Artigo Acesso aberto Revisado por pares

Molecular Phenotype of Inflammatory Bowel Disease-Associated Neoplasms With Microsatellite Instability

2005; Elsevier BV; Volume: 129; Issue: 1 Linguagem: Inglês

10.1053/j.gastro.2005.04.011

ISSN

1528-0012

Autores

Karsten Schulmann, Yuriko Mori, Victoria Croog, Jing Yin, Andreea Olaru, Anca Sterian, Fumiaki Sato, Suna Wang, Yan Xu, Elena Deacu, Agnes Berki, James P. Hamilton, Takatsugu Kan, John Abraham, Wolff Schmiegel, Noam Harpaz, Stephen J. Meltzer,

Tópico(s)

Cancer Genomics and Diagnostics

Resumo

Background&Aims: Patients with inflammatory bowel disease (IBD) are at increased risk of developing colorectal cancer (CRC). We sought to determine the frequency of high-level microsatellite instability (MSI-H) and the mutational and methylation profile of MSI-H IBD-related neoplasms (IBDNs). Methods: A total of 124 IBDNs (81 cancers, 43 dysplasias) from 78 patients were studied for the frequency of MSI-H and hypermethylation of 3 target genes: MLH1, HPP1, and RAB-32. Fifteen MSI-H IBDNs were characterized according to their profile of frameshift mutations in 28 mononucleotide repeats and compared with 46 sporadic MSI-H CRCs. Results: Nineteen of 124 IBDNs were MSI-H. The frequency of frameshift mutations in coding mononucleotide repeats was significantly lower in MSI-H IBDNs than in sporadic MSI-H CRCs for TGFBR2 (7 of 14 vs 34 of 43 samples; P = .047) and ACVR2 (3 of 14 vs 25 of 43 samples; P = .029). In contrast, ICA1 was mutated in 3 of 9 MSI-H IBDNs vs 2 of 54 sporadic MSI-H CRCs (P = .028). HPP1 and RAB32 methylation was independent of MSI status and was observed in 4 of 59 and 0 of 64 nondysplastic mucosae, 20 of 38 and 1 of 25 dysplasias, and 28 of 61 and 20 of 60 carcinomas, respectively. Conclusions: The profiles of coding microsatellite mutations (instabilotypes) differ significantly between MSI-H IBDNs and MSI-H sporadic CRCs. Specifically, TGFBR2 and ACVR2 mutations are significantly rarer in MSI-H IBDNs than in MSI-H sporadic CRCs. Furthermore, HPP1 methylation occurs early, in 7% of nondysplastic and approximately half of dysplastic mucosae, whereas RAB32 methylation occurs at the transition to invasive growth, being rarer in dysplasias. Background&Aims: Patients with inflammatory bowel disease (IBD) are at increased risk of developing colorectal cancer (CRC). We sought to determine the frequency of high-level microsatellite instability (MSI-H) and the mutational and methylation profile of MSI-H IBD-related neoplasms (IBDNs). Methods: A total of 124 IBDNs (81 cancers, 43 dysplasias) from 78 patients were studied for the frequency of MSI-H and hypermethylation of 3 target genes: MLH1, HPP1, and RAB-32. Fifteen MSI-H IBDNs were characterized according to their profile of frameshift mutations in 28 mononucleotide repeats and compared with 46 sporadic MSI-H CRCs. Results: Nineteen of 124 IBDNs were MSI-H. The frequency of frameshift mutations in coding mononucleotide repeats was significantly lower in MSI-H IBDNs than in sporadic MSI-H CRCs for TGFBR2 (7 of 14 vs 34 of 43 samples; P = .047) and ACVR2 (3 of 14 vs 25 of 43 samples; P = .029). In contrast, ICA1 was mutated in 3 of 9 MSI-H IBDNs vs 2 of 54 sporadic MSI-H CRCs (P = .028). HPP1 