Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 2006 Jul 6;44(1):75–80. doi: 10.1136/jmg.2006.042572

Tumour selection advantage of non‐dominant negative P53 mutations in homozygotic MDM2‐SNP309 colorectal cancer cells

Hafid Alazzouzi 1,2,3,4,5,6,7,8, Gianpaolo Suriano 1,2,3,4,5,6,7,8, Angel Guerra 1,2,3,4,5,6,7,8, Alberto Plaja 1,2,3,4,5,6,7,8, Eloi Espín 1,2,3,4,5,6,7,8, Manel Armengol 1,2,3,4,5,6,7,8, Pia Alhopuro 1,2,3,4,5,6,7,8, Sergia Velho 1,2,3,4,5,6,7,8, Yasuhisa Shinomura 1,2,3,4,5,6,7,8, Juan José González‐Aguilera 1,2,3,4,5,6,7,8, Hiroyuki Yamamoto 1,2,3,4,5,6,7,8, Lauri A Aaltonen 1,2,3,4,5,6,7,8, Víctor Moreno 1,2,3,4,5,6,7,8, Gabriel Capellà 1,2,3,4,5,6,7,8, Miguel Angel Peinado 1,2,3,4,5,6,7,8, Raquel Seruca 1,2,3,4,5,6,7,8, Diego Arango 1,2,3,4,5,6,7,8, Simó Schwartz Jr
PMCID: PMC2597912  PMID: 16825434

Abstract

Background

Mdm2 is a natural inhibitor of p53 function and its overexpression impairs p53 transcriptional activity. T→G single‐nucleotide polymorphism at position 309 (SNP309) of mdm2 induces overexpression of mdm2, but inhibits p53.

Objectives

To determine whether SNP309 is a risk‐modifier polymorphism in colorectal cancer (CRC) and whether tumour selection of P53 mutations are influenced by SNP309.

Methods

Single‐stranded conformation polymorphism and automatic sequencing were performed.

Results

SNP309 is not associated with the risk of CRC or recurrence of tumours. These data do not over‐ride the tumour‐selection capabilities of P53 mutations in CRC. However, a significant association with non‐dominant‐negative P53 mutations (p = 0.02) was found.

Conclusions

MDM2‐SNP309 favours tumour selection of non‐dominant negative P53 mutations in CRC, which also show an earlier age of tumour onset.


Impairment of p53 function is a common feature in cancer cells and has been strongly associated with progression of cancer.1,2,3 The transcriptional activity of p53 in response to DNA damage or cellular stress can lead to cell cycle arrest in normal cells, and to the activation of apoptotic and repair pathways.1,4 As cell death or survival depends largely on the balance between apoptosis and repair, changes in p53 have become a central paradigm of tumorigenesis. Under normal homoeostatic conditions, cells show no p53‐dependent transcriptional activity,5 largely owing to the inhibitory effects of mdm2, a natural inhibitor of p53 that binds and targets p53 for ubiquitination and degradation.4,5,6 Under conditions of stress, however, p53 levels increase and several downstream targets are trancriptionally activated.5 In most tumours, inhibition of the p53 pathway is achieved by P53 mutations or through the overexpression of mdm2.3,7,8

Approximately half of the colorectal cancers (CRCs) harbour mutations in P53, and overexpression of mdm2 can be found in one third of them, suggesting that the great majority of CRCs have a dysfunctional p53 pathway.2,3,9 Further, it has been suggested that mdm2 might have a role in progression of colon cancer through both p53‐dependent and p53‐independent mechanisms, and a p53‐independent role of mdm2 in mice tumorigenesis has also been reported.10,11

A T→G single‐nucleotide polymorphism at position 309 (SNP309) of the promoter region of MDM2 extends the length of an existing DNA binding site for the Sp1 transcription factor. This increases the affinity of Sp1 for the MDM2 promoter and causes overexpression of mdm2. Accordingly, cells homozygotic for the SNP309 (GG) show the highest expression of mdm2 , whereas heterozygotic TG cells show intermediate levels of overexpression compared with the TT genotype.12 In agreement with this, SNP309 has been shown to strongly diminish the activity of the p53 pathway.13

