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Shuji Ogino, MD, PhD, MS (Epidemiology)

Associate Professor, Department of Pathology, Harvard Medical School

Associate Professor, Department of Epidemiology, Harvard School Of Public Health

Associate Pathologist, Pathology, Brigham And Women's Hospital

Associate Professor of Pathology, Department of Medical Oncology, Dana-Farber Cancer Institute

Contact Info

Shuji Ogino
Brigham And Women's Hospital
75 Francis Street
Boston, MA, 02115
Mailstop: Amory 3F
Phone: 617-632-1972


Yumiko Fujita
Administrative Assistant
Medical Oncology
Dana-Farber Cancer Institute
450 Brookline Ave., Room M422
Boston, MA, 02215
Phone: 617-632-1972
Fax: 617-582-8558

DF/HCC Program Affiliation

Cancer Epidemiology
Gastrointestinal Malignancies

Lab Website

The MPE Lab

Research Abstract

The Molecular Pathological Epidemiology Laboratory (The MPE Laboratory)
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The relationship between exposures and molecular changes in tumors has been examined for decades (eg, smoking -> KRAS mutation), under the umbrella of "molecular epidemiology". However, this type of analysis needs a consideration of disease heterogeneity (for a simple example, KRAS mutation present vs. absent), which necessitates a paradigm shift from conventional epidemiology. Conventional epidemiology is based on the premise that individuals with a given disease (by name) are homogeneous and can be lumped together to analyze the associations with exposures.
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Considering this paradigm shift, “Molecular Pathological Epidemiology (MPE)” (or Molecular Pathologic Epidemiology) has been coined for integrative science which can consider inherent disease heterogeneity in epidemiology research (Ogino et al. J Natl Cancer Inst 2010; Ogino et al. Gut 2011; Ogino et al. Nat Rev Clin Oncol 2011; Ogino et al. Int J Epidemiol 2012; Ogino et al. Am J Epidemiol 2012). MPE is an interdisciplinary and transdisciplinary field of science. I have been advancing the MPE field as the first “Molecular Pathological Epidemiologist (MPEist, MPE’ist, MPE-ist)” (Ogino et al. Am J Epidemiol 2012). The power and promise of MPE has been well attested by our recent study (Liao et al. N Engl J Med 2012) which discovered an interactive effect of aspirin use and colorectal cancer PIK3CA mutation on tumor behavior. MPE encompasses ALL HUMAN DISEASES (just as pathology and epidemiology encompass the entire spectrum of human illnesses) (Ogino et al. Mod Pathol 2013). As I am a unique faculty in pathology (Harvard Medical School) and epidemiology (Harvard School of Public Health), my long-term goal is to transform pathology and epidemiology into an integrative science for both education and research.
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In MPE, we try to dissect complex interrelationship between; (1) environmental, dietary, lifestyle and genetic factors; (2) alterations in the tumor microenvironment and cellular genetics and epigenetics; and (3) disease pathways and evolution. MPE encompasses all human diseases (most of which are complex multifactorial diseases), and takes into account genome, epigenome, methylome, transcriptome, proteome, metabolome, microbiome, metagenome, reactome, and interactome. MPE is based on the "Unique Tumor Principle" (Ogino et al. Int J Epidemiol 2012; Ogino et al. Expert Rev Mol Diagn 2012), and more broadly, the "Unique Disease Principle" (Ogino et al. Mod Pathol 2013). MPE design can be used as the next step of genome-wide association study (GWAS) (“GWAS-MPE Approach”; Ogino et al. Gut 2011). Other new concepts related to MPE include "Colorectal Continuum Paradigm / Theory / Hypothesis" (Yamauchi, Morikawa, et al. Gut 2012; Yamauchi, Lochhead, et al. Gut 2012), which underscores the importance of interplay of gut microbiota, microbiome, host factors (diet, immunity, inflammation, etc.), and carcinogenesis. The MPE paradigm has been accepted worldwide (e.g., Hughes et al. PLoS ONE 2011; Hughes et al. Int J Epidemiol 2012; Curtin et al. Pathol Res Int 2011; Kelley et al. J Natl Compr Canc Netw 2011; Campbell et al. J Clin Oncol 2012; Ku et al. Mod Pathol 2012; Kanthan et al. Pathol Res Int 2012; Rex et al. Am J Gastroenterol 2012; Koshiol et al. Ann Epidemiol 2012; Greystoke et al. Gastroenterol Res Practice 2012; Chia et al. Nat Rev Clin Oncol 2012; Beggs et al. J Pathol 2013).
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A similar concept has been named "etiologic heterogeneity" by Dr. Colin Begg (Int J Cancer 2011; Am J Epidemiol 2012). Dr. Margaret Spitz, et al. has named "integrative epidemiology" to describe integration of molecular and genomic analyses (exposures and tumors) into epidemiology (Cancer Discovery 2012). This "integrative epidemiology" encompasses MPE and conventional molecular epidemiology.
