A case of colorectal carcinoma in adenoma analyzed by a cDNA array.
METHODS
A 68-year-old woman presenting with bloody stools and anemia was referred to our hospital. Colonoscopy showed a Is-type tumor of 45 mm in diameter in the cecum and three Is-type tumors in the ascending colon. Ileocecal resection with regional lymph node dissection was performed. Microscopically, the large tumor consisted of a well-differentiated adenocarcinoma with a tubulovillous adenoma (TVA) component (carcinoma in adenoma). Some carcinoma (CA) cells had invaded the submucosal layer, but the lymph nodes were negative for malignancy. The other three polyps were diagnosed as TVAs. Because her family history fulfilled the Amsterdam criteria II for hereditary non-polyposis colorectal cancer (HNPCC), genetic analysis was performed. All of the four tumor tissues were classified as microsatellite stable (MSS) according to the National Cancer Institute guideline for analysis of microsatellite instability (MSI). K-ras mutation was detected in both CA and TVA lesions of the carcinoma in adenoma. To clarify relevant alterations of gene expression associated with adenoma-carcinoma progression, the gene expression profiles of these tumor tissues were analyzed by a cDNA array.


RESULTS
Although the gene expression profiles were similar, insulin-like growth factor-II (IGF-II) was expressed most differentially in CA and TVA tissues. The results were further substantiated by comparison of the gene expression profiles of CA and TVA lesions of the carcinoma in adenoma.


CONCLUSIONS
The results suggest that overexpression of IGF-II played an important role in the progression of adenoma to carcinoma in this patient.
Nosho
Katsuhiko
K
First Department of Internal Medicine, Sapporo Medical University, Sapporo, Japan. nosho@sapmed.ac.jp
Yamamoto
Hiroyuki
H
Takamaru
Hiroyuki
H
Hamamoto
Yasuo
Y
Goto
Akira
A
Yoshida
Yukinari
Y
Arimura
Yoshiaki
Y
Endo
Takao
T
Hirata
Koichi
K
Imai
Kohzoh
K
D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D018253:Adenoma, Villous / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D018076:DNA, Complementary / Q000032:analysis* / Q000235:genetics; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic / Q000502:physiology; D011905:Genes, ras / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D007335:Insulin-Like Growth Factor II / Q000235:genetics; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology / Q000601:surgery; D010375:Pedigree; D012333:RNA, Messenger / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction
D014408:Biomarkers, Tumor; D018076:DNA, Complementary; D012333:RNA, Messenger; D007335:Insulin-Like Growth Factor II