Proliferative activity at colonic anastomoses as determined by statin. A nonproliferation-specific nuclear protein.
OBJECTIVE
One theory of anastomotic recurrence in large bowel carcinoma is that epithelial hyperplasia at the suture line causes metachronous carcinoma.


METHODS
S44, a monoclonal antibody directed against statin, a nuclear protein expressed in quiescent cells, was used to determine whether the anastomosis represents an area with a high proliferation rate. During follow-up colonoscopic examination of patients who had undergone previous resection for colorectal carcinoma, biopsies were taken from the anastomotic site and from the mucosa 10 to 15 cm from the anastomosis. One side of 10 well-oriented crypts was counted for each patient with the number of nuclei positive for statin being determined by the presence of dark brown reaction product.


RESULTS
The average percentages of statin-positive cells varied between 19.4 and 44.4 (average, 31.3 +/- 6.5) for the normal mucosa and 22.8 to 35.1 (average, 29.98 +/- 3.67) for the anastomotic mucosa. The differences were not significant. There were no differences between those patients in whom the postoperative time elapsed was two years or less and those greater than two years.


CONCLUSIONS
This study is unique in that the proliferative activity at the site of colonic anastomosis was determined in a clinical setting, and patients in which the anastomoses were created anywhere from 1 to 14 years earlier were included. Using S44 as a marker, this study does not support the theory that suture line recurrence is a result of an enhanced proliferation rate.
Kyzer
S
S
Department of Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada.
Gordon
P H
PH
Mitmaker
B
B
Wang
E
E
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis*; D018797:Cell Cycle Proteins; D002455:Cell Division; D003106:Colon / Q000737:chemistry / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D009364:Neoplasm Recurrence, Local / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D009687:Nuclear Proteins / Q000032:analysis*; D020648:Peptide Elongation Factor 1; D011506:Proteins / Q000032:analysis*
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins; C503234:EEF1A2 protein, human; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D020648:Peptide Elongation Factor 1; D011506:Proteins