Recently, SNP309 was shown to be associated with development of tumours in patients with Li–Fraumeni syndrome, who have germline P53 mutations. Interestingly, people with Li–Fraumeni syndrome with SNP309 with either homozygotic (GG) or heterozygotic (GT) status show early age of onset for several tumour types, suggesting that SNP309 is a potential cancer risk‐modifier polymorphism.12 Also, sporadic soft‐tissue sarcomas from a selected cohort of patients show early age of tumour onset, suggesting that SNP309 does not require inactivating germline p53 mutations to increase susceptibility to cancer.12

However, the tumorigenic potential of MDM2‐SNP309 in CRC (as well as in uterine leiomyosarcomas and squamous cell carcinoma of the head and neck) has been recently challenged,14,15 questioning whether the incidence of SNP309 might contribute to risk of CRC and also whether SNP309 can modulate the positive selection exerted by P53 mutations in tumour cells. In this study, we further investigate the possible contribution of MDM2‐SNP309 to CRC using a series of 295 tumours. Moreover, to gain further insight into the apparent contradictory data in the literature, we studied the possible role of MDM2‐SNP309 in CRC depending on P53 mutations.

Materials and methods

Tumours were obtained from the University Hospital Vall d'Hebron (Barcelona, Spain), the Catalan Institute of Oncology (Barcelona), the Sapporo Medical University (Sapporo, Japan), the Hospital of S Joao (Porto, Portugal) and also from several different hospitals in Finland. Accordingly, 61 tumours were obtained from Japan, 34 from Finland, 48 from Portugal and 152 from Spain. Control samples from healthy people >65 years of age and with no evidence of neoplastic diseases were also collected from the University Hospital Vall d'Hebron. Samples were collected in accordance with previously established ethical protocols from each one of the participating institutions, and the respective ethics committees approved the study. Genomic DNA was extracted with phenol–chloroform according to standard procedures. All tumours were analysed for the presence of microsatellite instability according to international criteria, using various panels of dinucleotide and mononucleotide repeat sequences as described previously.16 Only tumours negative for microsatellite instability were included in this study. A total of 295 tumours and 184 controls were analysed for the MDM2 fragment encompassing nucleotide 309 by means of polymerase chain reaction single‐stranded conformation polymorphism (PCR‐SSCP) and sequencing. Primer sequences were 5′‐CGG GAG TTC AGG GTA AAG GT‐3′ and 5′‐TCG GAA CGT GTC TGA ACT TG‐3′. Genomic DNA (25–100 ng) was amplified by PCR with the addition of [α‐32P] dCTP using the following cycling conditions: 30 s at 94°C, 30 s at 60°C and 45 s at 72°C for 35 cycles. PCR products were diluted with denaturing buffer (formamide with 0.025% xylene cyanol and 0.025% bromophenol blue) and heated up to 95°C for 5 min before loading on to 0.8× mutation detection enhancement gels (Flowgen, Rockland, Maine, USA). Samples were run for 12–18 h and gels exposed to autoradiography. SSCP patterns for each genotype (TT, TG and GG) of SNP309 were previously characterised by sequencing analysis of representative cases on an ABI Prism 377 Automatic sequencer (Perkin‐Elmer, Foster City, California, USA) using the ABI Prism Dye Terminator Cycle Sequencing Kit (Perkin‐Elmer). The statuses of SNP309 in 40 of the analysed samples were previously reported.14 Clinical follow‐up of 5 years on average was available for 202 of the patients with CRC in this study. Data on P53 mutations were already available in 260 cases. The relationship between the SNP309 genotype and the risk of CRC and P53 mutations was assessed by odds ratio (OR) with 95% confidence interval (CI) limits. Significance (p<0.05) was assessed by the two‐sided Fisher's exact test or the t test when adequate.

Results and discussion

Does MDM2‐SNP309 predispose to CRC?

A total of 336 sporadic colorectal tumours and control samples from lymphocytes of healthy people >65 years of age from Spain were analysed for the SNP309. Genotypes TT, TG and GG were detected in 53%, 34% and 13% of control samples (n = 184) and in 44%, 45% and 11%, respectively, of colorectal tumours (n = 152; table 1). No association of the GG SNP309 with higher risk of CRC was detected (OR 1.04, 95% CI 0.52 to 2.08; p = 0.94), nor were differences found with heterozygotic and TT genotypes, suggesting that SNP309 is not a risk factor for sporadic colon cancer (table 1). Also no association was detected when considering tumours from Caucasian patients (Spanish and Portuguese; n = 200; not shown). Further, similar distributions of the T and G alleles were detected in tumours from Japan (n = 61) and Finland (n = 34).

