title: Clinicopathological and molecular features of colorectal serrated neoplasias with different mucosal crypt patterns.
abstract: OBJECTIVE
  Endoscopic examination shows that serrated neoplasias (SNs), such as serrated adenomas and sessile serrated adenomas, exhibit different mucosal crypt patterns. However, it remains unclear whether advanced serrated polyps with different mucosal crypt patterns have different clinicopathological or molecular features.
  
  
  METHODS
  We classified the mucosal crypt patterns of 86 SNs into three types (hyperplastic, adenomatous, and mixed pattern) and evaluated their clinicopathological and molecular features.
  
  
  RESULTS
  We found significant differences in the proliferative activity status between SNs with mixed/adenomatous patterns and those with the hyperplastic patterns. SNs with the hyperplastic pattern were frequently located in the proximal colon and had a macroscopically superficial appearance, whereas SNs with the adenomatous pattern were often located in the distal colon and had a protruding appearance. Furthermore, a significant difference was observed in the frequency of the CpG island methylator phenotype (CIMP), involving the methylation of two or more CIMP-related genes (MINT1, MINT2, MINT31, p16, and MLH1), between SNs with the hyperplastic pattern and those with the mixed/adenomatous patterns (18/32 (56%) vs. 8/28 (29%) or 7/26 (27%); P=0.0309 or P=0.0249, respectively). Moreover, the prevalence of KRAS mutations was significantly higher in SNs with the adenomatous pattern than in those with the hyperplastic pattern (7/26 (27%) vs. 1/32 (3%); P=0.0173). In comparison with other patterns, the mixed pattern was detected more frequently in mixed serrated polyps (MSPs), which contain separate histological components. Some MSPs exhibited concordant molecular alterations among the different histological components.
  
  
  CONCLUSIONS
  The clinicopathological and molecular features of SNs correlated strongly with their mucosal crypt patterns, which were observed using chromoendoscopy.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. konishimd@med.showa-u.ac.jp
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.forename: Kazuo
authors.initials: K
authors.lastname: Konishi
authors.forename: Toshiko
authors.initials: T
authors.lastname: Yamochi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Katagiri
authors.forename: Hisako
authors.initials: H
authors.lastname: Nozawa
authors.forename: Hiromu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Minoru
authors.initials: M
authors.lastname: Toyota
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Kubota
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramoto
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tojo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Konda
authors.forename: Reiko
authors.initials: R
authors.lastname: Makino
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Nozomi
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Ota
authors.forename: Michio
authors.initials: M
authors.lastname: Imawari
mesh_terms: D018256:Adenomatous Polyps / Q000235:genetics / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics; D049109:Cell Proliferation; D016009:Chi-Square Distribution; D003111:Colonic Polyps / Q000235:genetics / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000235:genetics / Q000473:pathology*; D018899:CpG Islands / Q000235:genetics; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000235:genetics / Q000473:pathology*; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology*; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008745:Methylation; D053842:Microsatellite Instability; D008875:Middle Aged; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology*; D011518:Proto-Oncogene Proteins / Q000235:genetics; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D018709:Statistics, Nonparametric; D055815:Young Adult; D018631:ras Proteins / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D019394:Ki-67 Antigen; D011518:Proto-Oncogene Proteins; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins