title: Overexpression of p53 predicts colorectal neoplasia risk in patients with inflammatory bowel disease and mucosa changes indefinite for dysplasia.
abstract: OBJECTIVE
  We previously demonstrated a significant colorectal neoplasia risk in inflammatory bowel disease (IBD) patients with mucosal changes indefinite for dysplasia (IND) and the potential diagnostic utility of p53 and cytokeratin 7 immunohistochemistry in IBD-associated neoplasia. The primary aim of this exploratory study was to determine the predictive value of the two markers for neoplasia risk in the IBD-IND population.
  
  
  METHODS
  We identified 44 eligible cases with IBD and IND in colon biopsy from our pathology database. We semi-quantified the expression of p53 and cytokeratin 7 in the colon biopsies by immunohistochemistry and correlated their expression, demographic information, and clinical features with colorectal neoplasia outcome.
  
  
  RESULTS
  The mean age of the cohort was 46.6 ± 15.1 years, with 25 (56.8%) being male. The median follow-up was 101 months (range: 6-247) after IND diagnosis. Among these 44 patients, 11 (25%) progressed to neoplasia (low-grade dysplasia = 6; high-grade dysplasia = 2; cancer 3) at a median follow-up of 66 months (range: 19-145). Univariate analysis demonstrated that age and p53 overexpression were associated with progression to neoplasia.
  
  
  CONCLUSIONS
  Twenty-five percent of patients with IBD and IND developed colorectal dysplasia or cancer. Overexpression of p53 and age are associated with neoplastic progression.
authors.affiliation: Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Bela
authors.initials: B
authors.lastname: Horvath
authors.affiliation: Department of Geriatric Surgery, the Second Xiangya Hospital of Central South University, Changsha, China, Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ganglei
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xianrui
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA and.
authors.forename: Keith K
authors.initials: KK
authors.lastname: Lai
authors.affiliation: Department of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA, liux3@ccf.org.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Liu
keywords: Crohn’s disease; colorectal neoplasia; cytokeratin 7; inflammatory bowel disease; p53; ulcerative colitis