Table 1MDM2‐single‐nucleotide polymorphism at position 309 and risk of cancer in colorectal tumours from Spanish patients.

Genotype Controls (n = 184) CRC (n = 152) OR 95% CI p Value
TT 97 66 1.0
TG 63 69 1.61 1.01 to 2.55 0.06
GG 24 17 1.04 0.52 to 2.08 0.94
TG/GG 87 86 1.45 0.94 to 2.23 0.11

The total number of tumours analysed is indicated in parentheses.

CRC, colorectal cancer.

Nonetheless, Bond et al12 found, in people with Li–Fraumeni syndrome with monoallelic P53 germline mutations and in sporadic soft‐tissue sarcomas, that tumours from patients with the homozygotic GG genotype had early ages of tumour onset and higher frequencies of second tumours, suggesting that SNP309 might accelerate tumour progression and recurrence of tumours. An association of the GG genotype with early age of tumour onset has also been reported recently in CRCs with wild‐type P53 in a series of 153 patients.17 In our Caucasian series, however, we found no differences among MDM2‐SNP309 genotypes when the age of tumour onset was considered (p = 0.74). Also, we further studied whether SNP309 might be associated with recurrence of tumours and advanced stage of progression. For this purpose, we gathered a total of 261 CRC tumours from different origins as described previously. Risk assessment for early recurrence of tumours (<2 years from surgical retrieval of the tumours) and local versus metastatic disease (ie Dukes A/B v C/D stages) yielded an overall risk of recurrence of the G allele of 0.78 (95% CI 0.43 to 1.43; p = 0.44) and OR of 0.89 (95% CI 0.54 to 1.47; p = 0.75) for an advanced stage (table 2). No associations were detected when considering only the Caucasian series (not shown).

Table 2MDM2‐single‐nucleotide polymorphism at position 309, P53 mutations and clinicopathological features in colorectal tumours.

Stage Dukes A/B (n = 108) Dukes C/D (n = 153) OR 95% CI p Value
TT 45 68 1.0
TG 51 66 0.85 0.50 to 1.45 0.59
GG 12 19 1.04 0.46 to 2.36 0.83
TT/GG 63 85 0.89 0.54–1.47 0.75
Early recurrence Dukes B/C No (n = 114) Yes (n = 50) OR 95% CI p Value
  TT 46 25 1.0
  TG 56 21 0.69 0.34 to 1.38 0.29
  GG 12 4 0.61 0.17 to 2.10 0.38
  TG/GG 68 25 0.67 0.34 to 1.32 0.23
 Dukes C (n = 56) (n = 35)
  TT 23 17 1.0
  TG 26 15 0.78 0.32 to 1.90 0.65
  GG 7 3 0.58 0.72 0.13 to 2.57
  TG/GG 33 18 0.74 0.31 to 1.73 0.52
P53 mutations Negative (n = 126) Positive (n = 134) OR 95% CI p Value
 TT 56 62 1.0
 TG 59 56 0.85 0.51 to 1.43 0.60
 GG 11 16 1.31 0.56 to 3.07 0.67
 TG/GG 70 72 0.93 0.57 to 1.51 0.80
P53 mutations D‐neg (n = 50) Non‐D‐neg (n = 30) OR 95% CI p Value
 TT 27 13 1.0
 TG 21 10 0.99 0.36 to 2.69 0.79
 GG 2 7 7.26 1.32 to 39.9 0.02*
 TG/GG 23 17 1.53 0.61 to 3.82 0.48

The total number of tumours analysed is indicated in parentheses.

*Significance was achieved.

CRC, colorectal cancer; D‐neg, tumours with dominant negative P53 mutations; Non‐D‐neg, tumours with non‐dominant‐negative P53 mutations.

These results are in good agreement with a previous report showing that SNP309 made no significant contribution to formation of tumours.14 Even though additional research is needed to investigate whether these observations also extend to other tumour types, SNP309, which has been shown to result in higher mdm2 levels and activity and can be found in approximately 13% of the population, does not seem to increase the risk of developing CRC.

Does SNP309 over‐ride the selective advantage imposed by P53 mutations in colorectal tumours?

Although we found no association between SNP309 and risk and progression of CRC, we investigated the possibility that SNP309 could modulate the selective advantage imposed by P53 mutations in colorectal tumours. We analysed the distribution of the SNP309 genotypes in 260 colon tumours with and without P53 mutations.

