{"title":"近端和远端结肠之间锯齿状腺癌的离散免疫组织化学和临床病理特征。","authors":"Naoki Tsugawa, Eiji Kamba, Takashi Murakami, Yudai Otsuki, Kei Nomura, Yuichiro Kadomatsu, Hirofumi Fukushima, Kiichi Sugimoto, Tsuyoshi Saito, Tomoyoshi Shibuya, Takashi Yao, Akihito Nagahara","doi":"10.1159/000548705","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal serrated adenocarcinoma (SAC), a subtype of colorectal adenocarcinoma determined histologically, has characteristics of epithelial serrations. Here, we examined the immunohistochemical and clinicopathological characteristics of colorectal SAC.</p><p><strong>Methods: </strong>Thirty-three specimens, pathologically diagnosed as SAC in our hospital between 2013-2022, were collected for immunohistochemistry of MLH1/MUC2/MUC5AC/p53, and sequencing of BRAF/KRAS mutations.</p><p><strong>Results: </strong>The proximal colon contained 25 lesions and the distal colon had 8. Patients with proximal SACs were predominantly female, whereas those exhibiting distal SACs were predominantly male (P = 0.003). Overall, lymph node and distant metastasis were present in 17 (52%) and 11 (33%) cases, respectively, with no significant differences between the proximal and distal groups. MLH1 expression loss was more frequent in proximal cases (40%) than distal SACs (13%). Most cases (97%) were MUC2+. MUC5AC+ was significantly more frequent in proximal cases (92%) than distal SACs (37%, P = 0.004). Significantly less p53 overexpression was present in proximal cases (40%) vs distal SACs (75%). Genetically, the 12 cases of SAC harboring BRAF mutations were all located in the proximal colon, with a significantly greater frequency (P = 0.030) whereas more frequent KRAS mutations were noted in distal SACs. Throughout 5 years of follow-up, three patients (two proximal SAC cases; one distal SAC case) died (mean 6.7 months after surgery) because of their disease.</p><p><strong>Conclusion: </strong>Proximal SACs exhibit distinct clinicopathological and molecular features compared to distal SACs, largely aligning with the sessile serrated and traditional serrated pathways, respectively.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-22"},"PeriodicalIF":3.6000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Discrete immunohistochemical and clinicopathological features of serrated adenocarcinoma between the proximal and distal colon.\",\"authors\":\"Naoki Tsugawa, Eiji Kamba, Takashi Murakami, Yudai Otsuki, Kei Nomura, Yuichiro Kadomatsu, Hirofumi Fukushima, Kiichi Sugimoto, Tsuyoshi Saito, Tomoyoshi Shibuya, Takashi Yao, Akihito Nagahara\",\"doi\":\"10.1159/000548705\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Colorectal serrated adenocarcinoma (SAC), a subtype of colorectal adenocarcinoma determined histologically, has characteristics of epithelial serrations. Here, we examined the immunohistochemical and clinicopathological characteristics of colorectal SAC.</p><p><strong>Methods: </strong>Thirty-three specimens, pathologically diagnosed as SAC in our hospital between 2013-2022, were collected for immunohistochemistry of MLH1/MUC2/MUC5AC/p53, and sequencing of BRAF/KRAS mutations.