Genetics and Genomics

Relationship of telomere length in colorectal cancer patients with cancer phenotype and patient prognosis



Telomeres, repetitive DNA capping ends of eukaryotic chromosomes, are important in the maintenance of genomic integrity. Perturbed telomeres are common features of many human malignancies, including colorectal cancer.


Telomere length (TL), measured by a Monochrome Multiplex Real-Time qPCR, was investigated in tumour tissues, adjacent mucosa, and blood from patients with colorectal cancer with different clinicopathological features and its impact on patient survival. TL was also measured in a limited number of liver metastases, non-cancerous liver tissues or corresponding tissues from the same patients.


TL in tumour tissues was shorter than in the adjacent mucosa (P < 0.0001). Shorter TL was observed in tumours with lower stage than in those with advanced stages (P = 0.001). TL was shorter in tumours at the proximal than at the distal sites of the colon (P < 0.0001). Shorter TL was also associated with microsatellite instability (P = 0.001) and mucinous tumour histology (P < 0.0001). Patients with a smaller TL ratio between tumour tissues and the adjacent mucosa were associated with increased overall survival (P = 0.022). Metastasised tumours had shorter telomeres than the adjacent non-cancerous liver tissues (P = 0.0005).


Overall, the results demonstrate differences in TL between tumours and the adjacent mucosa, between tumours located at different sites and association with patient survival.

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We wish to thank the patients for their participation in the study.

Author information

Conceptualisation: P.V. and R.K. Data curation: M.K., S.K.R., M.U., K.J. and N.S. Formal analysis: M.K., S.R., M.U., K.J. and N.S. Funding acquisition: P.V. and V.V. Methodology: S.R. and R.K. Project administration: P.V., R.K. and L.V. Resources: V.L., N.S. and O.V. Supervision: P.V. and R.K. Visualisation: M.K. Writing and original draft: M.K., P.V. and R.K. Writing ± review & editing: P.V., R.K., L.V. and V.V.

Correspondence to Michal Kroupa or Pavel Vodicka.

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Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

All patients included in the study (recruited at the General University Hospital at the Charles University and Thomayer Hospital in Prague, Teaching Hospital and Medical School of Charles University in Pilsen, Czech Republic) signed informed consent. Ethics committees of the above hospitals approved the study. The study was performed in accordance with the Declaration of Helsinki.


This study was supported by the Grant Agency of the Czech Republic (GA CR 18-09709 S), the Internal Agency of the Ministry of Health of the Czech Republic (AZV 17-30920A, NV18-03-00199, AZV 15–27580A, and NV19-09-00237), and by the Centrum of Clinical and Experimental liver surgery (UNCE/MED/006), the National Sustainability Program I (NPU I) Nr. LO1503 provided by the Ministry of Education Youth and Sports of the Czech Republic and Progres Q28/LF1.

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All participants have given expressed consent for publication of their details. All personal information has been made anonymous.

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The data are available in coded form at the Department of Molecular Biology of Cancer, Institute of Experimental Medicine.


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