INTESTINE Vol.9 No.1(5-1)

Theme Colorectal cancer in ulcerative colitis
Title Genetic and epigenetic alterations related to carcinogenesis in ulcerative colitis associated neoplasia
Publish Date 2005/01
Author Keiichi Tominaga Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine / Department of Gastroenterology, Dokkyo University School of Medicine
Author Shigehiko Fujii Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine
Author Kenichiroh Mukawa Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine / Department of Gastroenterology, Dokkyo University School of Medicine
Author Hideyuki Hiraishi Department of Gastroenterology, Dokkyo University School of Medicine
Author Takahiro Fujimori Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine
[ Summary ] It is recognized that extensive and long standing ulcerative colitis (UC) predisposes patients to the development of colorectal neoplasia. There is general agreement that UC associated colorectal cancer is preceded by dysplasia, arising from a chronic inflammation-dysplasia-carcinoma sequence. UC-associated neoplasia, in the precancerous and early stages, is difficult to detect endoscopically and difficult to discriminate from an inflammatory regenerative epithelium, histologically. Therefore, annual surveillance colonoscopy is recommended for extensive and long standing UC patients. However, current surveillance colonoscopy methods remain unsatisfactory, therefore we need a new high risk marker to support diagnosis. Recently, various genetic and epigenetic alterations have been reported, such as the p53 mutation, microsatellite instability, pl6 hypermethylation, E-cadherin hypermethylation, age related methylation, and chromosomal alterations, in UC patients with neoplasia. These molecular alterations represent candidates with for new markers, and analyses of the alterations may contribute to more effective cancer surveillance.
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