scholarly journals MISMATCH REPAIR PROTEINS AND SURVIVIN IN ADENOMATOUS COLON POLYPS WITH LOW GRADE AND HIGH GRADE DYSPLASIA: AN IMMUNOHISTOCHEMICAL STUDY. Las proteínas para la reparación de desajustes y survivin en pólipos adenomatosos de colon con displasias de bajo y a

2018 ◽  
Vol 10 (3) ◽  
pp. 98-111
Author(s):  
Marian Adamkov ◽  
Desanka Výbohová ◽  
Slávka Drahošová ◽  
Štefan Galbavý
Keyword(s):  
Mismatch Repair ◽  
Survivin Expression ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
Colon Polyps ◽  
High Grade ◽  
Immunohistochemical Expression ◽  
Significant Relation ◽  
Colon Adenomas ◽  
Mismatch Repair Proteins

Objective: The aim of our study was to observe the immunohistochemical expression pattern of mismatch repair proteins (MMRP) MLH1, MSH2, MSH6 and PMS2, as well as survivin, in colon polyps. Methods: We assessed above mentioned proteins in a unified group of 124 tubular adenomatous colon polyps with regard to the presence of dysplastic abnormalities in order to explore their relationship. Furthermore, we studied their relation to such clinicomorphological parameters as the age of patients, size of adenoma, degree of dysplastic changes and localization of the lesion. Results: Survivin was expressed in 97 cases (78.2%), MLH1 was found in 111 cases (89.5%), MSH2 in 115 cases (92.7%), MSH6 in 118 cases (95.2%) and PMS2 in 105 cases (84.7%). The majority of absent MMRP cases was detected where the adenoma size was less than 10 mm with LGD (low-grade dysplasia). Survivin expression significantly correlated with the adenoma size and dysplasia grade. Subcellular survivin compartmentalization was statistically associated with the adenoma size, dysplasia grade and adenoma localization. Furthermore, we confirmed a significant relation between survivin expression and MMRP. In general, the intensity of immunoreaction was stronger in the MMRP than in survivin. Conclusions: Our recent results suggest that MMRP may suppress the antiapoptotic activity of survivin in LGD and HGD (high grade dysplasia) colon adenomas. Antecedentes: Las proteínas de reparación de desajustes (MMRP) y survivin representan señales diametralmente opuestas que pueden controlar las vías apoptóticas. Además, se sabe que tanto MMRP como survivin son poderosos parámetros pronósticos. Material y métodos: El objetivo de nuestro estudio fue observar el patrón de expresión inmunohistoquímica de MMRP MLH1, MSH2, MSH6 y PMS2, y survivin en un grupo unificado de 124 adenomatosos pólipos tubulares de colon con respecto a la presencia de anomalías displásicas para explorar sus relaciones. Además, estudiamos su relación con los parámetros clinicomorfológicos, como la edad de los pacientes, el tamaño del adenoma, el grado de cambios displásicos y la localización de la lesión. Resultados: Survivin se expresó en 97 casos (78.2%), MLH1 se encontró en 111 casos (89.5%), MSH2 en 115 casos (92.7%), MSH6 en 118 casos (95.2%) y PMS2 en 105 casos (84.7%). La mayoría de los casos ausentes de MMRP se detectaron en un tamaño de adenoma inferior a 10 mm, estos casos se asociaron principalmente con displasia de bajo grado y fueron más frecuentes en el colon distal. La expresión de survivin se correlacionó significativamente con el tamaño del adenoma y el grado de displasia. La compartimentalización de survivin subcelular se asoció estadísticamente con el tamaño del adenoma, el grado de displasia y localización del adenoma. Además, confirmamos una relación significativa entre la expresión de survivin y el MMRP. En general, la intensidad de la inmunorreacción fue más fuerte en MMRP en comparación con la intensidad del survivin. Conclusiones: Con base en nuestros resultados recientes, sugerimos que el MMRP puede suprimir la actividad antiapoptótica del survivin en los adenomas de colon con displasias de bajo y alto grado.

scholarly journals Long term outcomes of colon polyps with high grade dysplasia following endoscopic resection

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jia-Jang Chang ◽  
Cheng-Hung Chien ◽  
Shuo-Wei Chen ◽  
Li-Wei Chen ◽  
Ching-Jung Liu ◽  
...  
Keyword(s):  
High Grade Dysplasia ◽  
Advanced Adenoma ◽  
Colon Polyps ◽  
High Grade ◽  
Colonic Adenoma ◽  
Screen Colonoscopy ◽  
Colon Adenomas ◽  
Advanced Adenomas

Abstract Background The risk of recurrent colonic adenoma associated with high-grade dysplasia (HGD) colon polyps at baseline colonoscopy remains unclear. We conducted a clinical cohort study with patients who underwent polypectomy during screen colonoscopy to assess recurrent colonic adenoma risk factors. Methods 11,565 patients at our facility underwent screen colonoscopy between September 1998 and August 2007. Data from patients with HGD colon polyps who had undergone follow-up colonoscopy were included for analysis. Results Data from 211 patients was included. Rates of metachronous adenoma and advanced adenoma at follow-up were 58% and 20%, respectively. Mean follow-up period was 5.5 ± 1.8 (3–12) years. Univariate logistic regression analysis revealed that an adenoma count of ≥ 3 at baseline colonoscopy was strongly associated with overall recurrence, multiple recurrence, advanced recurrence, proximal recurrence, and distal adenoma recurrence with odds ratios of 4.32 (2.06–9.04 95% CI), 3.47 (1.67–7.22 95% CI), 2.55 (1.11–5.89 95% CI), 2.46 (1.16–5.22 95% CI), 2.89 (1.44–5.78 95% CI), respectively. Multivariate analysis revealed gender (male) [P = 0.010; OR 3.09(1.32–7.25 95% CI)] and adenoma count ≥ 3 [P = 0.002; OR 3.08(1.52–6.24 95% CI)] at index colonoscopy to be significantly associated with recurrence of advanced adenoma. Conclusion Recurrence of colonic adenoma at time of follow-up colonoscopy is common in patients who undergo polypectomy for HGD colon adenomas during baseline colonoscopy. Risk of further developing advanced adenomas is associated with gender and the number of colon adenomas present.

scholarly journals Long Term Outcomes of Colon Polyps with High Grade Dysplasia after Endoscopic Resection

2020 ◽  
Author(s):  
Jia-Jang Chang ◽  
Cheng-Hung Chien ◽  
Shuo-Wei Chen ◽  
Li-Wei Chen ◽  
Ching-Jung Liu ◽  
...  
Keyword(s):  
Male Gender ◽  
High Grade Dysplasia ◽  
Screening Colonoscopy ◽  
Colon Polyps ◽  
High Grade ◽  
Surveillance Colonoscopy ◽  
Colon Adenomas ◽  
Colonic Adenomas ◽  
Advanced Adenomas

Abstract Background The clinical characteristics of patients with high-grade dysplasia (HGD) in colon polyps at baseline colonoscopy in relation to the risk of recurrent colonic adenomas have been unclear. We conducted this hospital- based cohort study recruiting patients who had undergone polypectomy at screening colonoscopy to assess the risk factors of recurrent colonic adenomas. Methods 11,565 subjects had undergone screening colonoscopic examinations between September 1998 and August 2007. The patients who had HGD in colon polyps and had undergone surveillance colonoscopy were eligible. Results A total of 211 patients were recruited. The rates of metachronous adenomas and advanced adenomas at surveillance colonoscopy were 58% and 20%, respectively, during the mean follow-up period of 5.5 ± 1.8 (3–12) years. On univariate logistic regression analysis, the number of adenomas ≥ 3 at baseline colonoscopy was strongly associated with the rates of overall recurrence, multiple recurrence, advanced recurrence, proximal recurrence, and distal adenoma recurrence with odds ratios of 4.32 (2.06–9.04 95%CI), 3.47 (1.67–7.22 95%CI), 2.55 (1.11–5.89 95%CI), 2.46 (1.16–5.22 95%CI), 2.89 (1.44–5.78 95%CI), respectively. On multivariate analysis, male gender [P = 0.010; OR 3.09(1.32–7.25 95% CI)] and number of adenomas ≥ 3 [P = 0.002; OR 3.08(1.52–6.24 95%CI)] at index colonoscopy were significantly associated with recurrent advanced adenomas. Conclusions Recurrence of colonic adenomas at surveillance colonoscopy is common in patients who had undergone polypectomy for colon adenomas with HGD at baseline colonoscopy. The risk of developing future advanced adenomas is associated with the number of colon adenomas and male gender.

scholarly journals Long Term Outcomes of Colon Polyps with High Grade Dysplasia Following Endoscopic Resection

2020 ◽  
Author(s):  
Jia-Jang Chang ◽  
Cheng-Hung Chien ◽  
Shuo-Wei Chen ◽  
Li-Wei Chen ◽  
Ching-Jung Liu ◽  
...  
Keyword(s):  
High Grade Dysplasia ◽  
Advanced Adenoma ◽  
Colon Polyps ◽  
High Grade ◽  
Colonic Adenoma ◽  
Screen Colonoscopy ◽  
Colon Adenomas ◽  
Advanced Adenomas

Abstract Background The risk of recurrent colonic adenoma associated with high-grade dysplasia (HGD) colon polyps at baseline colonoscopy remains unclear. We conducted a clinical cohort study with patients who underwent polypectomy during screen colonoscopy to assess recurrent colonic adenoma risk factors. Methods 11,565 patients at our facility underwent screen colonoscopy between September 1998 and August 2007. Data from patients with HGD colon polyps who had undergone follow-up colonoscopy were included for analysis. Results Data from 211 patients was included. Rates of metachronous adenoma and advanced adenoma at follow-up were 58% and 20%, respectively. Mean follow-up period was 5.5 ± 1.8 (3-12) years. Univariate logistic regression analysis revealed that an adenoma count of ≥ 3 at baseline colonoscopy was strongly associated with overall recurrence, multiple recurrence, advanced recurrence, proximal recurrence, and distal adenoma recurrence with odds ratios of 4.32 (2.06-9.04 95%CI), 3.47 (1.67-7.22 95%CI), 2.55 (1.11-5.89 95%CI), 2.46 (1.16-5.22 95%CI), 2.89 (1.44-5.78 95%CI), respectively. Multivariate analysis revealed gender (male) [P=0.010; OR 3.09(1.32-7.25 95% CI)] and adenoma count ≥ 3 [P=0.002; OR 3.08(1.52-6.24 95%CI)] at index colonoscopy to be significantly associated with recurrence of advanced adenoma. Conclusion Recurrence of colonic adenoma at time of follow-up colonoscopy is common in patients who undergo polypectomy for HGD colon adenomas during baseline colonoscopy. Risk of further developing advanced adenomas is associated with gender and the number of colon adenomas present.

CD133/CD166/Ki-67 Triple Immunouorescence Assessment for Putative Cancer Stem Cells in Colon Carcinoma*

2014 ◽  
Vol 23 (2) ◽  
pp. 161-170 ◽  
Author(s):  
Claudiu Margaritescu ◽  
Daniel Pirici ◽  
Irina Cherciu ◽  
Alexandru Barbalan ◽  
Tatiana Cârtâna ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Stem Cells ◽  
Colon Cancer ◽  
Cancer Stem Cells ◽  
Colon Carcinoma ◽  
Sodium Dodecyl ◽  
High Grade Dysplasia ◽  
Early Event ◽  
Low Grade ◽  
High Grade