and RAB32 methylation was independent of MSI status and was observed in 4 of 59 and 0 of 64 nondysplastic mucosae, 20 of 38 and 1 of 25 dysplasias, and 28 of 61 and 20 of 60 carcinomas, respectively. Conclusions: The profiles of coding microsatellite mutations (instabilotypes) differ significantly between MSI-H IBDNs and MSI-H sporadic CRCs. Specifically, TGFBR2 and ACVR2 mutations are significantly rarer in MSI-H IBDNs than in MSI-H sporadic CRCs. Furthermore, HPP1 methylation occurs early, in 7% of nondysplastic and approximately half of dysplastic mucosae, whereas RAB32 methylation occurs at the transition to invasive growth, being rarer in dysplasias. Patients with ulcerative colitis (UC) and Crohn's colitis are at increased risk of developing colorectal cancer (CRC). The duration of inflammatory bowel disease (IBD) is one the most important risk factors impinging on this risk.1Ekbom A. Helmick C. Zack M. Adami H.O. Ulcerative colitis and colorectal cancer. A population-based study.N Engl J Med. 1990; 323: 1228-1233Crossref PubMed Scopus (1619) Google Scholar, 2Bernstein C.N. Blanchard J.F. Kliewer E. Wajda A. Cancer risk in patients with inflammatory bowel disease a population-based study.Cancer. 2001; 91: 854-862Crossref PubMed Scopus (1046) Google Scholar CRC occurs rarely before a 7-year duration of colitis. A recent meta-analysis reported a cumulative risk of CRC of 18% after 30 years of disease.3Eaden J.A. Abrams K.R. Mayberry J.F. The risk of colorectal cancer in ulcerative colitis a meta-analysis.Gut. 2001; 48: 526-535Crossref PubMed Scopus (2445) Google Scholar Another important risk factor for CRC is the extent of the disease, with standardized incidence ratios of 1.7 for proctitis, 2.8 for left-sided colitis, and 14.8 for pancolitis.1Ekbom A. Helmick C. Zack M. Adami H.O. Ulcerative colitis and colorectal cancer. A population-based study.N Engl J Med. 1990; 323: 1228-1233Crossref PubMed Scopus (1619) Google Scholar In addition, a positive family history of CRC and the diagnosis of concomitant primary sclerosing cholangitis have been shown to be associated with an increased risk of CRC in patients with UC.4Askling J. Dickman P.W. Karlen P. Brostrom O. Lapidus A. Lofberg R. Ekbom A. Family history as a risk factor for colorectal cancer in inflammatory bowel disease.Gastroenterology. 2001; 120: 1356-1362Abstract Full Text Full Text PDF PubMed Scopus (387) Google Scholar, 5Nuako K.W. Ahlquist D.A. Mahoney D.W. Schaid D.J. Siems D.M. Lindor N.M. Familial predisposition for colorectal cancer in chronic ulcerative colitis a case-control study.Gastroenterology. 1998; 115: 1079-1083Abstract Full Text Full Text PDF PubMed Scopus (204) Google Scholar, 6Nuako K.W. Ahlquist D.A. Sandborn W.J. Mahoney D.W. Siems D.M. Zinsmeister A.R. Primary sclerosing cholangitis and colorectal carcinoma in patients with chronic ulcerative colitis a case-control study.Cancer. 1998; 82: 822-826Crossref PubMed Scopus (85) Google Scholar, 7Broome U. Lofberg R. Veress B. Eriksson L.S. Primary sclerosing cholangitis and ulcerative colitis evidence for increased neoplastic potential.Hepatology. 