Analyses of Clinicopathological Findings and Molecular Alterations in Colorectal Laterally Spreading Tumors Tamotsu Sugai 1 , Hiroo Yamano 2 , Ryou Takagi 2,4 , Kenjiro Yoshikawa 2 , Eiichiro Yamamoto 3 , Minoru Toyota 3 , Yoshihiro Shioi 1 , Noriyuki Uesugi 1 , Toshimi Chiba 4 , Kazuyuki Suzuki 4 1Division of Molecular Diagnostic Pathology, Department of Pathology, School of Medicine, Iwate Medical University, Morioka, Japan 2Division of Gastroenterology, Akita Red Cross Hospital, Akita, Japan 3Department of Biochemistry, Sapporo Medical University, Sapporo, Japan 4Division of Gastroenterology, Department of Internal Medicine School of Medicine, Iwate Medical University, Morioka, Japan Keyword: LST , Ki-ras , APC , CIMP , 腺腫内癌 pp.939-952
Published Date 2010/5/25
DOI https://doi.org/10.11477/mf.1403101952
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 Colorectal laterally spreading tumors(LST)are classified into LST-G and LST-NG. Previous studies have shown that colorectal LSTs have distinct clinicopathological features and a high malignancy potential. The aims of this study were to analyze the clinicopathological features and molecular findings of colorectal LSTs. A total of 423 LSTs were examined including 252 LST-G and 171 LST-NG types with a view to identifying their clinicopathological features. In addition, molecular study in 64 LSTs that were histlogically diagnosed as adenoma(30 LST-Gs and 34 LST-NGs)was designed for evaluating distinct molecular features using a crypt isolation method. These tumors were examined using PCR-based microsatellite assays, single-strand conformational polymorphism assays and COBRA to detect chromosomal allelic loss, APC, ki-ras, BRAF and p53 gene mutations, and the methylation status at the MLH-1, MGMT, p16, HPP-1, RASSF2A, SFRP1, DKK-1, ZFP64 and SALL4 genes. MSI was also examined. There was significant difference in the tumor location(left/right colon)and histological type between LST-Gs and LST-NGs. On the other hand, the frequency of submucosal cancer was high in some specific types of LSTs. Whereas high frequency of ki-ras and APC mutations, as well as the methylation of ZFP-64, RASSF2A and HPP-1 genes characterized the LST-G type, distinct molecular features were found in LST-NGs. 5q LOH, methylation of the SFRP1 and SALL4 genes were common molecular events in both LST-Gs and LST-NGs. None of MST was detected in the LSTs. The molecular and clinicopathological findings suggest that LST-Gs and LST-NGs have different colorectal tumorigenesis.

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