APC hypermethylation for early diagnosis of colorectal cancer: a meta-analysis and literature review

Tie-Jun Liang, Hong-Xu Wang, Yan-Yan Zheng, Ying-Qing Cao, Xiaoyu Wu, Xin Zhou and Shu-Xiao Dong _

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Oncotarget. 2017; 8:46468-46479. https://doi.org/10.18632/oncotarget.17576

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Tie-Jun Liang1, Hong-Xu Wang2, Yan-Yan Zheng3, Ying-Qing Cao4, Xiaoyu Wu5, Xin Zhou6 and Shu-Xiao Dong7

1Department of Digestive Disease, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

2Department of General Surgery, Jiyang People’s Hospital, Jiyang, Shandong, China

3Department of Medical Imaging, Jiyang People’s Hospital, Jiyang, Shandong, China

4Department of Anus & Intestine Surgery, Taian City Central Hospital, Taian, Shandong, China

5Department of Surgical Oncology, The Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

6Department of General Surgery, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

7Department of Gastrointestinal Surgery, Linyi People’s Hospital, Linyi, Shandong, China

Correspondence to:

Shu-Xiao Dong, email: [email protected]

Keywords: adenomatous polyposis coli, APC, methylation, biomarker, adenoma

Received: September 12, 2016    Accepted: April 02, 2017    Published: May 02, 2017


Adenomatous polyposis coli (APC) promoter hypermethylation has been frequently observed in colorectal cancer (CRC). The association between APC promoter methylation and clinicopathological significance in CRC is under investigation. We performed a meta-analysis to quantitatively evaluate the significance of APC methylation in CRC. The study included a total of 24 articles and 2025 CRC patients. The frequency of APC promoter hypermethylation was significantly higher in colorectal adenoma than in normal colorectal tissue, OR was 5.76, 95% CI, 2.45-13.56; p<0.0001, I2=0%. APC promoter more frequently hypermethylated in CRC stage I compared to normal colorectal tissue, OR was 13.42, 95% CI, 3.66-49.20; p<0.0001, I2=31%. The risk of incidence of CRC was significantly correlated to APC promoter hypermethylation, pooled OR was 9.80, 95%CI, 6.07-15.81; p<0.00001, I2=43%. APC methylation was not associated with grade, stage of CRC as well as tumor location, patients’ gender, and smoking behavior. The results indicate that APC promoter hypermethylation is an early event in carcinogenesis of CRC, could be a valuable diagnostic marker for early-stage CRC. APC methylation is not significantly associated with overall survival in patients with CRC. APC is a potential drug target for development of personalized treatment.

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