1995; 22: 1404-1408Crossref PubMed Scopus (12) Google Scholar, 8Kornfeld D. Ekbom A. Ihre T. Is there an excess risk for colorectal cancer in patients with ulcerative colitis and concomitant primary sclerosing cholangitis? A population based study.Gut. 1997; 41: 522-525Crossref PubMed Scopus (240) Google Scholar Recently, the histologic degree of inflammation has been proposed as an independent risk factor for CRC in UC.9Rutter M. Saunders B. Wilkinson K. Rumbles S. Schofield G. Kamm M. Williams C. Price A. Talbot I. Forbes A. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis.Gastroenterology. 2004; 126: 451-459Abstract Full Text Full Text PDF PubMed Scopus (1055) Google Scholar Patients with long-standing extensive Crohn's colitis are also at an increased risk of CRC.2Bernstein C.N. Blanchard J.F. Kliewer E. Wajda A. Cancer risk in patients with inflammatory bowel disease a population-based study.Cancer. 2001; 91: 854-862Crossref PubMed Scopus (1046) Google Scholar, 10Sachar D.B. Cancer in Crohn's disease dispelling the myths.Gut. 1994; 35: 1507-1508Crossref PubMed Scopus (118) Google Scholar Moreover, the risk of small bowel cancer is significantly increased in patients with Crohn's disease (CD) relative to the general population.2Bernstein C.N. Blanchard J.F. Kliewer E. Wajda A. Cancer risk in patients with inflammatory bowel disease a population-based study.Cancer. 2001; 91: 854-862Crossref PubMed Scopus (1046) Google Scholar The median age of diagnosis of bowel cancer (CRC and small bowel cancer) in patients with IBD is significantly earlier than in sporadic bowel cancer.2Bernstein C.N. Blanchard J.F. Kliewer E. Wajda A. Cancer risk in patients with inflammatory bowel disease a population-based study.Cancer. 2001; 91: 854-862Crossref PubMed Scopus (1046) Google Scholar, 11Harpaz N. Talbot I.C. Colorectal cancer in idiopathic inflammatory bowel disease.Semin Diagn Pathol. 1996; 13: 339-357PubMed Google Scholar IBD-associated CRCs are different from sporadic carcinoma in several respects. For example, unlike sporadic CRC, which arises from polypoid adenomas, IBD-associated CRC develops from often flat areas of dysplastic mucosa; sporadic adenomas require 10–15 years to evolve in carcinomas, whereas IBD-associated dysplasias generally progress within 3 years. In addition, IBD-associated dysplasias arise within a setting of intense inflammation, whereas sporadic adenomas are not associated with inflammation.12Itzkowitz S.H. Harpaz N. Diagnosis and management of dysplasia in patients with inflammatory bowel diseases.Gastroenterology. 2004; 126: 1634-1648Abstract Full Text Full Text PDF PubMed Scopus (386) Google Scholar Although the molecular events that facilitate the progression of adenoma to carcinoma in sporadic CRC have been well investigated,13Fearon E.R. Vogelstein B. A genetic model for colorectal tumorigenesis.Cell. 1990; 61: 759-767Abstract Full Text PDF PubMed Scopus (10484) Google Scholar much remains unclear regarding the molecular events underlying IBD-associated neoplasms (IBDNs). Previous studies have shown important differences between sporadic and IBD-associated neoplasias regarding the frequency and timing of certain genetic alterations. For example, a recent study of gene expression profiles in IBDNs showed significant differences from their sporadic counterparts.14Selaru F.M. Xu Y. Yin J. Zou T. Liu T.C. Mori Y. Abraham J.M. Sato F. Wang S. Twigg C. Olaru A. Shustova V. Leytin A. Hytiroglou P. Shibata D. Harpaz N. Meltzer S.J. Artificial neural networks distinguish among subtypes of neoplastic colorectal lesions.Gastroenterology. 