Clinical Gastroenterology Vol.25 No.10(5)

Theme Precancerous Conditions and Cancer High-risk Lesions in the Colorectum
Title Aberrant Crypt Foci (ACF) -- Precursor of Colorectal Adenoma and Cancer
Publish Date 2010/09
Author Koichi Okamoto Department of Gastroenterology and Oncology, University of Tokushima Graduate School
Author Atsushi Inoue Department of Gastroenterology and Oncology, University of Tokushima Graduate School
Author Yasuteru Fujino Department of Gastroenterology and Oncology, University of Tokushima Graduate School
Author Tetsuji Takayama Department of Gastroenterology and Oncology, University of Tokushima Graduate School
[ Summary ] Aberrant crypt foci (ACF), which are tiny lesions in the colorectum observed when densely stained with methyleneblue, have attracted attention as a precursor of colorectal carcinogenesis. Histologically, ACF consist of large crypts which often have branching and various grades of dysplasia. They are classified into dysplastic ACF, and nondysplastic ACF depending on their degree of dysplasty. It is possible to identify ACF using magnifying endoscopy. It has been found that the number of ACFs increase proportionally, with the lowest incidence in normal subjects and increasing in adenoma patients, and the highest in cancer patients. We also found many polyps which were superimposed on ACF, suggesting that ACF develops into polyps. ACF observation with magnifying endoscopy is useful for surveillance of high-risk groups for colorectal cancer and for chemopreventive study targeting ACF.
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