الفهرس 
The predictive value of epigenetic markers for chemosensitivity in Egyptian colorectal caner patients
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Abstract
Colorectal cancer (CRC) in Egypt is one of highly prevalent and deadly tumor type characterized by its early onset and its aggressive behavior. The pathogenesis of CRC is complex and affected by multiple factors: genetic, epigenetic and long standing inflammatory conditions. The aim of this work was to study impact of DNA methylation as well as inflammatory markers in the clinical outcome of CRC patients treated with FP based therapy. Three blood samples were collected from patients diagnosed with CRC before starting the FP therapy and after 3 and 6 months of the therapy. Global DNA methylation, methylation specific of TS, TP, DPD and COX2 genes as well as their mRNA expression were determined. At baseline CRC patients showed significant global hypomethylation and hypermethylation of TP and DPD, along with overexpression of DNMT3A, DNMT3B, TS, TP, COX2, IL6 and IL1B. A significant high median 5mC level was observed in CRC patients >45 years, good performing, right colon cancers, T2 tumors, and stage II. Both 5mC level and DNMT3B expression were significantly increased in patients with mucinous and high grade tumors. Significant high expression of TS gene was detected in patients with high CA19.9 level and high IL1Ý gene in rectal cancer. In addition, significant high expression of COX2 gene was seen in patients with unmethylated COX2 promoter and in patients {u2264} 45 years. FP therapy significantly decreased global DNA methylation markers (5mC level, 5mC %, DNMT3A and DNMT3B), while it did not change the methylation of promoter genes