MICROSATELLITE INSTABILITY IN DIFFERENT HISTOLOGICAL TУPES OF COLON POLYPES WITH ASYMPTOMATIC HYSTORY
About the author:
Varyvoda O. Yu.
Type of article:
According to many researchers, CRC most often occurs in the background of polyposis lesion. The aim of the work was to determine the status of MSI in colon polyps, to determine the frequency of polyposis of the colon in asymptomatic patients, to determine the sex-age, histological rate of types and the distribution by localization of the identified polyps. As a result of the study, 32% (64 persons) of asymptomatic patients had been diagnosed polyposis lesions of the colon, of which 8 cases had cancer (12.5%), which is a rather significant proportion of the total. In the share of potentially dangerous polyps, in terms of the development of cancer, 29 cases (45.3%) occurred, which again confirms the need for preventive screenings of the adult population. An immunohistochemical investigation showed the presence of MSI in one case of cancer, where none of the proteins has reacted, which we can consider as a high-level MSN. Expression of MLH-1 protein in the group “Adenoma Minimal Dysplasia” was significantly lower (57.14 ± 18.70%) (p <0.05) compared to the groups “Hyperplastic polyps” and “Adenomy maximal dysplasia”. Expression of MSH-2 protein in the “Adenoma Minimal Dysplasia” group was significantly (p <0.05) lower (2.29 ± 0.30) compared to the group “Hyperplastic Polyps”, where the figure was 3.00 ± 0.00. Expression of the MSH-6 protein was the highest in the Adenoma maximal dysplasia group (3.00 ± 0.00) and significantly (p <0.05) exceeded this figure in the Hyperplastic Polyps group, where it was 2.14 ± 0.30. High expressions of MSH-6 protein expression in the “Hyperplastic Polyps” group give reason to reconsider the significance of these polyps in the development of carcinoma, since they have not been considered as precancerous. The obtained results allow to increase the quality of premorbid diagnostics of CRC development in patients with asymptomatic course of polyposis of the colon and, in the future, to introduce recommendations for predicting the development of malignant transformations of polyps.
polyps, adenomas, colorectal cancer, microsatellite instability
- Prosolenko KA, Zhukova VB. Adekvatnaya kuratsiya patsiyentov s tolstokishechnymi polipami. Yeffektivnaya profilaktika kolorektal’nogo raka. Zdorov’ya Ukraí̈ni. 2006;21(1):15-7. [in Russiаn].
- Screening for Colorectal Cancer: Recommendation and Rationale U.S. Preventive Services Task Force. 2002;137(2):129-31.
- Bond JH. Polyp Guideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Am. J. Gastroent. 2000;95(11):3053-63.
- Ho-Kyung Chun, Dongil Choi, Min Ju Kim, Jongmee Lee, Seong Hyeon Yun, Seung Hoon Kim, еt al. Preoperative Staging of Rectal Cancer: Comparison of 3-T High-Field MRI and Endorectal Sonography. American Journal of Roentgenology. 2006;187:1557-62.
- Sidney J. Winawer. Izlozheniye pozitsii OMGE: Kolorektal’nyy rak. Skrining i nablyudeniye. WGO/OMGE, 2004. [in Russiаn].
- Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993 Dec 30;329(27):1977-81.
- Practice Guidelines colorectal cancer screening. World Gastroenterology Organisation, 2008.
- Cancer reference information (2006 April 1). Available from: http://www.cancer.org (12 may 2006).
- Itzkowitz SH, Present DH. Crohn’s and Colitis Foundation of America Colon Cancer in IBD Study Group, consensus conference: colorectal cancer screening and surveillance in inflammatory bowel disease. Inflamm. Bowel Dis. 2005;11:314-21.
- Ivashkin VT. Kolorektal’nyy rak. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii. 1999;1:88-95. [in Russiаn].
- Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer. CA Cancer J. Clin. 2006;56:160-7.
- Hünerbein M, Totkas S, Ghadimi BM, Schlag PM. Preoperative Evaluation of Colorectal Neoplasms by Colonoscopic Miniprobe Ultrasonography. Ann Surg. 2000;232(1):46-50.
- Nykyshaev VY, Patyy AR, Tumak YN, Kolyada YA. Éndoskopycheskaya dyahnostyka ranneho kolorektalnoho raka. Ukrayinskyy zhurnal maloinvazyvnoyi ta endoskopichnoyi khirurhiyi. 2012:16(1):35-55. [in Russiаn].
- Atkin WS, Cook CF, Cuzick J, Edwards R, Northover JM, Wardle J. Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. Lancet. 2002 Apr 13;359(9314):1291-300.
- Davila RE, Rajan E, Baron TH, Adler DG, Egan JV, Faigel DO, еt al. ASGE guideline: colorectal cancer screening and surveillance. Gastrointest Endosc. 2006 Apr;63(4):546-57.
- ASGE guideline: The role of endoscopy in the diagnosis, staging, and management of colorectal cancer. Gastrointest Endosc. 2005;61:1-6.
- Wiersema MJ, Harewood GC. Endoscopic ultrasound for rectal cancer. Gastroenterol. Clinics. N. Am. 2002;31:1093-105.
- Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med. 2000 Jul 20;343(3):169-74.
- Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationaleUpdate based on new evidence. Gastrointestinal Consortium Panel. Gastroenterology. 2003 Feb;124(2):544-60.
- Baron JA, Beach M, Mandel JS, van Stolk RU, Haile RW, Sandler RS, et al. Calcium supplements and colorectal adenomas. Polyp Prevention Study Group. Ann N Y Acad Sci. 1999;889:138-45.
- Guidelines for Colonoscopy Surveillance after Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. CA Cancer J. Clin. 2006;56:143-59.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 345-349 pages, index UDK 616.345-006.6-076.5:616.345-006.5