International Journal of Colorectal Disease

, Volume 22, Issue 5, pp 483–489

Role of MTHFR polymorphisms and folate levels in different phenotypes of sporadic colorectal cancers

  • Shih-Ching Chang
  • Pei-Ching Lin
  • Jen-Kou Lin
  • Shung-Haur Yang
  • Huann-Sheng Wang
  • Anna Fen-Yau Li
Original Article

DOI: 10.1007/s00384-006-0190-x

Cite this article as:
Chang, SC., Lin, PC., Lin, JK. et al. Int J Colorectal Dis (2007) 22: 483. doi:10.1007/s00384-006-0190-x


Background and aims

By altering both DNA methylation and nucleotide synthesis, folate metabolism is thought to contribute to colorectal carcinogenesis. We examined the role of folate metabolism in three different phenotypes of sporadic colorectal cancers (CRCs), phenotypes that were classified by the status of microsatellite instability (MSI) and chromosomal instability (CIN): MSI-H, microsatellite stability (MSS)/aneuploidy, and MSS/diploid.

Patients and methods

A total of 195 sporadic colorectal tumors and another 195 age- and gender-matched healthy volunteers in Taipei-Veteran General Hospital and Taipei City Hospital were collected. We analyzed for MTHFR (methylenetetrahydrofolate reductase) polymorphisms (C677T, A1297C), folate, and vitamin B12 levels. We determined MSI status and DNA ploidy with fluorescent polymerase chain reaction and flow cytometry. Relations between clinicopathological variables and molecular variables were analyzed by χ2 tests (with Yates’ correction) for categorical variables and Student’s t test for numerical variables.


Folate levels (5.02±4.43 ng/ml) were significantly lower in cancer patients than in controls (7.22±4.46 ng/ml). Vitamin B12 level was similar between cancer patients and controls. The frequency of the TT genotype of MTHFR C627T (12.3%) was slightly higher than controls (8.2%), but it did not reach statistical significance (p=0.174). Within the low-folate group (<5 ng/ml), the frequency of the TT genotype in cancer patients (14.4%) was significantly higher than in controls (4.6%). Sixteen patients who had MSI-H CRC (8.2%) had a significantly higher frequency of TT MTHFR (37.5%) and lower folate levels (3.56±2.41 ng/ml) than patients with MSS tumors (10.1%, 5.14±3.72 ng/ml). Patients with MSS/aneuploid tumors had significantly lower folate levels (4.50±3.06 ng/ml) than those with MSS/diploid tumors (6.69±4.73 ng/ml).


Folate deficiency and the MTHFR genetic polymorphism play an important role in colorectal carcinogenesis, including MSI and CI.


Folate metabolism plays an important role in colorectal carcinogenesis. We demonstrate that patients with MSI-H tumors had higher frequency of TT MTHFR C627T (37.5%), and patients with MSS/aneuploid tumor had lower folate level (4.50±3.06 ng/ml).


MTHFRFolateMicrosatellite instabilityChromosomal instabilityColorectal cancer



carcinoembryonic antigen


chromosomal instability


colorectal cancer


hereditary nonpolyposis colorectal cancer


high microsatellite instability


microsatellite stability


methylenetetrahydrofolate reductase

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Shih-Ching Chang
    • 1
  • Pei-Ching Lin
    • 2
  • Jen-Kou Lin
    • 1
  • Shung-Haur Yang
    • 1
  • Huann-Sheng Wang
    • 1
  • Anna Fen-Yau Li
    • 3
  1. 1.Department of Surgery, Division of Colon & Rectal Surgery, Taipei Veterans General HospitalNational Yang-Ming UniversityTaipeiTaiwan
  2. 2.Department of Clinical Pathology, Ren-Ai BranchTaipei City HospitalTaipeiTaiwan
  3. 3.Department of Pathology, Taipei Veterans General HospitalNational Yang-Ming UniversityTaipeiTaiwan