Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

Neri, Emanuele; Faggioni, Lorenzo; Cini, Lorenzo; Bartolozzi, Carlo

doi:10.2147/cmr.s15705

Cited by 12 publications

(15 citation statements)

References 45 publications

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“…However, it was not a universal finding as two other adenomas with a transition to a carcinoma harboured hyperdiploid DNA values of 2,2c and 2,6c (samples 20 and 23). Most adenomas without signs of malignant transformation (samples 3,6,7,8,9,18,21) had hyperdiploid DNA values ranging from 2,17c to 2,49c). The only exception was the adenoma of case 4, a patient with a distinct stage II cancer, which harboured tumor cells of near triploid DNA content of 2,80c (sample 14).…”

Section: Dna Ploidy Status Of Adenomas and Adenocarcinomasmentioning

confidence: 99%

“…On the one hand special attention was taken to analyse carcinomas which morphologically had developed from adenomas, i.e. samples in which the adenoma-carcinoma-sequence was evident (cases 1,6,7,8,9). On the other hand, we analysed samples Table 1); C, D. DNA ploidy analysis of an adenoma and its adjacent adenocarcinoma, respectively.…”

Section: Clinicopathological Analysismentioning

confidence: 99%

“…With respect to malignancy, it was found that only 4% of tubular adenomas but 40% of villous adenomas developed into carcinoma [6]. It may take about 10 years for an adenomatous polyp to transform into cancer [7].…”

Section: Introductionmentioning

confidence: 99%

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DNA ploidy and morphology of colon tumors in the adenoma–carcinoma sequence

Staarmann

Kotb

Petersen

2015

Folia Histochem Cytobiol.

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Introduction. Chromosomal changes are widespread in the vast majority of colon carcinomas and aneuploidy is an established prognostic factor. However, this knowledge so far has no influence on tumor classification. We reported a morphology-based classification scheme, the core classification, that correlates with DNA ploidy. In particular, tripolar mitoses were identified as surrogate markers of a near triploid DNA content. In addition, a survey on chromosome numbers and survival rates in carcinomas suggested that triploidy as a particular state of aneuploidy may be correlated with a more aggressive tumor phenotype. We therefore aimed to analyse DNA ploidy in the colorectal adenoma-carcinoma sequence. Material and methods. The study collection consisted of 15 adenomas and 15 adenocarcinomas of 10 patients. Some of them showed a morphological transition between benign and malignant tumor components which were selectively analysed by DNA measurements. In addition, we assessed the morphological parameters of the core classification. Results. The main findings of the study may be summarized as follows. 1) DNA ploidy changes are already consistently detectable in colon adenomas. They are usually associated with hyperdiploidy. 2) Adenoma tissue adjacent to carcinomas, however, may carry a hypodiploid DNA content while the nearby carcinoma samples were hyperdiploid. Hypodiploidy may thus represent a transition state to near triploid carcinomas.3) The size of tumor nuclei and mitoses usually reflects the ploidy level of colon tumors. Specifically, triploid mitoses may point to a near triploid DNA content. 4) Triploidy per se cannot be equated with tumor aggressiveness as it may already be found in adenocarcinoma in situ. 5) Tripolar and tetrapolar mitoses in invasive colon cancer, however, are potential indicators of an advanced chromosomal instability and seemed to be associated with advanced tumor stages. Conclusions. We present data that hypodiploidy may represent a transition state from adenoma to carcinoma in a subset of colorectal tumors and that near-triploidy may be associated with a more aggressive course of the disease. However, the interpretation of tripolar mitoses and triploidy is largely dependent on the cell type (benign vs. malignant) and tissue context (invasive vs. non-invasive cancer). Furthermore, its interpretation may be distinct for different tumor stages and histotypes. Aneuploidy and multipolar mitoses are frequent findings in cancer cells. Their relevance for tumor biology deserves further studies.

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Section: Dna Ploidy Status Of Adenomas and Adenocarcinomasmentioning

confidence: 99%

Section: Clinicopathological Analysismentioning

confidence: 99%

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DNA ploidy and morphology of colon tumors in the adenoma–carcinoma sequence

Staarmann

Kotb

Petersen

2015

Folia Histochem Cytobiol.