Genotypes TT, TG and GG were detected in 46%, 42% and 12% of tumours with P53 mutations (n = 134) and in 44%, 47% and 9%, respectively, of colorectal tumours with wild‐type P53 (n = 126). No differences were detected regarding the mutational status of P53, and a similar distribution of the SNP309 genotypes was found (p = 0.42). The OR for the GG genotype in the P53 mutation group was 1.31 (95% CI 0.56 to 3.07; p = 0.67). We also studied whether tumours with or without P53 mutations showed different ages of tumour onset regarding the SNP309 genotype. However, we found no differences (p = 0.75). Accordingly, our data show no evidence that SNP309 increases the susceptibility to colon cancer or alters the selection advantage of P53 mutations in colorectal tumour cells.

Does SNP309 favour the selection advantage of non‐dominant negative P53 mutations in colorectal tumours?

People with Li–Fraumeni syndrome inherit a mutated allele of P53. These people develop tumours significantly earlier if they have the G allele of SNP309 compared with patients with the TT allele. This is consistent with the idea that in these patients the G allele would result in hyperactive mdm2 and reduced p53 activity. Nonetheless, in about half of the colorectal tumours from people with Li–Fraumeni syndrome, a second hit (mainly by loss of heterozygocity (LOH)) is required to achieve inhibition of the p53 pathway and tumour selection advantage.18 Therefore, it is unlikely that SNP309 inactivates the p53 pathway as an underlying P53 hit in these tumours, but instead might modulate tumour cell selection, together with P53 mutations and LOH as a second hit. As stated earlier, we found no association of SNP309 with P53 mutation status in our tumour series. However, as P53 mutations show either dominant‐negative or non‐dominant‐negative activity over the wild‐type allele, we challenged the hypothesis that SNP309 could be a modulator of the selection‐advantage capabilities of specific P53 mutations. In this scenario, the incidence of non‐dominant‐negative mutations might be higher in colorectal tumours with a GG background, as this could downregulate the activity of the p53 pathway to levels that confer on tumour cells with P53 mutations a growth advantage, even though complete inactivation of the p53 pathway might not be achieved until LOH of the wild‐type P53 allele occurs as a second hit.

In our series, the dominant‐negative activity of P53 mutations could be assigned to 80 of the analysed tumours according to experimental data retrieved from the P53 Mutation Database of the International Agency for Research on Cancer (http://www‐p53.iarc.fr/; table 3). Tumours were separated into two groups with dominant‐negative (n = 50) and non‐dominant‐negative (n = 30) mutations.

Table 3 Dominant‐negative activity of P53 mutations in the tumours.

