Chromosomal instability (CIN) phenotype, CIN high or CIN low, predicts survival for colorectal cancer

J Clin Oncol. 2012 Jun 20;30(18):2256-64. doi: 10.1200/JCO.2011.38.6490. Epub 2012 Apr 30.


Purpose: To examine whether chromosomal instability (CIN) phenotype, determined by the severity of CIN, can predict survival for stages II and III colorectal cancer (CRC).

Patients and methods: We determined microsatellite instability (MSI) and loss of heterozygosity (LOH) status in 1,103 patients (training [n = 845] and validation [n = 258] sets with stages II and III CRC). The LOH ratio was defined as the frequency of LOH in chromosomes 2p, 5q, 17p, and 18q. According to the LOH ratio, non-MSI high tumors were classified as CIN high (LOH ratio ≥ 33%) or CIN low (LOH ratio < 33%). CIN-high tumors were subclassified as CIN high (mild type; LOH ratio < 75%) or CIN high (severe type; LOH ratio ≥ 75%). We used microarrays to identify a gene signature that could classify the CIN phenotype and evaluated its ability to predict prognosis.

Results: CIN high showed the worst survival (P < .001), whereas there was no significant difference between CIN low and MSI high. CIN high (severe type) showed poorer survival than CIN high (mild type; P < .001). Multivariate analysis revealed that CIN phenotype was an independent risk factor for disease-free and overall survival, respectively, in both the training (P < .001 and P = .0155) and validation sets (P < .001 and P = .0076). Microarray analysis also revealed that survival was significantly poorer in those with the CIN-high than in the CIN-low gene signature (P = .0203). In a validation of 290 independent CRCs (GSE14333), the CIN-high gene signature showed significantly poorer survival than the CIN-low signature (P = .0047).

Conclusion: The CIN phenotype is a predictive marker for survival and may be used to select high-risk patients with stages II and III CRC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chromosomal Instability*
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / mortality*
  • Female
  • Humans
  • Loss of Heterozygosity
  • Male
  • Microsatellite Instability
  • Molecular Sequence Data
  • Phenotype
  • Prognosis

Associated data

  • GENBANK/GSE14333