Background & Aims: Colorectal cancer represents the third most common malignancy and the fourth most common cause of cancer death worldwide. The existence of drug-resistant colon cancer stem cells is thought to be one of the most important reasons behind treatment failure in colon cancer, their existence putatively leading to metastasis and recurrences. The aim of our study was to investigate the immunoexpression patterns of CD133 and CD166 in colon carcinoma, both individually and in combination, assessing their significance as prognostic markers.Methods. A total of 45 retrospective colon adenocarcinoma cases were investigated by enzymatic and multiple fluorescence immunohistochemistry for their CD133 and CD166 expression and colocalization.Results. Both CD133 and CD166 were expressed to different extents in all cancer specimens, with apredominant cytoplasmic pattern for CD133 and a more obvious membranous-like pattern for CD166.Overall, when comparing their reactivity for the tumoral tissue, CD166 expression areas seemed to be smaller than those of CD133. However, there was a direct correlation between CD133 and CD166 expression levels throughout the entire spectrum of lesions, with higher values for dysplastic lesions. Colocalization of CD133/ CD166 was obvious at the level of cells membranes, with higher coeficients in high grade dysplasia, followed by well and moderate differentiated tumours.Conclusions. CD133/CD166 colocalization is an early event occurring in colon tumorigenesis, with thehighest coeficients recorded for patients with high grade dysplasia, followed by well differentiated tumours. Thus, we consider that the coexpression of these two markers could be useful for further prognostic andtherapeutically stratification of patients with colon cancer.Abbreviations: AJCC - American Joint Committee on Cancer; CCD - charge-coupled device camera sensor; CD133 - prominin-1 (PROM1); CD166 - Activated Leukocyte Cell Adhesion Molecule (ALCAM); CRC - colorectal cancer; CSC - cancer stem cells; DAB - 3,3'-diaminobenzidine chromogen; DAPI - 4',6-diamidino- 2-phenylindole; HE - Hematoxylin and eosin staining; HGD - high grade dysplasia; HRP - horseradish peroxidase; LGD - low grade dysplasia; SDS - sodium dodecyl sulfate*Part of this work has been accepted as a poster presentation at the Digestive Disease Week (DDW) meeting, Chicago, IL, USA May 3-6, 2014

scholarly journals A133 GASTRIC ESD: PRELIMINARY EXPERIENCE IN A TERTIARY CENTER IN QUEBEC

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 117-118
Author(s):  
D Maillet ◽  
E Desilets ◽  
T Maniere
Keyword(s):  
Curative Resection ◽  
Residual Disease ◽  
High Grade Dysplasia ◽  
R0 Resection ◽  
Low Grade ◽  
High Grade ◽  
En Bloc ◽  
Delayed Bleeding ◽  
Tertiary Center ◽  
Intramucosal Adenocarcinoma

