title: Colorectal cancer "methylator phenotype": fact or artifact?
abstract: It has been proposed that human colorectal tumors can be classified into two groups: one in which methylation is rare, and another with methylation of several loci associated with a "CpG island methylated phenotype (CIMP)," characterized by preferential proximal location in the colon, but otherwise poorly defined. There is considerable overlap between this putative methylator phenotype and the well-known mutator phenotype associated with microsatellite instability (MSI). We have examined hypermethylation of the promoter region of five genes (DAPK, MGMT, hMLH1, p16INK4a, and p14ARF) in 106 primary colorectal cancers. A graph depicting the frequency of methylated loci in the series of tumors showed a continuous, monotonically decreasing distribution quite different from the previously claimed discontinuity. We observed a significant association between the presence of three or more methylated loci and the proximal location of the tumors. However, if we remove from analysis the tumors with hMLH1 methylation or those with MSI, the significance vanishes, suggesting that the association between multiple methylations and proximal location was indirect due to the correlation with MSI. Thus, our data do not support the independent existence of the so-called methylator phenotype and suggest that it rather may represent a statistical artifact caused by confounding of associations.
authors.affiliation: Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-910 Brazil.
authors.forename: Charles
authors.initials: C
authors.lastname: Anacleto
authors.forename: Andréia M
authors.initials: AM
authors.lastname: Leopoldino
authors.forename: Benedito
authors.initials: B
authors.lastname: Rossi
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Soares
authors.forename: Ademar
authors.initials: A
authors.lastname: Lopes
authors.forename: José Cláudio C
authors.initials: JC
authors.lastname: Rocha
authors.forename: Otávia
authors.initials: O
authors.lastname: Caballero
authors.forename: Anamaria A
authors.initials: AA
authors.lastname: Camargo
authors.forename: Andrew J G
authors.initials: AJ
authors.lastname: Simpson
authors.forename: Sérgio D J
authors.initials: SD
authors.lastname: Pena
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D002352:Carrier Proteins; D003110:Colonic Neoplasms / Q000473:pathology; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology*; D018899:CpG Islands; D019175:DNA Methylation; D017931:DNA Primers / Q000737:chemistry; D042822:Genomic Instability; D006801:Humans; D008745:Methylation; D018895:Microsatellite Repeats; D000070957:MutL Protein Homolog 1; D009363:Neoplasm Proteins / Q000235:genetics; D009687:Nuclear Proteins / Q000235:genetics; D010641:Phenotype; D011401:Promoter Regions, Genetic; D017422:Sequence Analysis, DNA; D013447:Sulfites / Q000494:pharmacology
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D002352:Carrier Proteins; D017931:DNA Primers; C501486:MLH1 protein, human; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D013447:Sulfites; D000070957:MutL Protein Homolog 1