| Theme | Mystery concerning the lower rectum | |
|---|---|---|
| Title | Clinicopathological study and the detection of K-ras codon 12 point mutation in colorectal carcinomas -- Differences between colonic carcinomas and rectal carcinomas from genetic and morphologic perspectives | |
| Publish Date | 2010/11 | |
| Author | Takahiro Fujimori | Department of Pathology, Dokkyo Medical University |
| Author | Kenjiro Kotake | Department of Surgery, Tochigi Cancer Center |
| Author | Hiroyuki Tanaka | Department of Pathology, Dokkyo Medical University |
| Author | Motohiko Hirose | Department of Pathology, Dokkyo Medical University |
| Author | Yuko Hakata | Department of Pathology, Dokkyo Medical University |
| Author | Yukari Fujimori | Department of Pathology, Dokkyo Medical University |
| Author | Hidetsugu Yamagishi | Department of Pathology, Dokkyo Medical University |
| Author | Kazuhito Ichikawa | Department of Pathology, Dokkyo Medical University |
| Author | Shigeki Tomita | Department of Pathology, Dokkyo Medical University |
| Author | Johji Imura | Department of Pathology, Dokkyo Medical University |
| Author | Hideaki Sato | Saiseikai Kawaguchi General Hospital |
| Author | Shigehiko Fujii | Gastroenterology, Kyoto Katsura Hospital |
| Author | Yasushi Sano | Gastrointestinal Cencer, Sano Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospita |
| Author | Yo Kato | Dokkyo Medical University Nikko Medical Center |
| Author | Akira Terano | Dokkyo Medical University President |
| [ Summary ] | In this article, we present recent reviews regarding the prevalence of morphologic backgrounds and codon 12 K-ras mutation analysis in colorectal carcinomas in comparison with multi-institutional registry of large bowel cancer in Japan (prospective registry data, cases treated in 1999). This registry was based on pathological concepts related to basic and environmental cancer. We present an outline of differences between the adenoma-carcinoma sequence (ACS) and de novo carcinogenesis. Over the past twenty years, the incidence of and mortality rates for colorectal carcinomas in Japan have risen in relation to the adoption of Western life styles and the increased numbers of elderly patients. It is widely accepted that advanced neoplasias (AVN) are detected in patients with clean colons during surveillance colonoscopies in Western countries. We predict that Western endoscopists may overlook not only IIc and LST-NG (both K-ras wild type), but also LST-G (K-ras mutant type) conditions, which are causally related to AVN in the right-side of the colon. This study concluded that not only is the presence of codon 12 K-ras mutations important in relation to cancer progression in right side colon carcinomas but also that it may predispose patients to more aggressive biological actions when interval cancers, are under surveillance after clean colons have been determined. To resolve this issue, further studies are required, based on concepts related to basic and environmental carcinomas, as well as genetic analysis of ACF and villous tumors, which may be premalignant lesions. |
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