Colorectal Cancer
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 28, 2007; 13(8): 1187-1194
Published online Feb 28, 2007. doi: 10.3748/wjg.v13.i8.1187
Comethylation of p16 and MGMT genes in colorectal carcinoma: Correlation with clinicopathological features and prognostic value
Koviljka Krtolica, Milena Krajnovic, Slavica Usaj-Knezevic, Dragan Babic, Dusan Jovanovic, Bogomir Dimitrijevic
Koviljka Krtolica, Milena Krajnovic, Bogomir Dimitrijevic, Laboratory for Radiobiology and Molecular Genetics, Institute of Nuclear Sciences “Vinca”, P. O. BOX 522, Belgrade, Serbia
Slavica Usaj-Knezevic, Dusan Jovanovic, Institute of Oncology, Sremska Kamenica, Serbia
Dragan Babic, Institute for Medical Statistics of Medical University, Belgrade, Serbia
Author contributions: All authors contributed equally to the work.
Supported by the grant 143010 from the Ministry of Science and Environment Protection of the Republic of Serbia
Correspondence to: Dr. Koviljka Krtolica, Laboratory for Radiobiology and Molecular Genetics, Institute of Nuclear Sciences “Vinca”, P. O. BOX 522, Belgrade, Serbia. krtolica@vin.bg.ac.yu
Telephone: +381-11-2447485 Fax: +381-11-2447485
Received: November 29, 2006
Revised: December 12, 2006
Accepted: January 12, 2007
Published online: February 28, 2007
Abstract

AIM: To investigate the significance of p16 and O6-methylguanine-DNA methyltransferase (MGMT) genes promoter hypermethylation and K-ras mutations on colorectal tumorigenesis and progression.

METHODS: p16 and MGMT methylation status was examined on 47 tumor samples, and K-ras mutational status was examined on 85 tumor samples. For methylation analysis, a methylation specific PCR (MS-PCR) method was used.

RESULTS: p16 and MGMT promoter methylation was found in 51% (24/47) and 43% (20/47) of CRCs, respectively, and the K-ras mutation was found in 44% (37/85) of CRCs. Comethylation of p16 and MGMT genes was significantly associated with lower aggressiveness of the disease within a two-year period of observation. Only 27% of patients with simultaneous p16 and MGMT methylation showed the detectible occurrence of metastasis and/or death, compared to 67% of patients without double methylation or with no methylation (3/11 vs 22/33, P < 0.05, χ2-test). In addition, p16 and MGMT comethylation showed a trend toward an association with longer survival in patients with CRCs (35.5 ± 6.0 mo vs 23.1 ± 3.2 mo, P = 0.072, Log-rank test). Progression of the disease within a two-year period was observed in 66% of patients carrying the K-ras mutation, compared to only 19% of patients with wild type K-ras (29/44 vs 7/37, P < 0.001, χ2-test). The presence of the K-ras mutation significantly correlated to shortened overall survival (20.0 ± 1.9 mo vs 37.0 ± 1.8 mo, P < 0.001, Log-rank test). The comethylation of p16 and MGMT genes was significantly associated with lower aggressiveness of the disease even when K-ras mutations were included in the analysis as an independent variable.

CONCLUSION: Our data suggest that comethylation of promoters of p16 and MGMT genes could have a prognostic value in patients with CRC. Specifically, concurrent methylation of both genes correlates with better prognosis.

Keywords: Colorectal carcinoma; DNA methylation; p16; MGMT; K-ras mutation