Tumour Patient age (years) Dukes stage Recurrence* P53 status 309 D‐neg activity† AA change
17 65 B NA Mut G Negative Arg282Trp
113 73 B 1 Mut T Negative Arg282Trp
130 75 B 0 Mut T Negative Arg231Stop
142 91 B 0 Mut T Negative Arg231Stop
300 73 B 0 Mut T Negative Arg282Trp
109 43 B 0 Mut TG Negative Gly266Val
14 70 B NA Mut TG Negative Arg196Stop
15 58 B NA Mut TG Negative Arg213Stop
38 58 B 0 Mut TG Negative Gly266Arg
127 31 C 0 Mut G Negative Gly266Arg
595 58 C 0 Mut G Negative Cys275Tyr
63 74 C 0 Mut T Negative Pro152Leu
190 58 C 0 Mut T Negative Tyr220Cys
282 78 C 1 Mut T Negative Arg282Trp
323 65 C 0 Mut T Negative Arg158Cys
917 72 C 0 Mut T Negative Ile195Thr
123 70 C 1 Mut T Negative Gly266Val
238 72 C 0 Mut TG Negative Arg282Trp
269 81 C 0 Mut TG Negative rg282Trp
11880/01 62 C NA Mut TG Negative Gly266Arg
71 55 D 1 Mut G Negative Arg282Trp
304 65 D 0 Mut G Negative Arg282Trp
4560/02 90 D NA Mut G Negative Tyr220His
107 79 D 0 Mut T Negative Arg282Trp
121 77 D 0 Mut T Negative Arg158His
1013/03 65 D NA Mut T Negative Gly262Asp
132 54 D 0 Mut TG Negative Arg196Stop
28 57 D 1 Mut TG Negative Ser215Asn
452/02 56 NA NA Mut TG Negative Arg282Trp
939 64 C 0 Mut G Negative Arg282Trp
20 76 A NA Mut T Positive Arg175His
25 54 A 0 Mut TG Positive Arg175His
27 62 A 0 Mut TG Positive Arg248Gln
31 65 A 0 Mut TG Positive Gly245Asp
138 80 B 0 Mut T Positive Gly245Asp
145 73 B 0 Mut T Positive Arg175His
12 78 B NA Mut T Positive Arg175His
18 68 B NA Mut T Positive Arg175His
19 86 B NA Mut T Positive Arg175His
39 79 B 1 Mut T Positive Arg273Cys
40 60 B 1 Mut T Positive Arg248Gln
3 76 B 0 Mut TG Positive Arg248Trp
52 70 B 0 Mut TG Positive Arg273His
75 77 B 1 Mut TG Positive Pro250Leu
151 79 B 1 Mut TG Positive Gly245Asp
239 74 B 0 Mut TG Positive Arg273Cys
29 65 B 0 Mut TG Positive Arg248Trp
16 70 C 0 Mut T Positive Asp184Tyr
26 64 C 0 Mut T Positive Ser241Thr
72 73 C 1 Mut T Positive Gly245Asp
139 49 C 1 Mut T Positive Arg175His
226 55 C 0 Mut T Positive Arg273Cys
13 59 C NA Mut T Positive Arg175His
23 69 C 0 Mut T Positive Arg248Glu
17 31 C 0 Mut TG Positive Arg248Trp
104 61 C 1 Mut TG Positive Lys132Asn
164 57 C 0 Mut TG Positive Arg273Cys
165 76 C 1 Mut TG Positive Arg248Trp
11 45 C NA Mut TG Positive Arg175His
37 75 C 0 Mut TG Positive Arg273Cys
664 72 C 1 Mut TG Positive Arg273His
931 63 C 1 Mut TG Positive Gly245Ser
981 56 C 1 Mut TG Positive Arg273His
199 84 D 0 Mut G Positive Arg175His
41 61 D NA Mut G Positive Arg175His
101 48 D 1 Mut T Positive Arg175His
986/03 68 D NA Mut T Positive Gly245Ser
4561/02 NA D NA Mut T Positive Arg248Trp
989/03 46 D NA Mut TG Positive Arg273Leu
920/03 80 NA NA Mut T Positive Cys117Arg
929/03 73 NA NA Mut T Positive Gly245Ser
454/02 70 NA NA Mut T Positive Arg175His
938/03 67 NA NA Mut TG Positive Cys176Phe
5574/01 80 NA NA Mut TG Positive Arg175His
24 89 B NA Mut T Positive Arg273His
23B 67 C 1 Mut T Positive Gly245Asp
26 64 C 1 Mut T Positive Arg248Gln
33 79 C 0 Mut T Positive Arg175His
35 61 C 1 Mut T Positive Arg248Gln
22 76 D 1 Mut T Positive Arg175His

*Early recurrence (<2 years from intervention) is indicated as positive (1) or negative (0).

†Dominant‐negative activity for the P53 mutation is indicated (experimental data available at the International Agency for Research on Cancer‐P53 Mutation Database http://www‐p53.iarc.fr/).

Mut, mutation; NA, not available.

We found a significant association between the GG genotype and the non‐dominant‐negative subgroup of tumours (OR 7.26, 95% CI 1.32 to 39.9, p = 0.021; table 2). Further, in the subset of tumours showing non‐dominant‐negative P53 mutations, tumours with the GG genotype have a significantly earlier age of onset compared with tumours with the TT genotype (mean 61.1 (SD 6.6) v 73.1 (2.2) years, respectively; p = 0.048). No significant differences regarding age of tumour onset, Dukes stage or recurrence were assessed between groups of tumours classified according to the dominant‐negative activity of P53 mutations, although a clear trend for early recurrence of dominant‐negative mutations was seen (p = 0.053; table 4). We therefore suggest that SNP309 might favour the selection of tumour cells with non‐dominant‐negative P53 mutations.

Table 4 Clinicopathological features of P53 mutations and dominant‐negative activity.

