ID | 117614 |
Title Alternative | 鋸歯状ポリポーシス症候群におけるadenoma-carcinoma pathwayによる発癌
Adenoma-cancer pathway in SPS
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Author |
Nakamura, Fumika
Tokushima University
Okamoto, Koichi
Tokushima University
Tokushima University Educator and Researcher Directory
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Kagemoto, Kaizo
Tokushima University
Miyamoto, Hiroshi
Tokushima University
Tokushima University Educator and Researcher Directory
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Muguruma, Naoki
Tokushima University
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Sonoda, Tomoko
Sapporo Medical University
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Keywords | serrated polyposis syndrome
colorectal cancer
adenoma
sessile serrated lesion
adenoma–carcinoma pathway
serrated-neoplasia pathway
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Content Type |
Thesis or Dissertation
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Description | Background: Although serrated polyposis syndrome (SPS) is associated with an increased colorectal cancer (CRC) risk, the carcinogenic mechanisms remain unknown. We investigated clinicopathological characteristics and genetic abnormalities in colorectal polyps and CRC to elucidate carcinogenic mechanisms in SPS.
Methods: We retrospectively analyzed clinicopathological features of colorectal polyps in 44 SPS patients, and examined mutations of genes including APC, RAS, BRAF, and TP53, and microsatellite instability (MSI) in CRC tissues. Results: Of the 44 patients, 25 (56%) fulfilled WHO criterion 1, 11 (25%) fulfilled criterion 2, and 8 (18%) fulfilled both. A total of 956 polyps were observed; 642 (67%) hyperplastic polyps (HP), 204 (21%) sessile serrated lesions (SSL), 10 (1%) traditional serrated adenoma (TSA), and 100 (11%) adenomas. The median numbers of polyps (/patient) were 10.5 (IQR 2.75-23) HPs, 4.0 (2.0-6.0) SSLs, 0 (0-0) TSA, and 1 (0-3.3) adenoma. SSL and HP located preferentially in the proximal and distal colon respectively. Twenty-two CRCs were found in 18 patients. Based on the histological coexistence of SSL/TSA, BRAF mutation and MSI, 5 CRCs (26%) were classified as serrated-neoplasia pathway. Conversely, based on the coexistence of adenoma, APC/RAS and TP53 mutations, 11 CRCs (58%) were classified as adenoma-carcinoma pathway. The remaining 3 were unclassifiable. Most CRCs through adenoma-carcinoma pathway were located in the left-side colorectum and patients bearing those met criterion 2, characterized by many HP and advanced adenomas. Adenoma was a significant risk factor for CRC. Conclusions: Our results suggest that more than half of the CRCs, particularly those in the left-side colorectum, developed through the adenoma-carcinoma pathway in SPS patients. Adenoma was a risk factor for CRCs, suggesting its importance in colorectal carcinogenesis. |
Journal Title |
Journal of Gastroenterology
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ISSN | 14355922
09441174
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NCID | AA11627089
AA10988015
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Publisher | Springer|Japanese Society of Gastroenterology
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Volume | 57
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Issue | 4
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Start Page | 286
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End Page | 299
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Published Date | 2022-02-23
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Remark | 内容要旨・審査要旨・論文本文の公開
本論文は,著者Fumika Nakamuraの学位論文として提出され,学位審査・授与の対象となっている。 This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Natureʼs AM terms of use (https://www.springernature.com/gp/open-research/policies/accepted-manuscript-terms), but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00535-022-01858-8 |
EDB ID | |
DOI (Published Version) | |
URL ( Publisher's Version ) | |
FullText File | |
language |
eng
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TextVersion |
ETD
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MEXT report number | 甲第3659号
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Diploma Number | 甲医第1541号
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Granted Date | 2022-09-22
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Degree Name |
Doctor of Medical Science
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Grantor |
Tokushima University
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departments |
University Hospital
Medical Sciences
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