PURPOSE: In a recent comparative histologic survey of flat colorectal neoplasias, we found more lesions with highgrade dysplasia (HGD) and carcinoma in Japanese than in Swedish patients. The purpose of this work was to assess the p53 protein overexpression in flat colorectal neoplasias in Swedish patients and to compare results with those reported in Japan. METHOD: A total of 57 neoplastic lesions of the colorectal mucosa were investigated: 29 had been regarded both at endoscopy and at histology as flat and the remaining 28 as exophytic. Deparaffinized, rehydrated sections were treated immunohistochemically to detect the p53 protein. Lesions having a moderate (++) or high (+ + +) staining were considered as overexpressing the p53 protein. RESULTS: Results indicated that 16.7 percent (1/6) of the exophytic adenomas with low-grade dysplasia (LGD) had distinct p53 overexpression as well as 57.1 percent (8/14) of those with HGD and 87.5 percent(7/8) with invasive growth. In flat neoplastic lesions, 7.7 percent (1/13) of the tubular adenomas with LGD, 25 percent (3/12) of tubular adenomas with HGD, and 75 percent (3/4) of adenocarcinomas arising in flat adenomas had p53 overexpression. CONCLUSIONS: In Swedish patients, the proportion of flat and exophytic colorectal neoplasias showing p53 immunoreactivity increased with increasing degree of dysplasia, the highest percent being recorded in lesions with invasive growth. Because a similar stepwise increase was reported for exophytic and flat colorectal neoplasias in Japan, it seems that the comparison of results in both countries is justifiable. One possible conclusion from this comparison is that the higher proportion of flat neoplastic colorectal lesions with HGD and carcinoma in the Japanese (compared with the Swedish) takes place for reasons extraneous to the overexpression of the p53 protein.
This is a preview of subscription content, log in to check access.
Lockhart-Mummery JP, Dukes C. The precancerous changes in the rectum and colon. Surg Gynecol Obstet 1928;46:591–6.Google Scholar
Swinton NW, Warren S. Polyps of the colon and rectum and their relation to malignancy. JAMA 1939;113:1927–36.Google Scholar
Jackman RJ, Mayo CW. The adenoma-carcinoma sequence in cancer of the colon. Surg Gynecol Obstet 1951;93:327–30.PubMedGoogle Scholar
Muto T, Kamiya J, Sawada T,et al. Small “flat adenoma” of the large bowel with special reference to its clinicopathologic features. Dis Colon Rectum 1985;28:847–51.PubMedGoogle Scholar
Rubio C, Shetye J. Flat adenoma-adenocarcinoma sequence in the colon of rats. Dis Colon Rectum 1994;37:1300–6.PubMedGoogle Scholar
Rubio C, Takayama S. Difference in histology and size in colonic tumors of rats receiving two different carcinogens. J Environ Pathol Toxicol Oncol 1990;13:191–7.Google Scholar
Kudo S. Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy 1993;25:455–61.PubMedGoogle Scholar
Adachi M, Muto T, Morioka Y, Ikenaga T, Hara M. Flat adenoma and flat mucosal carcinoma (IIb type)—a new precursor of colorectal carcinoma? Report of two cases. Dis Colon Rectum 1988;31:236–43.PubMedGoogle Scholar
Rubio CA, Kumagai J, Kanamori M, Yanagisawa A, Nakamura K, Kato Y. Flat adenomas and flat adenocarcinomas of the colorectal mucosa in japanese and Swedish patients: a comparative histologic study. Dis Colon Rectum 1995;38:1075–9.PubMedGoogle Scholar
Greenblatt MS, Bennett WP, Hollstein M, Harris CC. Mutations in the p53 tumor suppressor gene: clues to cancer etiology and molecular pathogenesis. Cancer Res 1994;54:4855–78.PubMedGoogle Scholar
Yukawa M, Fujimori T, Maeda S, Tabuchi M, Nagasako K. Comparative clinicopathological and immunohistochemical study of ras and p53 in flat and polypoid type colorectal tumours. Gut 1994;35:1258–61.PubMedGoogle Scholar
Ohue M, Tomita N, Monden T,et al. A frequent alteration of p53 gene in carcinoma in adenoma of colon1. Cancer Res 1994;54:4798–804.PubMedGoogle Scholar
Yamamura-Idei Y, Satonaka K, Fujimori T, Maeda S, Chiba T. p53 mutations in flat-and polypoid-type colorectal tumors detected by temperature-gradient gel electrophoresis. Dig Dis Sci 1994;39:2043–51.PubMedGoogle Scholar
Jaramillo E, Watanabe M, Slezak P, Rubio C. Flat neoplastic lesions of the colon and rectum detected by high resolution video endoscopy and chromoscopy. Gastrointest Endosc 1995;42:114–22.PubMedGoogle Scholar