</p><p><strong>Results: </strong>The proximal colon contained 25 lesions and the distal colon had 8. Patients with proximal SACs were predominantly female, whereas those exhibiting distal SACs were predominantly male (P = 0.003). Overall, lymph node and distant metastasis were present in 17 (52%) and 11 (33%) cases, respectively, with no significant differences between the proximal and distal groups. MLH1 expression loss was more frequent in proximal cases (40%) than distal SACs (13%). Most cases (97%) were MUC2+. MUC5AC+ was significantly more frequent in proximal cases (92%) than distal SACs (37%, P = 0.004). Significantly less p53 overexpression was present in proximal cases (40%) vs distal SACs (75%). Genetically, the 12 cases of SAC harboring BRAF mutations were all located in the proximal colon, with a significantly greater frequency (P = 0.030) whereas more frequent KRAS mutations were noted in distal SACs. Throughout 5 years of follow-up, three patients (two proximal SAC cases; one distal SAC case) died (mean 6.7 months after surgery) because of their disease.</p><p><strong>Conclusion: </strong>Proximal SACs exhibit distinct clinicopathological and molecular features compared to distal SACs, largely aligning with the sessile serrated and traditional serrated pathways, respectively.</p>\",\"PeriodicalId\":11315,\"journal\":{\"name\":\"Digestion\",\"volume\":\" \",\"pages\":\"1-22\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Digestion\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000548705\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548705","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
结直肠锯齿状腺癌(SAC)是一种组织学确定的结直肠腺癌亚型,具有上皮锯齿状的特征。在这里,我们检查了结直肠SAC的免疫组织化学和临床病理特征。方法:收集我院2013-2022年病理诊断为SAC的标本33例,进行MLH1/MUC2/MUC5AC/p53免疫组化及BRAF/KRAS突变测序。结果:近端结肠病变25例,远端结肠病变8例。近端SACs患者以女性为主,远端SACs患者以男性为主(P = 0.003)。总体而言,淋巴结转移17例(52%),远处转移11例(33%),近端组和远端组之间无显著差异。MLH1表达缺失在近端SACs病例中(40%)比远端SACs病例(13%)更常见。大多数病例(97%)为MUC2+。MUC5AC+在近端SACs中的发生率(92%)明显高于远端SACs (37%, P = 0.004)。与远端SACs(75%)相比,近端SACs病例中p53过表达明显较少(40%)。遗传上,12例携带BRAF突变的SAC均位于结肠近端,频率显著高于(P = 0.030),而KRAS突变更频繁地发生在远端SAC。在5年的随访中,3例患者(2例近端SAC, 1例远端SAC)因疾病死亡(平均术后6.7个月)。结论:与远端SACs相比,近端SACs表现出不同的临床病理和分子特征,在很大程度上分别与无柄锯齿和传统锯齿路径一致。
Discrete immunohistochemical and clinicopathological features of serrated adenocarcinoma between the proximal and distal colon.
Introduction: Colorectal serrated adenocarcinoma (SAC), a subtype of colorectal adenocarcinoma determined histologically, has characteristics of epithelial serrations. Here, we examined the immunohistochemical and clinicopathological characteristics of colorectal SAC.
Methods: Thirty-three specimens, pathologically diagnosed as SAC in our hospital between 2013-2022, were collected for immunohistochemistry of MLH1/MUC2/MUC5AC/p53, and sequencing of BRAF/KRAS mutations.
Results: The proximal colon contained 25 lesions and the distal colon had 8. Patients with proximal SACs were predominantly female, whereas those exhibiting distal SACs were predominantly male (P = 0.003). Overall, lymph node and distant metastasis were present in 17 (52%) and 11 (33%) cases, respectively, with no significant differences between the proximal and distal groups. MLH1 expression loss was more frequent in proximal cases (40%) than distal SACs (13%). Most cases (97%) were MUC2+. MUC5AC+ was significantly more frequent in proximal cases (92%) than distal SACs (37%, P = 0.004). Significantly less p53 overexpression was present in proximal cases (40%) vs distal SACs (75%). Genetically, the 12 cases of SAC harboring BRAF mutations were all located in the proximal colon, with a significantly greater frequency (P = 0.030) whereas more frequent KRAS mutations were noted in distal SACs. Throughout 5 years of follow-up, three patients (two proximal SAC cases; one distal SAC case) died (mean 6.7 months after surgery) because of their disease.
Conclusion: Proximal SACs exhibit distinct clinicopathological and molecular features compared to distal SACs, largely aligning with the sessile serrated and traditional serrated pathways, respectively.
期刊介绍:
''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.