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“…Other risk factors for susceptibility to CRC mentioned as low physical activity, obesity (Karagianni et al, 2010) consumption of charred meats, cigarette smoking (Burnett-Hartman et al, 2011) alcohol use and diet regimen (Neri et al, 2011 Adenomatous polyps are believed to be the precursors of most colorectal cancers both in sporadic and hereditary cases (Muto et al, 1975). People who have adenomas with villous features or high grade dysplasia are more likely to develop CRC (O'Brien et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

Iravani

Kashfi²,

Azimzadeh³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Colorectal cancer is the third most common type of cancer in males and the second in females in Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor for colorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. Aim: The object of this study was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients and to investigate the variation between our populations with other populations. Materials and Methods: A total of 167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013 and specimens were taken through polypectomy and transferred to pathology. All data in patient files including pathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of < 0.05 was considered significant. Results: Mean age of participants was 57±15. Some 84 were females (50.3%) and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) were in females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%) with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followed by 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, data being missing in two cases. Conclusions: Recto sigmoid was site of most of the polyps. The most prevalent type of lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70 (31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screening plans to prevent further healthcare problems with colorectal cancer in the Iranian population.

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“…Genes upregulated in adenoma relative to normal tissue, which maintained increased expression in colorectal carcinoma and adenoma, would encode proteins suitable as putative targets for immunoprevention ( 1 , 2 ) . The identification of early and easily detectable tumor markers, that might contribute to the treatment of colorectal carcinogenesis, as the biological mechanisms required for preinvasive adenoma to progress to carcinoma, is highly relevant subject ( 3 , 4 ) . Despite constant improvement of staging methods for colorectal carcinoma, we also observed a high degree of unpredictability of results, demonstrating a greater need for knowledge of determinants of the evolution of neoplasia ( 5 – 8 ) .…”

Section: Introductionmentioning

confidence: 99%

Imunoexpressão das proteínas COX-2, p53 e caspase-3 em adenoma colorretal e mucosa não neoplásica

Nogueira

Pires

Soares³

et al. 2013

Einstein (São Paulo)

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Objective:To analyze the immunoexpression of the COX-2, p53, and caspase-3 proteins in colorectal adenomas and non-neoplastic mucosa.Methods:72 individuals were subjected to colonoscopy, which provided 50 samples of adenomas and 45 samples of non-neoplastic colorectal mucosa. The tissue samples were obtained via the tissue microarray technique and subjected to immunohistochemical analysis using primary anti-p53, anti-COX-2, and anti-caspase-3 antibodies. The positivity and intensity of the immunoreaction were classified. The analyzed variables were as follows: site of the adenomas in the colon, degree of dysplasia, size, and score of positivity and intensity of immunoexpression of the p-53, caspase-3, and COX-2 proteins.Results:The immunoexpression of mutated protein p53 was positive in 30 (60%) adenoma samples and negative in 20 (40%) adenoma samples. The immunoexpression of mutated protein p53 was negative in 39 (86.6%) samples and positive in 6 (13.3%) samples of the non-neoplastic colorectal mucosa (p<0.0001). Significant differences were seen between both the largest size (p=0.006) and the highest degree of dysplasia (p<0.0001) of the adenomas and the intensity of immunoexpression of mutated protein p53. The positivity and intensity of immunoexpression of COX-2 (p=0.14) and caspase-3 (p=0.23) showed no significant differences between the adenomas and the non-neoplastic colorectal mucosa.Conclusion:Mutated protein p53 was hyperexpressed in the adenomas compared with the non-neoplastic mucosa. Greater size and greater degree of dysplasia in the adenomas were associated with higher expression of mutated protein p53. The immunoexpression of COX-2 and caspase-3 in the adenomas did not exhibit a correlation with the anatomical-pathological features of the tumors and did not differ from the corresponding expression levels in the non-neoplastic mucosa.

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Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

Cited by 12 publications

References 45 publications

DNA ploidy and morphology of colon tumors in the adenoma–carcinoma sequence

DNA ploidy and morphology of colon tumors in the adenoma–carcinoma sequence

Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

Imunoexpressão das proteínas COX-2, p53 e caspase-3 em adenoma colorretal e mucosa não neoplásica

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