Flat elevated lesions of the colon and rectum: a spectrum of neoplastic and nonneoplastic entities

Gualco, Gabrıela; Reissenweber, Nelson; Cliché, Ivanah; Bacchi, Carlos E.

doi:10.1016/j.anndiagpath.2006.03.003

Cited by 14 publications

(6 citation statements)

References 27 publications

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“…Since left-sided tumors have polypoid morphology, it is easier to detect them with colonoscopy in the early stages of carcinogenesis. Right-sided CRC have flat morphology that is difficult to detect [ 7 , 8 ].…”

Section: Anatomical and Histological Perspectivementioning

confidence: 99%

Difference Between Left-Sided and Right-Sided Colorectal Cancer: A Focused Review of Literature

et al. 2018

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Colorectal cancer is the third most common cancer worldwide with a high mortality rate at the advanced stages. However, colorectal cancer is not a single type of tumor; its pathogenesis depends on the anatomical location of the tumor and differs between right side and left side of the colon. Tumors in the proximal colon (right side) and distal colon (left side) exhibit different molecular characteristics and histology. In the right-sided tumors, mutations in the DNA mismatch repair pathway are commonly observed; and these tumors generally have a flat histology. In the left-sided tumors, chromosomal instability pathway-related mutations, such as KRAS, APC, PIK3CA, p53 mutations are observed and these tumors demonstrate polypoid-like morphology. Therapy responses are totally different between these tumor entities. Left-sided colorectal cancer (LCRC) patients benefit more from adjuvant chemotherapies such as 5-fluorouracil (5-FU)-based regimes, and targeted therapies such as anti- epidermal growth factor receptor (EGFR) therapy, and have a better prognosis. Right-sided colorectal cancer (RCRC) patients do not respond well to conventional chemotherapies, but demonstrate more promising results with immunotherapies because these tumors have high antigenic load. For the development of effective therapy regimes and better treatment options, it is essential to evaluate right-sided and left-sided tumors as separate entities, and design the therapy regime considering the differences between these tumors.

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Section: Anatomical and Histological Perspectivementioning

confidence: 99%

Difference Between Left-Sided and Right-Sided Colorectal Cancer: A Focused Review of Literature

et al. 2018

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“…The current screening method for CRC and adenomas uses standard white light endoscopy to detect morphological changes and lesions in the mucosa. Average polyp miss rates have been reported as high as 22%, with flat and depressed lesions being the most difficult to identify with conventional white light colonoscopy [3]–[7]. Furthermore, the presence of flat dysplastic lesions in the setting of chronic ulcerative colitis presents a significantly increased risk for the development of frank carcinoma [8].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Fluorescence-Based Endoscopic Detection of Colon Dysplasia in the Mouse Using a Novel Peptide Probe

et al. 2011

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Colorectal cancer (CRC) is a major cause of cancer-related deaths in much of the world. Most CRCs arise from pre-malignant (dysplastic) lesions, such as adenomatous polyps, and current endoscopic screening approaches with white light do not detect all dysplastic lesions. Thus, new strategies to identify such lesions, including non-polypoid lesions, are needed. We aim to identify and validate novel peptides that specifically target dysplastic colonic epithelium in vivo. We used phage display to identify a novel peptide that binds to dysplastic colonic mucosa in vivo in a genetically engineered mouse model of colo-rectal tumorigenesis, based on somatic Apc (adenomatous polyposis coli) gene inactivation. Binding was confirmed using confocal microscopy on biopsied adenomas and excised adenomas incubated with peptide ex vivo. Studies of mice where a mutant Kras allele was somatically activated in the colon to generate hyperplastic epithelium were also performed for comparison. Several rounds of in vivo T7 library biopanning isolated a peptide, QPIHPNNM. The fluorescent-labeled peptide bound to dysplastic lesions on endoscopic analysis. Quantitative assessment revealed the fluorescent-labeled peptide (target/background: 2.17±0.61) binds ∼2-fold greater to the colonic adenomas when compared to the control peptide (target/background: 1.14±0.15), p<0.01. The peptide did not bind to the non-dysplastic (hyperplastic) epithelium of the Kras mice. This work is first to image fluorescence-labeled peptide binding in vivo that is specific towards colonic dysplasia on wide-area surveillance. This finding highlights an innovative strategy for targeted detection to localize pre-malignant lesions that can be generalized to the epithelium of hollow organs.

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“…2,3 However, it is challenging that the current endoscopic screening methods with white light detect these dysplastic lesions. 4,5 Thus, the development of new approaches to identify such lesions is of great medical significance.…”

mentioning

confidence: 99%

Quantitative biomarkers of colonic dysplasia based on intrinsic second-harmonic generation signal

Zhuo

Zhu

et al. 2011

J. Biomed. Opt.

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Flat elevated lesions of the colon and rectum: a spectrum of neoplastic and nonneoplastic entities

Cited by 14 publications

References 27 publications

Difference Between Left-Sided and Right-Sided Colorectal Cancer: A Focused Review of Literature

Difference Between Left-Sided and Right-Sided Colorectal Cancer: A Focused Review of Literature

In Vivo Fluorescence-Based Endoscopic Detection of Colon Dysplasia in the Mouse Using a Novel Peptide Probe

Quantitative biomarkers of colonic dysplasia based on intrinsic second-harmonic generation signal

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