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We have been utilizing comprehensive databases of two large U.S. nationwide prospective cohort studies, the Nurses’ Health Study (N=121,000 followed since 1976) and the Health Professionals Follow-up Study (N=51,500 followed since 1986), as well as CALGB trials (Alliance for Clinical Trials in Oncology). Our discoveries by the MPE approach include (to mention just several); influence of the tumor microenvironment on tumor phenotype (Straussman et al. Nature 2012); YAP1 (yes-associated protein 1; or YAP) in colorectal cancer (Barry et al. Nature, published online); interactions between aspirin use and PTGS2 (cyclooxygenase-2, COX-2) expression in colorectal cancer (Chan et al. New Engl J Med 2007; Chan et al. JAMA 2009); interactions between obesity (host energetics) and FASN (fatty acid synthase) expression in colorectal cancer (Ogino et al. J Clin Oncol 2008; Kuchiba et al. J Natl Cancer Inst 2012); interactions between host energetics and CTNNB1 (-catenin) activation in colorectal cancer (Morikawa et al. JAMA 2011); LINE-1 (long interspersed nucleotide element-1) hypomethylation and colon cancer aggression (Ogino et al. J Natl Cancer Inst 2008) and colorectal cancer family history (Ogino et al. J Natl Cancer Inst 2013); one-carbon nutrients, alcohol and colon cancer risk according to TP53 (p53) status and LINE-1 methylation level (Schernhammer et al. Gastroenterology 2008; Schernhammer et al. Gut 2010); fusobacterium (microbiota) in colorectal cancer (Kostic et al. Genome Res 2012); CDK8 in colorectal cancer (Firestein et al. Nature 2008; Firestein et al. Int J Cancer 2010); VTI1A-TCF7L2 fusion (translocation) in colorectal cancer (Bass et al. Nat Genet 2011). In summary, a better understanding of heterogeneity of carcinogenic processes and influences of exogenous and endogenous factors will further contribute to personalized prevention as well as personalized treatment strategy.
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To transform pathology and epidemiology by the integrative MPE field and concept, I recently launched two programs. One is the “MPE Working Group (MPEWG)”, to establish standardized methodologies in MPE research. MPEWG currently consists of researchers in the MPE areas (including biostatistics experts such as Professor Donna Spiegelman and Professor Bernard Rosner), mainly based on Harvard School of Public Health, Brigham and Women’s Hospital, and Dana-Farber Cancer Institute,. The second program is the “STROBE-MPE” initiative (Ogino et al. Am J Epidemiol 2012). STROBE stands for “STrengthening of the Reporting of OBservational Epidemiology” (von Elm et al. PLoS Med 2007), and is an international guideline for epidemiology research. I always call for collaboration in this STROBE-MPE international initiative.
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The second focus of my research (which is very much related to MPE) is epigenetics and epigenomics of colorectal cancer. We have found that LINE-1 hypomethylation is highly correlated with mortality in colorectal cancer (Ogino et al. J Natl Cancer Inst 2008); that LINE-1 hypomethylated colorectal cancer is associated with family history of colorectal cancer (Ogino et al. J Natl Cancer Inst 2013); and that it is preventable by folate (leafy vegetables) and avoidance of excessive alcohol consumption (Schernhammer et al. Gut 2010). I have been characterizing the CpG island methylator phenotype (CIMP), a unique molecular phenotype in colorectal cancer. Especially, my investigation led to the discovery of “CIMP-low (CIMP-L)”, a unique phenotype in colorectal cancer which is associated with KRAS mutation (Ogino et al. J Mol Diagn 2006), which was confirmed by other investigators including Peter Laird’s group (Hinoue et al. Genome Res 2012). We were the first to apply "structural equation modeling (SEM)" to correlation structure analysis of CpG island methylation and genetic changes in colorectal cancer (Tanaka et al. Am J Pathol 2010); We have been deciphering prognostic roles of CIMP, MSI and KRAS, BRAF and PIK3CA mutations in colorectal cancer (Ogino et al. Gut 2009; Ogino et al. Clin Cancer Res 2009; Ogino et al. Clin Cancer Res 2012; Liao et al. Clin Cancer Res 2012; Imamura et al. Clin Cancer Res 2012). Recently, we have found that frequencies of colorectal cancer genetic and epigenetic features (CIMP-high, MSI-high, and BRAF mutation) change gradually along subsites, which has led to the “Colorectal Continuum Concept / Paradigm / Theorem” (Yamauchi, Morikawa et al. Gut 2012; Yamauchi, Lochhead et al. Gut 2012) as mentioned above. This novel “Colorectal Continuum Paradigm” has a considerable impact on gastrointestinal research and clinical practice.


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