Dominant‐negative activity p Value
Positive Negative
Mean (SD) age in years 67.55 (11.73) 66.3 (12.70) 0.66
Stage 0.47
 Dukes A/B 18 9
 Dukes C/D 27 20
Recurrence 0.053
 Positive 16 5
 Negative 17 18

In agreement with this hypothesis, dominant‐negative P53 mutations might sufficiently downregulate the p53 pathway to confer tumour cell selection, independently of the SNP309 status. It is noteworthy, however, that dominant‐negative mutations are often not fully dominant, and therefore selection of tumour cells might also depend on the final modulation of the p53 pathway exerted by P53 mutations, LOH or the presence of GG SNP309. Indeed, although GG SNP309 associates with non‐dominant‐negative P53 mutations, some cases with dominant‐negative mutations also showed GG SNP309. Further, LOH of P53 was also detected in some of the analysed tumours, independently of the SNP309 genotype and the dominant‐negative activity of P53 mutations (not shown). Nonetheless, dominant‐negative P53 mutations occur with the same frequency in people with the TT, TG or GG SNP309 genotype. In this context, acquisition of a monoallelic non‐dominant‐negative P53 mutation in intestinal cells from people with a GG SNP309 would be sufficient to confer on these cells a growth advantage and favour progression of tumours. In this scenario, the presence of GG SNP309 might decrease the levels of p53, compromising the functionality of the p53 pathway and conferring advantage on the tumour cell. Whether this selection is motivated by SNP309 itself or due to a limited cellular response to oncogenic stress signals is still to be investigated. It is unlikely, however, that SNP309 is equivalent to a second hit as LOH. Most likely, non‐dominant‐negative P53 mutations in cells from people with a TT SNP309 would not confer enough selective advantage, and a second hit would be required in these people to promote tumour cell progression. This might explain the significantly younger age of tumour onset in patients with a GG genotype. These results, therefore, may help to explain the apparently contradictive data regarding SNP309 and cancer incidence, and also question whether data from previous p53‐association studies might need to be re‐evaluated according to the dominant‐negative activity of P53 mutations.

Key points

  • MDM2‐single‐nulceotide polymorphism at position 309 (SNP309) is not a risk‐modifier polymorphism of human colorectal cancer and therefore is not associated with the incidence of colon cancer.

  • MDM2‐SNP309 is not associated with dominant‐negative P53 mutations in colon tumours or with tumour recurrence.

  • MDM2‐SNP309, however, is associated with non‐dominant‐negative P53 mutations in a specific subset of tumours, which also show a significantly earlier age of tumour onset, suggesting that it might favour tumour selection of P53 mutations with non‐dominant‐negative activity.

Abbreviations

CRC - colorectal cancer

LOH - loss of heterozygosity

PCR - polymerase chain reaction

SNP309 - single‐nucleotide polymorphism at position 309

SSCP - single‐stranded conformation polymorphism

Footnotes

Funding: This work was supported by the Spanish Fondo de Investigaciones Sanitarias (grant numbers 01/1350, 01–0282 and 04–0236) and the Ministerio de Ciencia y Tecnología (grant number SAF2003/5821), Spain, grants‐in‐aid for scientific research from the Ministry of Education, Culture, Sports, Science and Technology of Japan and by grants‐in‐aid for cancer research from the Ministry of Health, Labor and Welfare of Japan. Publication costs were supported by the Departament d'Universitats, Recerca i Societat de la Informació from the Generalitat de Catalunya.

Competing interests: None.

