Cancer Causes & Control

, Volume 23, Issue 9, pp 1549–1555 | Cite as

DNA methyltransferase 3b (DNMT3b), tumor tissue DNA methylation, Gleason score, and prostate cancer mortality: investigating causal relationships

  • Anna Gillio-TosEmail author
  • Valentina Fiano
  • Daniela Zugna
  • Loredana Vizzini
  • Neil Pearce
  • Luisa Delsedime
  • Franco Merletti
  • Lorenzo Richiardi
Original paper



Aberrant DNA methylation plays a role in prostate cancer progression. We studied the relationships among DNA methyltransferase (DNMT) genotype, DNA methylation, Gleason score, and mortality in two cohorts of prostate cancer patients, previously reported with associations between DNA methylation in GSTP1, APC, and RUNX3 and prostate cancer mortality. Herein, we considered possible causal relationships between the studied variables, assuming that (1) DNMT activity affects tumor tissue methylation, (2) methylation status affects tumor morphology, and thus the Gleason score, and (3) DNA methylation affects mortality via Gleason score.


The cohorts comprised 438 patients diagnosed at one Italian pathology ward before 1997, with DNA obtained from paraffin-embedded tumor tissues. The polymorphism rs406193 in the DNMT3b gene was assessed by allele discrimination in real-time PCR. According to the assumed causal model, we analyzed the effects of rs406193 (T carriers vs others) on the Gleason score without adjusting for gene methylation, and the effects of rs406193 on gene methylation and prostate cancer mortality without adjusting for Gleason score.


We found no evidence of association between T carriers and the number of methylated genes. However, T carriers had reduced risk of a Gleason score 8+ (odds ratio = 0.57, 95 % CI 0.39–0.85), and a hazard ratio of 0.81 (0.61–1.09) of dying from prostate cancer, which would have been erroneously estimated of 0.93 if adjusted for Gleason score.


These findings provide clues on the role of a DNMT3b SNP in prostate cancer progression and illustrate the importance of considering possible causal relationships in the analyses.


DNA methylation DNA methyltransferase 3b Prostate cancer Gleason score Mortality Causal relationship 



The study was supported by the Italian Association for Research on Cancer (AIRC), the Compagnia San Paolo/Firms and the Piedmont Region. The research leading to these results has also received funding from the EU 7th Framework Programme under grant agreement number 247642, GEoCoDE. The work of Loredana Vizzini was partially supported by the Master in Epidemiology, University of Turin and Compagnia di San Paolo. The Centre for Public Health Research is supported by a Programme Grant from the Health Research Council of New Zealand.

Conflict of interest

No potential conflict of interest was disclosed.


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Anna Gillio-Tos
    • 1
    Email author
  • Valentina Fiano
    • 1
  • Daniela Zugna
    • 1
  • Loredana Vizzini
    • 1
  • Neil Pearce
    • 3
    • 4
  • Luisa Delsedime
    • 2
  • Franco Merletti
    • 1
    • 3
  • Lorenzo Richiardi
    • 1
    • 3
  1. 1.Cancer Epidemiology Unit, CERMS and CPO-PiemonteUniversity of TurinTurinItaly
  2. 2.Department of PathologyMolinette HospitalTurinItaly
  3. 3.Centre for Public Health ResearchMassey UniversityWellingtonNew Zealand
  4. 4.Faculty of Epidemiology and Public HealthLondon School of Hygiene and Tropical MedicineLondonUK

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