Unidad de Genética Médica, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Departamento de Cirugía, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Hospital Fundación San Vicente de Paúl, Medellín, Colombia; Clínica Las Vegas, Medellín, Colombia.
Biomedica. 2022 May 1;42(Sp. 1):154-171. doi: 10.7705/biomedica.5957.
Introduction: Colorectal cancer has a high incidence in the world population. Different molecular pathways, such as chromosomal instability, microsatellite instability, and epigenetics are involved in its development. Objective: To perform molecular characterization in 44 individuals with sporadic colorectal cancer. Materials and methods: We conducted mutation analyses of the APC, KRAS, TP53 y BRAF genes using Sanger sequencing techniques; microsatellite instability was determined by capillary electrophoresis with five STR genetic markers while the methylation status of the MHL1 promotor gene was analyzed using methylation-specific PCR. Results: APC, KRAS, and TP53 genes mutation frequency was 18.1%, 25%, and 4.5%, respectively; the somatic mutations detected were located more frequently in the right colon. The frequency of microsatellite instability was 27.2% and 73.1% of the tumors had the MHL1 gene methylated while 91.6% of microsatellite instability-positive tumors had the methylated MLH1 gene. The mutation profile of microsatellite stability tumors APC, KRAS, and TP53 genes was more frequent than in the microsatellite instability-positive tumors. The methylation of the MLH1 gene was the most predominant molecular alteration. Conclusions: We identified molecular alterations in different genetic pathways of the colorectal cancer patients evaluated, which are common in the carcinogenesis of this cancer. These patients showed a different mutational profile compared to other populations. Our findings confirm the molecular heterogeneity described in the development of colorectal cancer.
结直肠癌在世界人群中发病率较高。不同的分子途径,如染色体不稳定性、微卫星不稳定性和表观遗传学,参与了结直肠癌的发生发展。
对 44 例散发性结直肠癌患者进行分子特征分析。
采用 Sanger 测序技术对 APC、KRAS、TP53 和 BRAF 基因进行突变分析;采用毛细管电泳法和 5 个 STR 遗传标记物检测微卫星不稳定性,采用甲基化特异性 PCR 分析 MHL1 启动子基因的甲基化状态。
APC、KRAS 和 TP53 基因突变频率分别为 18.1%、25%和 4.5%;检测到的体细胞突变更频繁地位于右结肠。微卫星不稳定性的频率为 27.2%,73.1%的肿瘤存在 MHL1 基因甲基化,91.6%的微卫星不稳定性阳性肿瘤存在 MLH1 基因甲基化。微卫星稳定肿瘤 APC、KRAS 和 TP53 基因突变谱比微卫星不稳定阳性肿瘤更频繁。MLH1 基因的甲基化是最主要的分子改变。
我们在评估的结直肠癌患者的不同遗传途径中发现了分子改变,这些改变在这种癌症的发生发展中很常见。与其他人群相比,这些患者显示出不同的突变特征。我们的发现证实了结直肠癌发展过程中描述的分子异质性。