Aims: Folate supplementation appears to reduce colorectal cancer (CRC) risk. CRC risk is
also modulated by the C to T polymorphism at position 677 of the methylenetetrahydrofolate
reductase (MTHFR) gene which results in a thermolabile variant of MTHFR and is associated
with reduced cellular folate levels. We looked for a relationship between MTHFR expression
in colorectal tumour tissue and the C677T polymorphism.
Methods: Thirty-nine patients with colorectal cancer who gave consent were studied. DNA was
extracted from citrated blood and tumour tissue and genotyped for the MTHFR C677T
polymorphism. Expression of MTHFR in colorectal tumour tissue and normal colonic mucosa
from the same patient was quantified by 'real-time' PCR. Hypothesis testing was performed
on ranks of the ratio of MTHFR expression to 18S. The analysis of variance model was
used to test whether interactions with genotype were significant.
Results: Overall expression of MTHFR was not significantly different in tumour tissue compared
to normal colonic mucosa (p=0.24). However, when genotype was taken into account,
a statistically significant reduction in MTHFR expression was observed in tumour versus
normal tissue from T-carriers (p=0.04) but no difference was observed in CC homozygotes.
73% of the eighteen T-carriers showed reduced expression of MTHFR in tumour tissue
compared to 33% of the twenty-one CC homozygotes.
Conclusions: Lowered MTHFR expression may contribute to colorectal tumorigenesis among carriers
of the T allele at position 677 of MTHFR. This finding suggests that the T carrier
subpopulation may benefit more from folate supplementation. The study also illustrates
the importance of considering genotypic covariates in the analysis of changes in gene
expression involved in carcinogenesis.