INTESTINE Vol.25 No.2(3-2)

Theme Atlas of type IIc colorectal cancer
Title Molecular characteristics of IIc lesions
Publish Date 2021/07
Author Yuta Kouyama Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Yushi Ogawa Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Kenichi Mochizuki Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Kazuki Kato Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Koki Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Katsuro Ichimasa Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Hideyuki Miyachi Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Koshi Mimori Department of Surgery, Kyushu University Beppu Hospital
[ Summary ] Most colorectal cancers (CRCs) are known to evolve from malignant transformation of polypoid adenomas. However, recent studies have reported that CRC may originate not only from protruding lesions, but also from flat and depressed colorectal neoplasms (CRNs). Reportedly, endoscopic detection of such depressed CRNs is challenging, and these lesions are at a signifi cantly high risk of presenting as a malignant phenotype at the time of diagnosis. Molecular features of depressed CRNs remain unclear owing to the lack of adequate sample biopsies. We performed whole exome and RNA sequencing for 19 depressed stage T1 CRCs. The rate of KRAS mutations was only 5 % in depressed CRCs and 50 % in protruding CRCs. Amplification of chromosome 13 was higher in depressed than in protruding CRCs. The expression of genes associated with epithelialmesenchymal transition, angiogenesis, and inflammatory response was higher in depressed than in protruding CRCs. Expression of growth factors such as fibroblast growth factor 14 and insulin-like growth factor 2 was higher in depressed CRCs.
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