Abstract
BACKGROUND/OBJECTIVES: DNA methylation is a key epigenetic process that regulates gene expression and is often disrupted in colorectal cancer (CRC). Aberrant methylation of promoter CpG islands can silence tumor suppressor genes and drive tumorigenesis. A subset of CRCs exhibits the CpG Island Methylator Phenotype (CIMP), characterized by widespread hypermethylation and distinct clinical outcomes. Identifying genes whose expression is epigenetically regulated by methylation is important for prioritizing candidate biomarkers and therapeutic targets in CRC. METHODS: We developed and compared a series of computational approaches to identify genes whose expression is regulated by DNA methylation in The Cancer Genome Atlas (TCGA) cohort of Colon Adenocarcinoma (COAD) patients. Samples were stratified according to their CpG Island Methylator Phenotype (CIMP) level to capture distinct epigenetic subgroups. The proposed framework integrates methylation and transcriptomic data to systematically detect methylation-expression associations indicative of epigenetic regulation. RESULTS: The best-performing method identified gene sets strongly associated with promoter methylation-expression relationships and enriched for pathways relevant to colorectal cancer progression and patient stratification. To evaluate the robustness and transferability of the approach, it was further validated on independent datasets, including Stomach Adenocarcinoma (STAD), Glioblastoma Multiforme (GBM), and Mesothelioma (MESO), supporting its robustness and potential generalizability across multiple tumor types. CONCLUSIONS: Our study highlights the potential of computational pipelines to uncover epigenetically regulated genes in colorectal cancer. The identified candidate genes provide a hypothesis-generating foundation for refining molecular stratification and guiding future studies aimed at epigenetic biomarker discovery and therapeutic hypothesis development.