Open Access Highly Accessed Research article

Tumor-specific usage of alternative transcription start sites in colorectal cancer identified by genome-wide exon array analysis

Kasper Thorsen1, Troels Schepeler1, Bodil Øster1, Mads H Rasmussen1, Søren Vang1, Kai Wang23, Kristian Q Hansen1, Philippe Lamy14, Jakob Skou Pedersen1, Asger Eller1, Francisco Mansilla1, Kirsti Laurila5, Carsten Wiuf4, Søren Laurberg6, Lars Dyrskjøt1, Torben F Ørntoft1 and Claus L Andersen1*

Author Affiliations

1 Department of Molecular Medicine, Aarhus University Hospital, Skejby, 8200 Aarhus N, Denmark

2 Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard University, Boston, MA 02115, USA

3 Department of Radiology, Harvard Medical School, Harvard University, Boston, MA 02115, USA

4 Bioinformatics Research Centre (BiRC), Aarhus University, 8000 Aarhus C, Denmark

5 Department of Signal Processing, Tampere University of Technology, P.O. Box 527, FI-33101 Tampere, Finland

6 Department of Surgery P, Aarhus University Hospital, THG, 8000 Aarhus C, Denmark

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BMC Genomics 2011, 12:505  doi:10.1186/1471-2164-12-505

Published: 14 October 2011



Approximately half of all human genes use alternative transcription start sites (TSSs) to control mRNA levels and broaden the transcriptional output in healthy tissues. Aberrant expression patterns promoting carcinogenesis, however, may arise from alternative promoter usage.


By profiling 108 colorectal samples using exon arrays, we identified nine genes (TCF12, OSBPL1A, TRAK1, ANK3, CHEK1, UGP2, LMO7, ACSL5, and SCIN) showing tumor-specific alternative TSS usage in both adenoma and cancer samples relative to normal mucosa. Analysis of independent exon array data sets corroborated these findings. Additionally, we confirmed the observed patterns for selected mRNAs using quantitative real-time reverse-transcription PCR. Interestingly, for some of the genes, the tumor-specific TSS usage was not restricted to colorectal cancer. A comprehensive survey of the nine genes in lung, bladder, liver, prostate, gastric, and brain cancer revealed significantly altered mRNA isoform ratios for CHEK1, OSBPL1A, and TCF12 in a subset of these cancer types.

To identify the mechanism responsible for the shift in alternative TSS usage, we antagonized the Wnt-signaling pathway in DLD1 and Ls174T colorectal cancer cell lines, which remarkably led to a shift in the preferred TSS for both OSBPL1A and TRAK1. This indicated a regulatory role of the Wnt pathway in selecting TSS, possibly also involving TP53 and SOX9, as their transcription binding sites were enriched in the promoters of the tumor preferred isoforms together with their mRNA levels being increased in tumor samples.

Finally, to evaluate the prognostic impact of the altered TSS usage, immunohistochemistry was used to show deregulation of the total protein levels of both TCF12 and OSBPL1A, corresponding to the mRNA levels observed. Furthermore, the level of nuclear TCF12 had a significant correlation to progression free survival in a cohort of 248 stage II colorectal cancer samples.


Alternative TSS usage in colorectal adenoma and cancer samples has been shown for nine genes, and OSBPL1A and TRAK1 were found to be regulated in vitro by Wnt signaling. TCF12 protein expression was upregulated in cancer samples and correlated with progression free survival.