References

  • 1.Bargonetti J, Manfredi J J. Multiple roles of the tumor suppressor p53. Curr Opin Oncol 20021486–91. [DOI] [PubMed] [Google Scholar]
  • 2.Grady W M, Markowitz S D. Genetic and epigenetic alterations in colon cancer. Annu Rev Genomics Hum Genet 20023101–128. [DOI] [PubMed] [Google Scholar]
  • 3.Tachibana M, Kawamata H, Fujimori T, Omotehara F, Horiuchi H, Ohkura Y, Igarashi S, Kotake K, Kubota K. Dysfunction of p53 pathway in human colorectal cancer: analysis of p53 gene mutation and the expression of p53‐associated factors p14ARF, p33ING1, p21WAF and MDM2. Int J Oncol 200425913–920. [PubMed] [Google Scholar]
  • 4.Moll U M, Petrenko O. The MDM2‐p53 interaction. Mol Cancer Res 200311001–1008. [PubMed] [Google Scholar]
  • 5.Freedman D A, Wu L, Levine A J. Functions of the MDM2 oncoprotein. Cell Mol Life Sci 19995596–107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Thut C J, Goodrich J A, Tjian R. Repression of p53‐mediated transcription by MDM2: a dual mechanism. Genes Dev 1997111974–1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Nigro J M, Baker S J, Preisinger A C, Jessup J M, Hostetter R, Cleary K, Bigner S H, Davidson N, Baylin S, Devilee P. Mutations in the p53 gene occur in diverse human tumour types. Nature 1989342705–708. [DOI] [PubMed] [Google Scholar]
  • 8.Onel K, Cordon‐Cardo C. MDM2 and prognosis. Mol Cancer Res 200421–8. [PubMed] [Google Scholar]
  • 9.Abdel‐Fattah G, Yoffe B, Krishnan B, Khaoustov V, Itani K. MDM2/p53 protein expression in the development of colorectal adenocarcinoma. J Gastrointest Surg 20004109–114. [DOI] [PubMed] [Google Scholar]
  • 10.Jones S N, Hancock A R, Vogel H, Donehower L A, Bradley A. Overexpression of Mdm2 in mice reveals a p53‐independent role for Mdm2 in tumorigenesis. Proc Natl Acad Sci USA 19989515608–15612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Wang H, Nan L, Yu D, Lindsey J R, Agrawal S, Zhang R. Anti‐tumor efficacy of a novel antisense anti‐MDM2 mixed‐backbone oligonucleotide in human colon cancer models: p53‐dependent and p53‐independent mechanisms. Mol Med 20028185–199. [PMC free article] [PubMed] [Google Scholar]
  • 12.Bond G L, Hu W, Bond E E, Robins H, Lutzker S G, Arva N C, Bargonetti J, Bartel F, Taubert H, Wuerl P, Onel K, Yip L, Hwang S, Strong L C, Lozano G, Levine A J. A single nucleotide polymorphism in the MDM2 promoter attenuates the p53 tumor suppressor pathway and accelerates tumor formation in humans. Cell 2004119591–602. [DOI] [PubMed] [Google Scholar]
  • 13.Arva N C, Gopen T R, Talbott K E, Campbell L E, Chicas A, White D E, Bond G L, Levine A J, Bargonetti J. A chromatin associated and transcriptionally inactive p53‐Mdm2 complex occurs in mdm2 SNP309 homozygous cells. J Biol Chem 200528026776–26787. [DOI] [PubMed] [Google Scholar]
  • 14.Alhopuro P, Ylisaukko‐oja S K, Koskinen W J, Bono P, Arola J, Järvinen H J, Mecklin J ‐ P, Atula T, Kontio R, Mäkitie A A, Suominen S, Leivo I, Vahteristo P, Aaltonen L M, Aaltonen L A. The MDM2 promoter polymorphism SNP309T>G and the risk of uterine leiomyosarcoma, colorectal cancer, and squamous cell carcinoma of the head and Neck. J Med Genet 200542694–698. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Sotamaa K, Liyanarachchi S, Mecklin J P, Järvinen H, Aaltonen L A, Peltomäki P, de la Chapelle A. p53 codon 72 and MDM2 SNP309 polymorphisms and age of colorectal cancer onset in Lynch syndrome. Clin Cancer Res 2005116840–6844. [DOI] [PubMed] [Google Scholar]
  • 16.Boland C R, Thibodeau S N, Hamilton S R, Sidransky D, Eshleman J R, Burt R W, Meltzer S J, Rodriguez‐Bigas M A, Fodde R, Ranzani G N, Srivastava S A. A National Cancer Institute workshop on microsatellite instability for cancer detection and familial predisposition: development of international criteria for the determination of microsatellite instability in colorectal cancer. Cancer Res 1998585248–5257. [PubMed] [Google Scholar]
  • 17.Menin C, Scaini M C, De Salvo G L, Biscuola M, Quaggio M, Esposito G, Belluco C, Montagna M, Agata S, D'Andrea E, Nitti D, Amadori A, Bertorelle R. Association between MDM2–SNP309 and age at colorectal cancer diagnosis according to p53 mutation status. J Natl Cancer Inst 200698285–288. [DOI] [PubMed] [Google Scholar]
  • 18.Varley J M, Thorncroft M, McGrown G, Appleby J, Kelsey A M, Tricker K J, Evans D G, Birch J M. A detailed study of loss of heterozygosity on chromosome 17 in tumours from Li‐Fraumeni patients carrying a mutation to the TP53 gene. Oncogene 199714865–871. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES