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Shouriyo Ghosh,Brijnandan Gupta,Pavan Verma,Sreenivas Vishnubathla,Sujoy Pal,Nihar R Dash,Siddhartha Datta Gupta,Prasenjit Das 대한장연구학회 2018 Intestinal Research Vol.16 No.1
Background/Aims: Aberrant crypt foci (ACF) are early microscopic lesions of the colonic mucosa, which can be detected bymagnified chromoendoscopy. Herein, we have investigated whether ACF identified in different clinical groups can be differentiated based on their characteristics. Methods: Macroscopically unremarkable mucosal flaps were collected from 270 freshcolectomies and divided into 3 clinical groups: colorectal carcinoma (group A), disease controls having known pre-neoplasticpotential (group Bc), and disease controls without risk of carcinoma development (group Bn). Topographic and histologic anal-ysis, immunohistochemistry, and molecular studies (high-resolution melt curve analysis, real-time polymerase chain reaction,and Sanger sequencing) were conducted for certain neoplasia-associated markers. Results: ACF were seen in 107 cases, out ofwhich 72 were left colonic ACF and 35 right colonic ACF (67.2% vs. 32.7%, P =0.02). The overall density of left colonic ACF was0.97/cm, which was greater than the right colonic ACF density of 0.81/cm. Hypercrinia was present in 41 out of 72 left colonicACF and in 14 out of 35 right colonic ACF (P =0.01). Immunohistochemical expression of p53 was also greater in left colonicACF than in right colonic ACF (60.5% vs. 38.2%, P =0.03). However, ACF identified among the 3 clinical groups did not show anydistinguishing topographic, histological, or genetic changes. Conclusions: Left colonic ACF appear to be high-risk based ontheir morphological and prototypic tumor marker signature. ACF identified in different clinical groups do not show significantgenotypic or topographic differences. Further detailed genetic studies are required to elucidate them further.