2002; 122: 606-613Abstract Full Text Full Text PDF PubMed Scopus (113) Google Scholar A number of studies have focused on markers of chromosomal instability, such as aneuploidy,15Rubin C.E. Haggitt R.C. Burmer G.C. Brentnall T.A. Stevens A.C. Levine D.S. Dean P.J. Kimmey M. Perera D.R. Rabinovitch P.S. DNA aneuploidy in colonic biopsies predicts future development of dysplasia in ulcerative colitis.Gastroenterology. 1992; 103: 1611-1620Abstract PubMed Google Scholar, 16Porschen R. Robin U. Schumacher A. Schauseil S. Borchard F. Hengels K.J. Strohmeyer G. DNA aneuploidy in Crohn's disease and ulcerative colitis results of a comparative flow cytometric study.Gut. 1992; 33: 663-667Crossref PubMed Scopus (42) Google Scholar, 17Lindberg J.O. Stenling R.B. Rutegard J.N. DNA aneuploidy as a marker of premalignancy in surveillance of patients with ulcerative colitis.Br J Surg. 1999; 86: 947-950Crossref PubMed Scopus (39) Google Scholar, 18Keller R. Foerster E.C. Kohler A. Floer B. Winde G. Terpe H.J. Domschke W. Diagnostic value of DNA image cytometry in ulcerative colitis.Dig Dis Sci. 2001; 46: 870-878Crossref PubMed Scopus (10) Google Scholar, 19Holzmann K. Klump B. Borchard F. Gregor M. Porschen R. Flow cytometric and histologic evaluation in a large cohort of patients with ulcerative colitis correlation with clinical characteristics and impact on surveillance.Dis Colon Rectum. 2001; 44: 1446-1455Crossref PubMed Scopus (18) Google Scholar loss of heterozygosity, genomic losses or gains using comparative genomic hybridization,20Greenwald B.D. Harpaz N. Yin J. Huang Y. Tong Y. Brown V.L. McDaniel T. Newkirk C. Resau J.H. Meltzer S.J. Loss of heterozygosity affecting the p53, Rb, and mcc/apc tumor suppressor gene loci in dysplastic and cancerous ulcerative colitis.Cancer Res. 1992; 52: 741-745PubMed Google Scholar, 21Willenbucher R.F. Aust D.E. Chang C.G. Zelman S.J. Ferrell L.D. Moore II, D.H. Waldman F.M. Genomic instability is an early event during the progression pathway of ulcerative-colitis-related neoplasia.Am J Pathol. 1999; 154: 1825-1830Abstract Full Text Full Text PDF PubMed Scopus (162) Google Scholar, 22Willenbucher R.F. Zelman S.J. Ferrell L.D. Moore II, D.H. Waldman F.M. Chromosomal alterations in ulcerative colitis-related neoplastic progression.Gastroenterology. 1997; 113: 791-801Abstract Full Text PDF PubMed Scopus (94) Google Scholar, 23Aust D.E. Willenbucher R.F. Terdiman J.P. Ferrell L.D. Chang C.G. Moore II, D.H. Molinaro-Clark A. Baretton G.B. Loehrs U. Waldman F.M. Chromosomal alterations in ulcerative colitis-related and sporadic colorectal cancers by comparative genomic hybridization.Hum Pathol. 2000; 31: 109-114Abstract Full Text PDF PubMed Scopus (62) Google Scholar, 24Odze R.D. Brown C.A. Hartmann C.J. Noffsinger A.E. Fogt F. Genetic alterations in chronic ulcerative colitis-associated adenoma-like DALMs are similar to non-colitic sporadic adenomas.Am J Surg Pathol. 