Hypomethylation of the global genome, considered to be composed mainly of repetitive sequences, is consistently observed in cancers, and aberrant hypo-and hypermethylation of CpG islands (CGIs) in promoter regions are also observed. Since methylation alterations in unique promoter sequences and in other genomic regions have distinct consequences, we analyzed the relationship between the global hypomethylation and the hypomethylation of unique promoter CGIs using human gastric cancers. Seven of ten gastric cancer cell lines showed marked decreases in 5-methylcytosine content, which correlated with hypomethylation of the LINE1 repetitive sequence. Six of the seven cell lines showed hypomethylation in five or all of the six normally methylated CGIs in promoter regions of six genes, and this was associated with induction of aberrant expression. The remaining three cell lines without global hypomethylation showed promoter hypomethylation in one or none of the six CGIs. Frequent promoter hypomethylation, however, did not correlate with frequent promoter hypermethylation. In primary gastric cancers too, global hypomethylation was associated with hypomethylation of LINE1 repetitive sequence and promoter hypomethylation. Of 93 gastric cancers, 33 cancers with frequent promoter hypomethylation and 27 cancers with frequent promoter hypermethylation constituted different groups. These findings represent experimental evidence that frequent hypomethylation of normally methylated promoter CGIs is associated with global hypomethylation, and that these hypomethylations occur independently of frequent promoter CGI hypermethylation. (Cancer Sci 2004; 95: 58-64) berrant methylation of various genomic regions is present in cancers. Firstly, global hypomethylation, the decrease of 5-methylcytosine content in the genome, 1) is known to involve coding regions of genes 2) and repetitive sequences.3, 4) Based on the facts that 80% of CpG dinucleotides are present in repetitive sequences and they are mostly methylated, 5,6) global hypomethylation is considered to be mainly due to hypomethylation of repetitive sequences.Secondly, hypomethylation is also observed in normally methylated CpG islands (CGIs) in promoter regions, and it induces aberrant expression of their downstream genes if transcription factors are available in cancer cells. Known normally methylated CGIs are very limited, and include some cancer-testis antigen genes, such as the MAGE genes.7-9) Hypomethylation of promoter CGIs is considered to have little effect on the content of 5-methylcytosine in the genome, and is distinct from hypomethylation of the repetitive sequences in the sense that it has a direct function on gene expression. While global hypomethylation is observed in most cancers, 1, 10) aberrant MAGE gene expressions were reported to occur in a smaller proportion of cancer cases (ranging from 0% to 86%, but generally from 10% to 40%).11) Therefore, a distinct regulatory mechanism may function for normally methylated promoter CGIs, and their hypomethylation m...