INTESTINE Vol.10 No.5(4-2)

Theme Update on laterally spreading tumor (LST)
Title Specific correlation of CpG island methylation status and K-ras mutation with endoscopic features of colorectal adenomas, especially laterally spreading tumors
Publish Date 2006/09
Author Sakiko Hiraoka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Jun Kato Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Yasushi Shiratori Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
[ Summary ] Out of 108 sporadic colorectal adenomas larger than 1 cm, the CpG island methylator phenotype (CIMP) was determined by examination of methylation status at p16, MINT 1, 2, 12, and 31 loci. K-ras codon 12 and 13 point mutations were also examined. The relationship between macroscopic appearance and CIMP status or K-ras mutations was analyzed. CpG island methylation, involving two or more loci out of five regions examined (CIMP-high) was more likely to be observed in the LST granular type (14 / 23 ; 61 %) than in conventional protruded-type adenomas (18 / 73 ; 25 %) (p = 0.002). The prevalence of K-ras mutations in the LST granular type (18 / 23 ; 78 %) was significantly higher than that in the protruded-type adenomas (18 / 73 ; 25 %) (p < 0.0001). Moreover, the prevalence of CIMP-high and K-ras mutations in the LST granular type, located in the proximal colon, was much higher (11 / 13 ; 85 %, and 12 / 13 ; 92 %, respectively). In contrast, the LST non-granular type exhibited a low prevalence for CIMP-high (1 / 12 ; 8 %) and K-ras mutations (2 / 12 ; 17 %). The high prevalence of CIMP-high and K-ras mutations in the LST granular type, especially in the proximal colon, could strongly suggest that the LST granular type appearance is associated with a unique genetic and epigenetic carcinogenic pathway.
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