BACKGROUND: Metastatic dissemination is the most frequent cause of death in patients with sporadic colorectal cancer (sCRC). It is believed that the metastatic process is related at least in part to a specific background of genetic alterations accumulated in cells from primary tumors, and the ability to detect such alterations is critical for the identification of patients with sCRC who are at risk of developing metastases. METHODS: The authors used high-resolution, 500-K single nucleotide polymorphism arrays to identify copy number alteration profiles present at diagnosis in primary tumors from patients with metastatic (n 5 23) versus nonmetastatic (n 5 26) sCRC. RESULTS: The results revealed a characteristic pattern of copy number alterations in metastatic sCRC tumors that involved losses of 23 regions at chromosomes 1p, 17p, and 18q, together with gains of 35 regions at chromosomes 7 and 13q. CONCLUSIONS: In line with expectations, the copy number profile investigated involved multiple genes that were associated previously with sCRC (ie, SMAD2) and=or the metastatic process (ie, podocalyxin-like [PODXL]), and it also was associated with a poorer outcome. Cancer 2014;120:1948-59. V C 2014 American Cancer Society.KEYWORDS: liver metastases, colorectal carcinoma, copy number change, single nucleotide polymorphism array.
INTRODUCTIONSporadic colorectal cancer (sCRC) is the second leading cause of death from cancer in the Western world. 1 Up to 50% of all patients with sCRC eventually will develop metastases, and their 5-year overall survival rate is approximately 50% to 60%. 2 Once metastases (ie, mostly liver metastasis) have occurred, a complete cure is unlikely, 2 and up to two-thirds of patients with sCRC who die have evidence of liver metastasis. 3 Accumulating evidence indicates that sCRC metastasis may emerge in the context of a specific genetic tumor background associated or not with other genetic alterations, further affecting cellular control of growth and proliferation. 4 The discovery of those specific genetic alterations that would contribute toward identifying patients who are at risk of harboring or developing metastases could contribute significantly to the development of new strategies for the diagnosis and management of the diseases.In recent years, multiple recurrent chromosomal abnormalities identified in primary tumors have been associated with metastatic CRC. 4,5 Among others, these include numerical gains of the long arm of chromosome 8 (8q), 13q, and 20q and losses of the short arm of chromosome 1 (1p), 8p, 17p, 18q, and 22q. In a recent study, we used interphase fluorescence in situ hybridization (iFISH) to further establish that 17p deletion (del[17p]) involving the 17p11.2 breakpoint region and del(22q) were highly prevalent cytogenetic alterations among patients with primary sCRC who had synchronous liver metastasis. 6 However, the identification of specific genes targeted by such chromosomal alterations has proven difficult, partially because of technical issues. In recent years, the ...