Abstract The development of colorectal cancer ( CRC ) is believed to follow series progress of pathological changes and with correspondent genetic changes of many genes. This includes intestinal epithelial crypts, aberrant focus, adenoma and carcinoma, each of that commonly involved genetic and proteomic alterations. And in genetic level, it usually includes mutations of APC, p53, K-ras and microsatellite instability. The somatic mutations of APC gene mostly occur in MCR ( Mutation Cluster Region ) in codon 1286-1513. The p53 mutations is dispersed in whole gene with 3 hot spots: codon 175, 248 273. K-ras codon 12 and 13 mutations is preferentially involved in polyps growth of CRC. And microsatellite instability is found in 15-25% CRC patients. We collect polyps and various stages CRC samples in Taiwan, and design 6 primer pairs of APC and p53 which is widely used in western countries to analyze mutations of the local CRC genetic changes. We also use two-dimensional electrophoresis and mass spectrometry to identify protein expression changes in CRC. We have found 30 proteins that exhibited either a significant decrease or increase between normal colon tissue and carcinoma, and 3 out of ( TSD1, TSD2, and TSD3 ) these were significantly associated with tumor progression. TSD3 is annotated by mass spectrometry and is identified to be a c1q-related protein. Though there are no report on the function of c1q-related protein, a NCBI virtual northern analysis shows its expression is varied in various cancer. On the other hand, there are only about 56 % genetic changes of APC and p53 during carcinogensis, which is much less than the 70-85 % mutational rate in western CRC patients. It indicates different genetic mutational pattern of CRC in Taiwan.

Familial adenomatous polyposis (FAP) is a condition caused by germline mutations in tumor suppressor gene APC, inherited in autosomal dominant manner. Patients with FAP develop hundreds to thousands of adenomatous colorectal polyps with extremely high risk of malignant reversal into adenocarcinoma of colon and/or rectum. The aim of this thesis is to re-analyze a cohort of highly suspected FAP probands from years 1993-2004 whose diagnosis previously failed to be confirmed by at that time commonly used methods of molecular diagnostics. Next generation sequencing on MiSeq and NextSeq platforms (Illumina®) was performed on 78 samples of probands' DNA, isolated from peripheral blood, using gene panel CZECANCA version 1.2 (Czech Cancer Panel for Clinical Application). The panel enables sequencing of exons and exon-intron junctions of 226 genes linked to hereditary cancer predispositions, newly also including the diagnostically important promoter 1B region of APC. Pathogenic variant in the APC gene was detected in 18 % of re-analyzed probands, 11 % of probands carry pathogenic variants in other genes associated with colorectal polyps. Additional 13 % of probands are carriers of a variants of unknown clinical significance. NGS gene panel CZECANCA enabled diagnosis confirmation or re-evaluation of 22 FAP...