title: Different genetic features associated with colon and rectal carcinogenesis.
abstract: OBJECTIVE
  The issue of whether colon and rectal cancer should be considered as a single entity or two distinct entities is still debated, and there is a need to improve studies addressing the heterogeneity of the pathogenetic pathway leading to sporadic colorectal cancers (SCRCs) as well as to identify biological and/or molecular differences between colon and rectal cancers.
  
  
  METHODS
  Specimens of SCRCs were analyzed for somatic mutations in APC, K-ras, and TP53 genes and loss-of-heterozygosity of chromosome 18.
  
  
  RESULTS
  Eleven SCRCs showed microsatellite instability. APC mutation frequency was significantly lower in microsatellite instability (MIN+) than in MIN- SCRCs. All MIN- SCRCs showed beta-catenin overexpression. A combined analysis of the biomarkers revealed two pathways mainly represented by MIN- SCRCs and differently followed on the basis of tumor location, APC-K-ras-TP53-Ch18q and APC-TP53-Ch18q.
  
  
  CONCLUSIONS
  The APC-beta-catenin pathway is inactivated in MIN- SCRCs and represents the first hit of SCRC development. Two preferential pathways followed by SCRCs occur, one K-ras dependent, in agreement with the Fearon and Vogelstein model, and the other K-ras independent. Significant differences between colon and rectal tumors occur in our series of MIN- SCRCs. The different pathways observed and their distribution can be summarized as follows: (a) K-ras mutations were more commonly detected in colon than in rectum; (b) the number of mutations detected was significantly higher in colon than in rectal tumors; and (c) a mutational pattern restricted to the APC gene was more common in rectal than in colon tumors. This molecular characterization can be translated into a clinical setting to improve diagnosis and to direct a rationale pharmacological treatment.
authors.affiliation: Department of Experimental Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori, and Federazione Italiana Ricerca Cancro, Institute of Molecular Oncology, Milan, Italy.
authors.forename: Milo
authors.initials: M
authors.lastname: Frattini
authors.forename: Debora
authors.initials: D
authors.lastname: Balestra
authors.forename: Simona
authors.initials: S
authors.lastname: Suardi
authors.forename: Maria
authors.initials: M
authors.lastname: Oggionni
authors.forename: Paola
authors.initials: P
authors.lastname: Alberici
authors.forename: Paolo
authors.initials: P
authors.lastname: Radice
authors.forename: Aurora
authors.initials: A
authors.lastname: Costa
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Daidone
authors.forename: Ermanno
authors.initials: E
authors.lastname: Leo
authors.forename: Silvana
authors.initials: S
authors.lastname: Pilotti
authors.forename: Lucio
authors.initials: L
authors.lastname: Bertario
authors.forename: Marco A
authors.initials: MA
authors.lastname: Pierotti
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor; D002887:Chromosomes, Human, Pair 18; D003110:Colonic Neoplasms / Q000235:genetics*; D003598:Cytoskeletal Proteins / Q000378:metabolism; D004252:DNA Mutational Analysis; D005091:Exons; D005260:Female; D017491:Genes, APC; D016158:Genes, p53; D011905:Genes, ras / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D019656:Loss of Heterozygosity; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D009154:Mutation; D012004:Rectal Neoplasms / Q000235:genetics*; D015534:Trans-Activators / Q000378:metabolism; D051176:beta Catenin
chemical_list: D014408:Biomarkers, Tumor; C495270:CTNNB1 protein, human; D003598:Cytoskeletal Proteins; D015534:Trans-Activators; D051176:beta Catenin