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タイトル別表記
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
著者
中村, 文香 徳島大学大学院医学研究科(医学専攻) 徳島大学 教育研究者総覧
Kagemoto, Kaizo Tokushima University
川口, 智之 Tokushima University
Sonoda, Tomoko Sapporo Medical University
キーワード
serrated polyposis syndrome
colorectal cancer
adenoma
sessile serrated lesion
adenoma–carcinoma pathway
serrated-neoplasia pathway
資料タイプ
学位論文
抄録
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.
掲載誌名
Journal of Gastroenterology
ISSN
14355922
09441174
cat書誌ID
AA11627089
AA10988015
出版者
Springer|Japanese Society of Gastroenterology
57
4
開始ページ
286
終了ページ
299
発行日
2022-02-23
備考
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。
論文本文は2023-02-23以降公開
権利情報
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
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
その他
文科省報告番号
甲第3659号
学位記番号
甲医第1541号
学位授与年月日
2022-09-22
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系