohistochemical expression patterns of four different CD133 antibody clones in glioblastoma. J Histochem Cytochem. 2011, 59:391-407.
- [59]Li CY, Li BX, Liang Y, Peng RQ, Ding Y, Xu DZ, Zhang X, Pan ZZ, Wan DS, Zeng YX, Zhu XF, Zhang XS: Higher percentage of CD133+ cells is associated with poor prognosis in colon carcinoma patients with stage IIIB. J Transl Med 2009, 7:56.