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Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma  [cached]
Takehiro Tanaka,Atsushi Fujimura,Koichi Ichimura,Hiroyuki Yanai
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i43.6263
Abstract: AIM: To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett’s adenocarcinoma in Japan. METHODS: We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett’s adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative patients. RESULTS: HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett’s adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients. CONCLUSION: Our results suggest that HER2-positive Barrett’s adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage.
The clinicopathological features of colorectal mucinous adenocarcinoma and a therapeutic strategy for the disease
Masakatsu Numata, Manabu Shiozawa, Takuo Watanabe, HIroshi Tamagawa, Naoto Yamamoto, Soichiro Morinaga, Kazuteru Watanabe, Teni Godai, Takashi Oshima, Shoichi Fujii, Chikara Kunisaki, Yasushi Rino, Munetaka Masuda, Makoto Akaike
World Journal of Surgical Oncology , 2012, DOI: 10.1186/1477-7819-10-109
Abstract: 144 patients with mucinous and 2673 with non-mucinous adenocarcinomas who underwent primary resection in two major centers in Yokohama, Japan were retrospectively evaluated for clinicopathological features and treatment factors. A multivariate analysis for overall survival followed by the comparison of overall survival using Cox proportional hazard model were performed.Patients with mucinous adenocarcinoma had larger primary lesions, higher preoperative CEA levels, a deeper depth of invasion, higher rates of nodal and distant metastasis, and more metastatic sites. A multivariate analysis for overall survival revealed a mucinous histology to be an independent prognostic factor. In the subgroup analysis stratified by stage, Patients diagnosed as StageIII and IV disease had a worse survival in mucinous adenocarcinoma than non-mucinous, while survival did not differ significantly in patients diagnosed as Stage0-II disease. In StageIII, local recurrence in rectal cases and peritoneal dissemination were more frequently observed in patients with a mucinous histology.Our study indentified that mucinous adenocarcinoma was associated with a worse survival compared with non-mucinous in patients with StageIII and IV disease. In rectal StageIII disease with mucinous histology, additional therapy to control local recurrence followed by surgical resection may be a strategical alternative. Further molecular investigations considering genetic features of mucinous histology will lead to drug development and better management of peritoneal metastasis
Immunohistochemical expression of the epidermal growth factor receptor (EGFR) in colorectal carcinoma: relation with clinicopathological parameters
Azevedo, Maurício Andrade;Souza, Bianca Doimo;Mader, Ana Maria Amaral Antonio;Martins, Lourdes Concei??o;Waisberg, Jaques;
Journal of Coloproctology (Rio de Janeiro) , 2011, DOI: 10.1590/S2237-93632011000300001
Abstract: introduction: the study of tissue immunostaining of the epidermal growth factor receptor (egfr) may contribute with the understanding of its role in the prognosis of colorectal carcinoma. objective: to analyze the immunohistochemical expression of egfr in colorectal carcinoma tissues and transitional tumor-mucosa and mucosa adjacent to neoplasia, and its relation with cancer. method: the study was conducted with 40 patients with colorectal carcinoma who had surgery with curative intent in order to analyze the immunoexpression of egfr with anti-egfr. we used parametric and nonparametric tests. results: the immunohistochemical expression of egfr in tumor samples showed a significant difference as to the level of immunostaining in tissue specimens of transitional tumor-mucosa (p=0.01) and the level of immunoreactivity in tissues of the adjacent mucosa (p=0, 04). the immunoexpression of egfr showed no significant relation with the size of the tumor, angiolymphatic invasion, neural invasion, cellular differentiation, level of carcinoma infiltration in the intestinal wall, lymph node metastases and liver metastases. conclusions: the egfr showed a more intense expression in the mucosa of colorectal carcinoma than in the transitional epithelium and adjacent non-neoplastic mucosa. the immunoexpression of egfr did not correlate with pathological parameters of colorectal carcinoma and liver metastases.