2000; 24: 1209-1216Crossref PubMed Scopus (78) Google Scholar, 25Odze R.D. Brien T. Brown C.A. Hartman C.J. Wellman A. Fogt F. Molecular alterations in chronic ulcerative colitis-associated and sporadic hyperplastic polyps a comparative analysis.Am J Gastroenterol. 2002; 97: 1235-1242Crossref PubMed Google Scholar, 26Fogt F. Vortmeyer A.O. Goldman H. Giordano T.J. Merino M.J. Zhuang Z. Comparison of genetic alterations in colonic adenoma and ulcerative colitis-associated dysplasia and carcinoma.Hum Pathol. 1998; 29: 131-136Abstract Full Text PDF PubMed Scopus (101) Google Scholar, 27Fogt F. Vortmeyer A.O. Stolte M. Mueller E. Mueller J. Noffsinger A. Poremba C. Zhuang Z. Loss of heterozygosity of the von Hippel Lindau gene locus in polypoid dysplasia but not flat dysplasia in ulcerative colitis or sporadic adenomas.Hum Pathol. 1998; 29: 961-964Abstract Full Text PDF PubMed Scopus (36) Google Scholar, 28Fogt F. Urbanski S.J. Sanders M.E. Furth E.E. Zimmerman R.L. Deren J.J. Noffsinger A.E. Vortmeyer A.O. Hartmann C.J. Odze R.L. Brown C.A. Distinction between dysplasia-associated lesion or mass (DALM) and adenoma in patients with ulcerative colitis.Hum Pathol. 2000; 31: 288-291Abstract Full Text PDF PubMed Scopus (54) Google Scholar, 29Fogt F. Zhuang Z. Poremba C. Dockhorn-Dworniczak B. Vortmeyer A. Comparison of p53 immunoexpression with allelic loss of p53 in ulcerative colitis-associated dysplasia and carcinoma.Oncol Rep. 1998; 5: 477-480PubMed Google Scholar or mutational or protein expression studies of oncogenes and tumor suppressor genes. Regarding the latter, it was shown that p53 gene alterations occur early, even in nonneoplastic colonic mucosa of patients with IBD, whereas APC alterations, which are common and early in sporadic CRC, were detected rarely and late in IBD-associated carcinogenesis.13Fearon E.R. Vogelstein B. A genetic model for colorectal tumorigenesis.Cell. 1990; 61: 759-767Abstract Full Text PDF PubMed Scopus (10484) Google Scholar, 26Fogt F. Vortmeyer A.O. Goldman H. Giordano T.J. Merino M.J. Zhuang Z. Comparison of genetic alterations in colonic adenoma and ulcerative colitis-associated dysplasia and carcinoma.Hum Pathol. 1998; 29: 131-136Abstract Full Text PDF PubMed Scopus (101) Google Scholar, 30Yin J. Harpaz N. Tong Y. Huang Y. Laurin J. Greenwald B.D. Hontanosas M. Newkirk C. Meltzer S.J. p53 point mutations in dysplastic and cancerous ulcerative colitis lesions.Gastroenterology. 1993; 104: 1633-1639Abstract PubMed Google Scholar, 31Hussain S.P. Amstad P. Raja K. Ambs S. Nagashima M. Bennett W.P. Shields P.G. Ham A.J. Swenberg J.A. Marrogi A.J. Harris C.C. Increased p53 mutation load in noncancerous colon tissue from ulcerative colitis a cancer-prone chronic inflammatory disease.Cancer Res. 2000; 60: 3333-3337PubMed Google Scholar, 32Brentnall T.A. Crispin D.A. Rabinovitch P.S. Haggitt R.C. Rubin C.E. Stevens A.C. Burmer G.C. Mutations in the p53 gene an early marker of neoplastic progression in ulcerative colitis.Gastroenterology. 1994; 107: 369-378Abstract PubMed Google Scholar, 33Burmer G.C. Rabinovitch P.S. Haggitt R.C. Crispin D.A. Brentnall T.A. Kolli V.R. Stevens A.C. Rubin C.E. Neoplastic progression in ulcerative colitis histology, DNA content, and loss of a p53 allele.Gastroenterology. 