title: Prediction of colorectal neoplasia by quantitative methylation analysis of estrogen receptor gene in nonneoplastic epithelium from patients with ulcerative colitis.
abstract: OBJECTIVE
  The incidence of colorectal neoplasia has increased among patients with longstanding and extensive ulcerative colitis (UC). Therefore, surveillance colonoscopy has been widely recommended. However, there is controversy about the impact of cancer surveillance, and ways to improve its effectiveness are being sought. The estrogen receptor (ER) gene shows age-related methylation in the colorectal epithelium and is frequently methylated in colorectal neoplasia, suggesting that ER methylation occurs early in the process of colorectal tumorigenesis.
  
  
  METHODS
  To clarify whether methylation analysis of the ER gene in nonneoplastic epithelium can help predict an increased risk for UC-associated neoplasia, a total of 105 nonneoplastic colorectal epithelia from 18 patients with longstanding and extensive UC, including 8 patients with neoplasia and 10 patients without neoplasia, were analyzed. In all patients, multiple samples were taken from six regions of the colorectum. The combined bisulfite restriction analysis method was used to determine the methylation status of the ER gene.
  
  
  RESULTS
  The mean methylation level of the ER gene was 25.4% in the nonneoplastic epithelia from UC patients with neoplasia, whereas it was only 4.0% in those without neoplasia (P<0.001). The methylation level of the ER gene in UC patients with neoplasia was significantly higher than in UC patients without neoplasia throughout the colorectum except for the cecum. In UC patients with neoplasia, the mean ER methylation level in the distal colon (36.1%) was significantly higher than in the proximal colon (14.6%; P<0.001).
  
  
  CONCLUSIONS
  These results suggest that the analysis of ER gene methylation in nonneoplastic colorectal epithelium could have the potential to be a useful adjunct for identifying individuals with longstanding and extensive UC who are at increased risk of neoplasia and contribute to more effective cancer surveillance.
authors.affiliation: Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Tochigi, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tominaga
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Fujii
authors.forename: Kenichiroh
authors.initials: K
authors.lastname: Mukawa
authors.forename: Mikio
authors.initials: M
authors.lastname: Fujita
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tomita
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Imai
authors.forename: Kazunari
authors.initials: K
authors.lastname: Kanke
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ono
authors.forename: Akira
authors.initials: A
authors.lastname: Terano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hiraishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000150:complications*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D004247:DNA / Q000032:analysis / Q000378:metabolism; D019175:DNA Methylation; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000737:chemistry / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011960:Receptors, Estrogen / Q000235:genetics*
chemical_list: D011960:Receptors, Estrogen; D004247:DNA