Clinicopathological features and the value of differential Cytokeratin 7 and 20 expression in resolving diagnostic dilemmas of ovarian involvement by colorectal adenocarcinoma and vice-versa
Bharat Rekhi, Sophia George, Bhulaxmi Madur, RF Chinoy, Rajesh Dikshit, Amita Maheshwari
Diagnostic Pathology , 2008, DOI: 10.1186/1746-1596-3-39
Abstract: In cases of complex presentations like an ovarian involvement by a metastatic colorectal adenocarcinoma and vice-versa, certain clinicopathological features are useful. Differential expression of CK 7 and CK20 is vital in resolving these dilemmas. CK20 positivity and CK7 negativity is associated with a colorectal adenocarcinoma. Markers like CEA and CA-125 have an added value.The ovary is a site for a wide range of tumors, both primary and metastatic. Approximately 10–30% of ovarian tumors are metastatic, commonly from the breast, stomach, and the colon [1]. Of these, colorectal metastasis account for approximately 4% [2]. Morphologically, these tumors mimic primary ovarian adenocarcinomas, especially ovarian endometrioid adenocarcinomas. Rarely, colorectum becomes a site for a metastasis from an ovarian adenocarcinoma [3]. Identification of the correct primary tumor in both the described presentations is necessary for an optimal management, including, specific chemotherapy (CT) in advanced stages. Whereas, ovarian adenocarcinomas respond to platinum based CT, cases of colonic adenocarcinomas are candidates for 5-fluorourocil based CT. [4]. The known clinical features favoring a metastatic tumor into the ovary include history of an antecedent malignancy, relatively smaller size of the tumor ~10 cms, solid structure, frequent bilaterality; absence of ascites and elevated serum carcinoembryonic antigen (CEA) levels [1]. Certain morphological features indicative of metastasis from colorectum include 'garland-like' tumor necrosis, segmental destruction of glands and absence of squamous metaplasia, whereas cribriform growth patterns and intraluminal "dirty" necrosis are indicators of endometrioid ovarian adenocarcinomas [5,6]. However, problem exists in sorting out these tumors, including in cases mucinous adenocarcinomas, when there is simultaneous involvement of the ovary and the colorectum at similar (synchronous) or at different (metachronous) times [6,7]. Lately, cy
TSPAN1 protein expression: A significant prognostic indicator for patients with colorectal adenocarcinoma  [cached]
Li Chen, Yuan-Yuan Zhu, Xiao-Juan Zhang, Gui-Lan Wang, Xin-Yu Li, Song He, Jian-Bin Zhang, Jian-Wei Zhu
World Journal of Gastroenterology , 2009,
Abstract: AIM: To determine if TSPAN1 overexpression is associated with clinicopathological and prognostic factors in human colorectal adenocarcinoma.METHODS: Total RNA was extracted in 20 human adenocarcinoma tissues for TSPAN1 mRNA assay by RT-PCR. Eighty-eight specimens of human colorectal adenocarcinoma were surgically removed. TSPAN1 protein levels in cancer tissues were determined by immunohistochemistry using a polyclonal antibody against self-prepared TSPAN1. The correlation between TSPAN1 expression and the clinicopathological factors and the overall survival rate was analyzed by univariate and multivariate assay.RESULTS: TSPAN1 mRNA was detected in 90.0% (18/20) of cancerous tissues. The light density of TSPAN1 mRNA expression levels was 0.89 ± 0.30 in adenocarcinoma by gel-image system. TSPAN1 protein expression was detected in 78.41% (69/88) and weakly expressed in 40% normal colorectal tissues. There were significant differences between colorectal adenocarcinoma and normal control epithelium (P < 0.05). TSPAN1 protein expression in colorectal cancerous tissue was significantly correlated with the histological grade, cell expression PCNA, lymph nodal metastasis and TNM staging of the disease. Patients with TSPAN1 protein overexpression had a significantly shorter survival period than that in patients with TSPAN1 protein negative or weak expression, respectively (P < 0.05). Furthermore, by multivariate analysis, TSPAN1 protein expression demonstrated an independent prognostic factor for human colorectal cancers (P < 0.05, relative risk 0.755; 95% confidence interval 0.302-1.208).CONCLUSION: The expression of TSPAN1 gene is increased in colorectal carcinoma, suggesting that TSPAN1 might serve as an independent prognostic factor for the colorectal adenocarcinoma patients.
Cancer stem cell markers CD133 and CD24 correlate with invasiveness and differentiation in colorectal adenocarcinoma  [cached]
Dongho Choi, Hyo Won Lee, Kyung Yul Hur, Jae Joon Kim, Gyeong-Sin Park, Si-Hyong Jang, Young Soo Song, Ki-Seok Jang, Seung Sam Paik
World Journal of Gastroenterology , 2009,
Abstract: AIM: To verify that CD markers are available for detecting cancer stem cell populations and to evaluate their clinical significance in colon cancer.METHODS: Immunohistochemistry for CD133, CD24 and CD44 was performed on the tissue microarray of 523 colorectal adenocarcinomas. Medical records were reviewed and clinicopathological analysis was performed.RESULTS: In colorectal adenocarcinoma, 128 of 523 cases (24.5%) were positive and 395 cases (75.5%) were negative for CD133 expression. Two hundred and sixty-four of 523 cases (50.5%) were positive and 259 cases (49.5%) were negative for CD24 expression. Five hundred and two of 523 cases (96%) were negative and 21 cases (4%) were positive for CD44 expression. Upon clinicopathological analysis, CD133 expression was present more in male patients (P = 0.002) and in advanced T stage cancer (P = 0.024). Correlation between CD24 expression and clinicopathological factors was seen in the degree of differentiation (P = 0.006). Correlation between CD44 expression and clinicopathological factors was seen in the tumor size (P = 0.001). Survival was not significantly related to CD133, CD24 and CD44 expression.CONCLUSION: CD markers were related to invasiveness and differentiation of colorectal adenocarcinoma. However, CD expression was not closely related to survival.
Clinicopathological Characteristics of Laterally Spreading Colorectal Tumor  [PDF]
Xinhua Zhao, Qiang Zhan, Li Xiang, Yadong Wang, Xianfei Wang, Aimin Li, Side Liu
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0094552
Abstract: Background and Aims Laterally spreading tumor (LST) is a colorectal pre-cancerous lesion. Previous studies have demonstrated distinct LST clinicopathological characteristics in different populations. This study evaluated clinicopathological characteristics of LST in a Chinese population. Methods A total of 259 Chinese LST patients with 289 lesions were recruited for endoscopic and clinicopathological analyses. Results Among these 289 lesions, 185 were granular type (LST-G), whereas 104 were non-granular type (LST-NG). LST-G lesions were further classified into homogeneous G-type and nodular mixed G-type, while LST-NG lesions were further classified into flat elevated NG-type and pseudo-depressed NG-type. Clinically, these four LST subtypes showed distinct clinicopathological characteristics, e.g., lesion size, location, or histopathological features (high-grade intraepithelial neoplasia and submucosal carcinoma). The nodular mixed G-type showed larger tumor size and higher incidence of high-grade intraepithelial neoplasia compared to the other three subtypes, while pseudo-depressed NG-type lesions showed the highest incidence of submucosal carcinoma. Noticeably, no diffidence was detected between the lesions of homogeneous G-type and flat elevated NG-type with regard to the histopathological features. Histology of the malignancy potential was associated with nodular mixed G-type [OR = 2.41, 95% CI (1.09–5.29); P = 0.029], flat elevated NG-type [OR = 3.49, 95% CI (1.41–8.22); P = 0.007], Diameter ≥30 mm [OR = 2.56, 95% CI (1.20–5.20); P = 0.009], Villous adenoma [OR = 2.76, 95% CI (1.01–7.58); P = 0.048] and serrated adenoma [OR = 6.99, 95% CI (1.81–26.98); P = 0.005]. Conclusion Chinese LSTs can be divided into four different subtypes, which show distinct clinicopathological characteristics. Morphology, size and pathological characteristics are all independent predictors of advanced histology.
Angiogenesis in advanced colorectal adenocarcinoma with special reference to tumoral invasion
TARTA, Cláudio;TEIXEIRA, Cláudio Rolim;TANAKA, Shinji;HARUMA, Ken;CHIELE-NETO, César;SILVA, Vinícius Duval da;
Arquivos de Gastroenterologia , 2002, DOI: 10.1590/S0004-28032002000100007
Abstract: background - angiogenesis is a crucial step in tumor growth and progression. its quantification by microvessel counting has a prognostic value in several types of malignancies and recently has been appraised in gastrointestinal tumors. aim - to assess the prognostisc significance of microvessel quantification in colorectal carcinomas, studying its association with hematogenous metastases, survival and clinicopathological variables such as size, histologic differentiation and depth of tumoral invasion. patients/methods - forty eight patients with colorectal adenocarcinoma were included in this study. histologic sections of invasion tumoral margin (4 μm) were analyzed and endothellined microvessels were immunostained with monoclonal mouse von willebrand factor (anti-fviii). the microvessel count was performed from the identification of the area with increased microvessel density - hot spots - and results of the mean in five of these fields. results- the cut-off microvessel count was 14 microvessels/0,785 mm2 , which divided the sample into hypovascular and hypervascular groups. while 2/8 (25%) tumors with muscularis propria invasion were classified as hypervascular, 11/15 (73%) tumors with serosa or perivisceral fat were classified as hypervascular. however, a non-significant statistical association was found between the angiogenesis quantification, hematogenous metastases, survival and clinicopathological variables such as size and histologic differentiation of the tumor. conclusions - the findings of significantly increase of microvessel count in conformity with tumoral invasion depth supports the hypothesis that tumor progression might be related to angiogenesis. although angiogenesis is an important step in the tumoral growth and during the metastatization process, other factors can be implicated.
Angiogenesis in advanced colorectal adenocarcinoma with special reference to tumoral invasion  [cached]
TARTA Cláudio,TEIXEIRA Cláudio Rolim,TANAKA Shinji,HARUMA Ken
Arquivos de Gastroenterologia , 2002,
Abstract: Background - Angiogenesis is a crucial step in tumor growth and progression. Its quantification by microvessel counting has a prognostic value in several types of malignancies and recently has been appraised in gastrointestinal tumors. Aim - To assess the prognostisc significance of microvessel quantification in colorectal carcinomas, studying its association with hematogenous metastases, survival and clinicopathological variables such as size, histologic differentiation and depth of tumoral invasion. Patients/Methods - Forty eight patients with colorectal adenocarcinoma were included in this study. Histologic sections of invasion tumoral margin (4 μm) were analyzed and endothellined microvessels were immunostained with monoclonal mouse Von Willebrand Factor (anti-FVIII). The microvessel count was performed from the identification of the area with increased microvessel density - hot spots - and results of the mean in five of these fields. Results- The cut-off microvessel count was 14 microvessels/0,785 mm2 , which divided the sample into hypovascular and hypervascular groups. While 2/8 (25%) tumors with muscularis propria invasion were classified as hypervascular, 11/15 (73%) tumors with serosa or perivisceral fat were classified as hypervascular. However, a non-significant statistical association was found between the angiogenesis quantification, hematogenous metastases, survival and clinicopathological variables such as size and histologic differentiation of the tumor. Conclusions - The findings of significantly increase of microvessel count in conformity with tumoral invasion depth supports the hypothesis that tumor progression might be related to angiogenesis. Although angiogenesis is an important step in the tumoral growth and during the metastatization process, other factors can be implicated.
Micronucleus analysis in patients with colorectal adenocarcinoma and colorectal polyps  [cached]
Ali Karaman, Do?an Nas?r Binici, Mehmet E?ref Kabalar, Züleyha ?al?ku?u
World Journal of Gastroenterology , 2008,
Abstract: AIM: To determine, by counting micronucleus (MN) frequencies, whether chromosomal or DNA damage have an effect on the pathogenesis of early colorectal adenocarcinoma (CRC).METHODS: We analyzed MN frequencies in 21 patients with CRC, 24 patients with colon polyps [10 neoplastic polyps (NP) and 14 non-neoplastic polyps (NNP)] and 20 normal controls.RESULTS: MN frequency was significantly increased in CRC patients and in NP patients compared with controls (3.72 ± 1.34, 3.58 ± 1.21 vs 1.97 ± 0.81, P < 0.001). However, there was no difference in the MN frequency between CRC patients and NP patients (P > 0.05). Similarly, there was no difference in the MN frequency between NNP patients (2.06 ± 0.85) and controls (P > 0.05).CONCLUSION: Our results suggest increased chromosome/DNA instabilities may be associated with the pathogenesis of early CRC.
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