Abstract Background Endoscopic submucosal dissection (ESD) is an endoscopic procedure developed in Asian countries to treat early gastric cancer (EGC). Western countries have less experience with this challenging technique. Aims The goal of this study is to evaluate the effectiveness of ESD as a preliminary experience. Methods This is an unicentric retrospective study of all consecutive gastric ESD for adenomas or EGC from 07/2017 to 08/2020. The primary endpoints were en bloc and R0 resection rates. Results Nineteen patients (mean age 74.2 (54–88), sex ratio 3F/16M) and 23 lesions were included. Mean diameter was 25 mm (10–90). Treatment was previously performed in 7 cases (30.4%), by ESD (5) or EMR (2). The procedure, performed under general anaesthesia, lasted on average 148 minutes (45–412). En bloc resections were performed in 16 cases (69.6%); 5 cases (21.7%) were converted to P-EMR and there was a failure to resect the lesion because of deep invasion or perforation in 2 cases (8.7%). Pathologic examination demonstrated 2 low-grade dysplasia, 4 high-grade dysplasia and 15 adenocarcinomas: intramucosal (8), sm1 (2), sm2 (2), sm3 (1) or sm deep (2). R0 and curative resection rates were 43.5% and 39.1% respectively. The complication rate related to the procedure was 30.4% including 5 perforations and 2 delayed bleeding: all were managed endoscopically. Five patients (21.7%) underwent subsequent gastrectomy for non-curative resection (4) or failed resection (1); 3 had no residual disease on final pathology, 1 had high grade dysplasia and 1 had intramucosal adenocarcinoma. One patient went to palliative care because he was unfit for surgery. Follow-up endoscopy was completed in all 17 patients who underwent endoscopic resection (mean 10 months (2–24)). Recurrence occurred in 23.5% (4/17); all were successfully treated by another ESD. Conclusions In our preliminary experience, the rate of en bloc and R0 resection were 70% and 44%. Compared to other studies, these low en bloc and curative resection rates may be explained by technically difficult lesions during the learning curve and might improve with experience. Nevertheless, surgery has been avoided in 13/19 patients (68%) with endoscopic intervention. Funding Agencies None

Controversies in the Diagnosis of Barrett Esophagus and Barrett-Related Dysplasia: One Pathologist's Perspective

2010 ◽  
Vol 134 (10) ◽  
pp. 1479-1484 ◽  
Author(s):  
John R. Goldblum
Keyword(s):  
English Literature ◽  
Goblet Cells ◽  
High Grade Dysplasia ◽  
Barrett Esophagus ◽  
Low Grade ◽  
High Grade ◽  
Biopsy Specimens ◽  
Columnar Lined Esophagus ◽  
Intramucosal Adenocarcinoma ◽  
Rule Out

Abstract Context.—Pathologists frequently assess esophageal biopsy specimens to “rule out Barrett esophagus,” as well as to assess for the presence or absence of dysplasia. Objective.—To review some of the recent controversies in the diagnosis of Barrett esophagus and Barrett-related dysplasia. Data Sources.—Sources were the author's experience and review of the English literature from 1978 to 2009. Conclusions.—Although goblet cells are required by the American College of Gastroenterology to confirm a diagnosis of Barrett esophagus, this definition might expand to include columnar-lined esophagus without goblet cells. The recognition of dysplasia in Barrett esophagus remains a difficult task for the surgical pathologist, with difficulties in distinguishing reactive epithelium from dysplasia, low-grade dysplasia from high-grade dysplasia, and even high-grade dysplasia from intramucosal adenocarcinoma.

Endoscopic Surveillance Practice for Barrett's Oesophagus in Scotland and Early Experience in Implementing Local Guidelines

2003 ◽  
Vol 48 (2) ◽  
pp. 43-45 ◽  
Author(s):  
E F Shen ◽  
S Gladstone ◽  
G Milne ◽  
S Paterson-Brown ◽  
I D Penman
Keyword(s):  
Early Experience ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Wide Variability ◽  
Low Grade Dysplasia ◽  
Surveillance Practice ◽  
Four Quadrant ◽  
The Impact

Management of columnar lined oesophagus (CLO; Barrett s oesophagus) is controversial. We prospectively audited surveillance practices in Scotland and prospectively assessed the impact of introducing local guidelines for Barrett s surveillance in Edinburgh. Most respondents were gastroenterologists. The majority take random, not four quadrant, biopsies from the CLO. In Edinburgh during 2000, 80 patients underwent surveillance. The guideline protocol was not followed in 30 (37.5%) patients. Follow up of patients without dysplasia generally conformed to the guidelines. Follow up of patients with low grade dysplasia was highly variable while management of those with high grade dysplasia followed the guidelines. Overall we found a wide variability in the management and surveillance of CLO. Early experience suggests that implementation of guidelines is helpful but there is still variation in practice.

Sign in / Sign up

Export Citation Format

Share Document