title: Altered gene expression of folate enzymes in adjacent mucosa is associated with outcome of colorectal cancer patients.
abstract: OBJECTIVE
  The purpose of this study was to analyze whether gene expression levels of folate enzymes in adjacent mucosa were associated with outcome of colorectal cancer patients.
  
  
  METHODS
  Real-time PCR was used to quantify expression levels of folate-associated genes including the reduced folate carrier (RFC-1), folylpolyglutamate synthase (FPGS), gamma-glutamyl hydrolase (GGH),and thymidylate synthase (TS) in tumor tissue and adjacent mucosa of patients with primary colorectal cancer (n=102). Furthermore, reduced folates in the tissues were measured with a binding-assay method.
  
  
  RESULTS
  Mean gene expression levels of RFC-1, FPGS, GGH, and TS were significantly higher in tumor biopsies compared with mucosa. Univariate and multivariate analyses showed that the FPGS gene expression level in mucosa, but not in tumor, was a prognostic parameter independent of the clinicopathological factors with regard to survival. Patients with high FPGS levels (>0.92) in mucosa also showed significantly higher total folate concentrations (P=0.03) and gene expression levels of RFC-1 (P<0.01), GGH (P<0.01), and TS (P=0.04) compared with patients with low FPGS levels. The total reduced folate concentration correlated with the gene expression levels of RFC-1 and FPGS but not with TS or GGH.
  
  
  CONCLUSIONS
  Our results suggest that normal-appearing colonic mucosa adjacent to primary colon cancer can show altered gene expression levels of FPGS that may have bearing on the development of aggressive metastatic behavior of the tumor and on tumor-specific survival.
authors.affiliation: Department of General Surgery, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden. elisabeth.odin@dep-surg.gu.se
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Odin
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Wettergren
authors.forename: Staffan
authors.initials: S
authors.lastname: Nilsson
authors.forename: Roger
authors.initials: R
authors.lastname: Willén
authors.forename: Göran
authors.initials: G
authors.lastname: Carlsson
authors.forename: C Paul
authors.initials: CP
authors.lastname: Spears
authors.forename: Lars
authors.initials: L
authors.lastname: Larsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Gustavsson
mesh_terms: D000368:Aged; D003106:Colon / Q000201:enzymology* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000201:enzymology* / Q000235:genetics* / Q000556:secondary; D005260:Female; D005492:Folic Acid / Q000378:metabolism; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins / Q000235:genetics / Q000378:metabolism; D010453:Peptide Synthases / Q000235:genetics / Q000378:metabolism; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012007:Rectum / Q000201:enzymology* / Q000473:pathology; D058978:Reduced Folate Carrier Protein; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D013940:Thymidylate Synthase / Q000235:genetics / Q000378:metabolism; D011623:gamma-Glutamyl Hydrolase / Q000235:genetics / Q000378:metabolism
chemical_list: D026901:Membrane Transport Proteins; D012333:RNA, Messenger; D058978:Reduced Folate Carrier Protein; C548699:SLC19A1 protein, human; D005492:Folic Acid; D013940:Thymidylate Synthase; D011623:gamma-Glutamyl Hydrolase; D010453:Peptide Synthases; C023103:folylpolyglutamate synthetase