1992; 103: 1602-1610PubMed Google Scholar, 34Tarmin L. Yin J. Harpaz N. Kozam M. Noordzij J. Antonio L.B. Jiang H.Y. Chan O. Cymes K. Meltzer S.J. Adenomatous polyposis coli gene mutations in ulcerative colitis-associated dysplasias and cancers versus sporadic colon neoplasms.Cancer Res. 1995; 55: 2035-2038PubMed Google Scholar, 35Aust D.E. Terdiman J.P. Willenbucher R.F. Chang C.G. Molinaro-Clark A. Baretton G.B. Loehrs U. Waldman F.M. The APC/beta-catenin pathway in ulcerative colitis-related colorectal carcinomas a mutational analysis.Cancer. 2002; 94: 1421-1427Crossref PubMed Scopus (126) Google Scholar, 36Umetani N. Sasaki S. Watanabe T. Shinozaki M. Matsuda K. Ishigami H. Ueda E. Muto T. Genetic alterations in ulcerative colitis-associated neoplasia focusing on APC, K-ras gene and microsatellite instability.Jpn J Cancer Res. 1999; 90: 1081-1087Crossref PubMed Scopus (67) Google Scholar, 37Harpaz N. Peck A.L. Yin J. Fiel I. Hontanosas M. Tong T.R. Laurin J.N. Abraham J.M. Greenwald B.D. Meltzer S.J. p53 protein expression in ulcerative colitis-associated colorectal dysplasia and carcinoma.Hum Pathol. 1994; 25: 1069-1074Abstract Full Text PDF PubMed Scopus (127) Google Scholar Similarly, mutations of DPC4 and K-ras have been shown to be infrequent in IBD-associated cancers,36Umetani N. Sasaki S. Watanabe T. Shinozaki M. Matsuda K. Ishigami H. Ueda E. Muto T. Genetic alterations in ulcerative colitis-associated neoplasia focusing on APC, K-ras gene and microsatellite instability.Jpn J Cancer Res. 1999; 90: 1081-1087Crossref PubMed Scopus (67) Google Scholar, 38Hoque A.T. Hahn S.A. Schutte M. Kern S.E. DPC4 gene mutation in colitis associated neoplasia.Gut. 1997; 40: 120-122PubMed Google Scholar, 39Lei J. Zou T.T. Shi Y.Q. Zhou X. Smolinski K.N. Yin J. Souza R.F. Appel R. Wang S. Cymes K. Chan O. Abraham J.M. Harpaz N. Meltzer S.J. Infrequent DPC4 gene mutation in esophageal cancer, gastric cancer and ulcerative colitis-associated neoplasms.Oncogene. 1996; 13: 2459-2462PubMed Google Scholar, 40Meltzer S.J. Mane S.M. Wood P.K. Resau J.H. Newkirk C. Terzakis J.A. Korelitz B.I. Weinstein W.M. Needleman S.W. Activation of c-Ki-ras in human gastrointestinal dysplasias determined by direct sequencing of polymerase chain reaction products.Cancer Res. 1990; 50: 3627-3630PubMed Google Scholar, 41Burmer G.C. Levine D.S. Kulander B.G. Haggitt R.C. Rubin C.E. Rabinovitch P.S. c-Ki-ras mutations in chronic ulcerative colitis and sporadic colon carcinoma.Gastroenterology. 1990; 99: 416-420PubMed Google Scholar, 42Bell S.M. Kelly S.A. Hoyle J.A. Lewis F.A. Taylor G.R. Thompson H. Dixon M.F. Quirke P. c-Ki-ras gene mutations in dysplasia and carcinomas complicating ulcerative colitis.Br J Cancer. 1991; 64: 174-178Crossref PubMed Scopus (95) Google Scholar, 43Chaubert P. Benhattar J. Saraga E. Costa J. K-ras mutations and p53 alterations in neoplastic and nonneoplastic lesions associated with longstanding ulcerative colitis.Am J Pathol. 1994; 144: 767-775PubMed Google Scholar, 44Lyda M.H. Noffsinger A. Belli J. Fenoglio-Preiser C.M. Microsatellite instability and K-ras mutations in patients with ulcerative colitis.Hum Pathol. 2000; 31: 665-671Abstract Full Text PDF PubMed Scopus (50) Google Scholar whereas they are frequent events in sporadic CRCs. Studies focusing on microsatellite instability (MSI), a second major form of genomic instability, have been conflicting regarding the frequency of high-level MSI (MSI-H), with reports ranging from 50% in peak height in the tumor sample compared with the corresponding normal sample. Due to limited DNA amounts, the analysis of coding mononucleotide repeat mutations was limited to 28 genes. Genes were selected based on the frequency of alterations in non-IBD MSI-H CRC and gastric cancers from our previous studies.51Mori Y. Yin J. Rashid A. Leggett B.A. Young J. Simms L. Kuehl P.M. Langenberg P. Meltzer S.J. Stine O.C. Instabilotyping comprehensive identification of frameshift mutations caused by coding region microsatellite instability.Cancer Res. 2001; 61: 6046-6049PubMed Google Scholar, 54Mori Y. Sato F. Selaru F.M. Olaru A. Perry K. Kimos M.C. Tamura G. Matsubara N. Wang S. Xu Y. Yin J. Zou T.T. Leggett B. Young J. Nukiwa T. Stine O.C. Abraham J.M. Shibata D. Meltzer S.J. Instabilotyping reveals unique mutational spectra in microsatellite-unstable gastric cancers.Cancer Res. 2002; 62: 3641-3645PubMed Google Scholar DNA was treated with bisulfite to convert unmethylated cytosines to uracils before methylation-specific polymerase chain reaction as described previously.56Sato F. Harpaz N. Shibata D. Xu Y. Yin J. Mori Y. Zou T.T. Wang S. Desai K. Leytin A. Selaru F.M. Abraham J.M. Meltzer S.J. Hypermethylation of the p14(ARF) gene in ulcerative colitis-associated colorectal carcinogenesis.Cancer Res. 2002; 62: 1148-1151PubMed Google Scholar DNA methylation levels of genes were determined with real-time quantitative methylation-specific polymerase chain reaction using the ABI 7700 Sequence Detection (TaqMan) System (Applied Biosystems, Foster City, CA), as described previously.57Shibata D.M. Sato F. Mori Y. Perry K. Yin J. Wang S. Xu Y. Olaru A. Selaru F. Spring K. Young J. Abraham J.M. Meltzer S.J. Hypermethylation of HPP1 is associated with hMLH1 hypermethylation in gastric adenocarcinomas.Cancer Res. 2002; 62: 5637-5640PubMed Google Scholar, 58Sato F. Shibata D. Harpaz N. Xu Y. Yin J. Mori Y. Wang S. Olaru A. Deacu E. Selaru F.M. Kimos M.C. Hytiroglou P. Young J. Leggett B. Gazdar A.F. Toyooka S. Abraham J.M. Meltzer S.J. Aberrant methylation of the HPP1 gene in ulcerative colitis-associated colorectal carcinoma.Cancer Res. 2002; 62: 6820-6822PubMed Google Scholar Primers and probes for quantitative methylation-specific polymerase chain reaction were as described for MLH1, HPP1, and RAB32.52Mori Y. Yin J. Sato F. Sterian A. Simms L.A. Selaru F.M. Schulmann K. Xu Y. Olaru A. Wang S. Deacu E. Abraham J.M. Young J. Leggett B.A. Meltzer S.J. Identification of genes uniquely involved in frequent microsatellite instability colon carcinogenesis by expression profiling combined with epigenetic scanning.Cancer Res. 2004; 64: 2434-2438Crossref PubMed Scopus (72) Google Scholar, 58Sato F. Shibata D. Harpaz N. Xu Y. Yin J. Mori Y. Wang S. Olaru A. Deacu E. Selaru F.M. Kimos M.C. Hytiroglou P. Young J. Leggett B. Gazdar A.F. Toyooka S. Abraham J.M. Meltzer S.J. Aberrant methylation of the HPP1 gene in ulcerative colitis-associ

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