title: Methylation and colorectal cancer.
abstract: Statistics rate colorectal adenocarcinoma as the most common cause of cancer death on exclusion of smoking-related neoplasia. However, the reported accumulation of genetic lesions over the adenoma to adenocarcinoma sequence cannot wholly account for the neoplastic phenotype. Recently, heritable, epigenetic changes in DNA methylation, in association with a repressive chromatin structure, have been identified as critical determinants of tumour progression. Indeed, the transcriptional silencing of both established and novel tumour suppressor genes has been attributed to the aberrant cytosine methylation of promoter-region CpG islands. This review aims to set these epigenetic changes within the context of the colorectal adenoma to adenocarcinoma sequence. The role of cytosine methylation in physiological and pathological gene silencing is discussed and the events behind aberrant cytosine methylation in ageing and cancer are appraised. Emphasis is placed on the interrelationships between epigenetic and genetic lesions and the manner in which they cooperate to define a CpG island methylator phenotype at an early stage in tumourigenesis. Finally, the applications of epigenetics to molecular pathology and patient diagnosis and treatment are reviewed.
authors.affiliation: Academic Unit of Pathology, Algernon Firth Building, University of Leeds, Leeds, LS2 9JT, UK. ugm8amj@leeds.ac.uk
authors.forename: A M
authors.initials: AM
authors.lastname: Jubb
authors.forename: S M
authors.initials: SM
authors.lastname: Bell
authors.forename: P
authors.initials: P
authors.lastname: Quirke
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics*; D000236:Adenoma / Q000235:genetics; D000368:Aged; D000375:Aging / Q000235:genetics; D014408:Biomarkers, Tumor / Q000032:analysis; D002843:Chromatin; D015179:Colorectal Neoplasms / Q000235:genetics*; D018899:CpG Islands; D003596:Cytosine / Q000378:metabolism*; D019175:DNA Methylation; D004032:Diet; D005260:Female; D020868:Gene Silencing; D017491:Genes, APC; D016147:Genes, Tumor Suppressor; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000235:genetics; D008297:Male; D008875:Middle Aged; D008957:Models, Genetic; D011401:Promoter Regions, Genetic; D011451:Prostaglandin-Endoperoxide Synthases / Q000235:genetics; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D002843:Chromatin; D003596:Cytosine; D011451:Prostaglandin-Endoperoxide Synthases