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Clinical Study

Association between risk factors, molecular features and CpG island methylator phenotype colorectal cancer among different age groups in a Taiwanese cohort

British Journal of Cancer volume 125, pages 48–54 (2021)Cite this article

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Abstract

Background

CpG island methylator phenotype (CIMP) represents a carcinogenesis pathway of colorectal cancer (CRC) and the association between CIMP CRC, molecular features and risk factors in East Asian population is less studied.

Methods

We prospectively enrolled newly diagnosed CRC patients at the National Taiwan University Hospital. Clinicopathological data and risk factors for CRC were collected during interview. The tumour samples were subjected to CIMP, RAS/BRAF mutation and microsatellite instability tests. CIMP-high was determined when ≧3 methylated loci of p16, MINT1, MINT2, MINT31 and MLH1 were identified. Multivariate logistic regression was used to evaluate the association between risk factors and CIMP-high CRC.

Results

Compared with CIMP-low/negative CRC, CIMP-high CRC was associated with more stage IV disease, BRAF V600E mutation and high body mass index (BMI ≧ 27.5 kg/m2) in younger patients (age < 50 y), and more right-sided tumour, BRAF V600E mutation, MSI-high and colorectal polyp in elder patients (age ≧ 50 y). Multivariate analyses showed that BMI ≧27.5 kg/m2 was significantly associated with CIMP-high CRC in younger patients.

Conclusions

We identified distinct clinicopathological features for CIMP-high CRC among different age groups in Taiwan. Our data suggest the association between BMI ≧27.5 kg/m2 and CIMP-high CRC in patients younger than 50 years.

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Fig. 1: Age-adjusted incidence rates (ASR) of colorectal cancer (ICD10 codes C18-C20) for both sexes in Taiwan using the WHO standard population 2000.

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Acknowledgements

We are grateful for the statistical assistance and calculation of age-adjusted incidence rates (ASR) of colorectal cancer provided by the Department of Medical Research at National Taiwan University Hospital.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan

    Kuo-Hsing Chen, Yi-Hsin Liang & Ann-Lii Cheng

  2. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan

    Kuo-Hsing Chen, Yu-Liang Chao, Yi-Hsin Liang, Ann-Lii Cheng & Kun-Huei Yeh

  3. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan

    Kuo-Hsing Chen, Yi-Hsin Liang, Ann-Lii Cheng & Kun-Huei Yeh

  4. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Liang-In Lin

  5. Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan

    Liang-In Lin

  6. Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan

    Chang-Tsu Yuan

  7. Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan

    Li-Hui Tseng

  8. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan

    Jin-Tung Liang & Been-Ren Lin

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  1. Kuo-Hsing Chen
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Contributions

K.H.C. and K.H.Y. designed the study. L.I.L. performed CIMP and RAS/BRAF analyses. L.H.T. performed MSI analysis. K.H.C., Y.L.C., Y.H.L., J.T.L. and B.R.L. collected patient’s clinical information and surgical specimens. C.T.Y. handled surgical specimens and did pathology interpretation. K.H.C. did data analysis. K.H.C., A.L.C. and K.H.Y. interpreted data and wrote manuscript.

Corresponding author

Correspondence to Kun-Huei Yeh.

Ethics declarations

Ethics approval and consent to participate

This study was approved by The Institutional Review Board of the National Taiwan University Hospital (NTUH).

Consent for publication

Not applicable.

Data availability

The datasets generated and/or analysed during the current study are not publicly available because another study is ongoing but are available from the corresponding author on reasonable request.

Competing interests

The authors declare no competing interests.

Funding information

This work was supported by the Ministry of Health and Welfare, R.O.C. (Taiwan) (DOH100-TD-C-111-001).

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Chen, KH., Lin, LI., Yuan, CT. et al. Association between risk factors, molecular features and CpG island methylator phenotype colorectal cancer among different age groups in a Taiwanese cohort. Br J Cancer 125, 48–54 (2021). https://doi.org/10.1038/s41416-021-01300-5

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