Lim Unhee, Flood Andrew, Choi Sang-Woon, Albanes Demetrius, Cross Amanda J, Schatzkin Arthur, Sinha Rashmi, Katki Hormuzd A, Cash Brooks, Schoenfeld Phillip, Stolzenberg-Solomon Rachael
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, Maryland, USA.
Gastroenterology. 2008 Jan;134(1):47-55. doi: 10.1053/j.gastro.2007.10.013. Epub 2007 Oct 10.
BACKGROUND & AIMS: Systemic inhibition of DNA methylation causes cancers in animals, in part by inducing genetic instability. Epidemiologic evidence linking low genomic methylation in systemic blood DNA to carcinogenesis is limited, however, specifically to the colorectum, in which genetic instability is a primary etiologic factor. We examined genomic methylation of leukocyte DNA in relation to colorectal adenoma (CRA) among asymptomatic women (40-79 years of age) participating in a multicenter colonoscopy screening study (CONCeRN Study, 2000-2002).
Of all participants who completed self-administered risk factor and food frequency questionnaires, peripheral blood donation, and colonoscopy, 115 pairs of CRA cases and controls with matching age and month of blood draw were studied. Genomic methylation of leukocyte DNA was determined by liquid chromatography mass spectrometry. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI).
Compared with women in the lowest tertile of genomic methylation, women in the second (OR, 0.72; 95% CI: 0.34-1.52) and third tertiles (OR, 0.17; 95% CI: 0.06-0.49) had lower risk of CRA (P trend = .002). The inverse relationship was stronger for nonadvanced than for advanced adenoma and, less notably, for proximal than for distal adenoma. The association was also moderately more protective with low rather than high total folate intake but did not differ by other nutrients involved in 1-carbon metabolism or colorectal cancer risk factors.
Our findings regarding asymptomatic CRA implicate systemic genomic methylation as a potential etiologic factor for an early stage of CRA.
DNA甲基化的全身性抑制会在动物体内引发癌症,部分原因是诱导基因不稳定。然而,将全身血液DNA中低基因组甲基化与致癌作用联系起来的流行病学证据有限,特别是在遗传不稳定是主要病因的结直肠癌方面。我们在一项多中心结肠镜筛查研究(CONCeRN研究,2000 - 2002年)中,对无症状女性(40 - 79岁)白细胞DNA的基因组甲基化与结肠直肠腺瘤(CRA)的关系进行了研究。
在所有完成自我管理的风险因素和食物频率问卷、外周血捐献以及结肠镜检查的参与者中,研究了115对年龄和采血月份匹配的CRA病例与对照。通过液相色谱质谱法测定白细胞DNA的基因组甲基化。采用条件逻辑回归来估计比值比(OR)和95%置信区间(CI)。
与基因组甲基化处于最低三分位数的女性相比,处于第二(OR,0.72;95% CI:0.34 - 1.52)和第三三分位数的女性患CRA的风险较低(P趋势 = 0.002)。这种负相关关系在非晚期腺瘤中比在晚期腺瘤中更强,在近端腺瘤中比在远端腺瘤中不太明显。低总叶酸摄入量比高总叶酸摄入量的保护作用也稍强,但在参与一碳代谢的其他营养素或结直肠癌风险因素方面没有差异。
我们关于无症状CRA的研究结果表明,全身性基因组甲基化可能是CRA早期阶段的潜在病因。