title: B2 adrenergic receptors and morphological changes of the enteric nervous system in colorectal adenocarcinoma.
abstract: OBJECTIVE
  To study the morphology of the enteric nervous system and the expression of beta-2 adrenergic (B2A) receptors in primary colorectal cancer.
  
  
  METHODS
  In this study, we included forty-eight patients with primary colorectal cancer and nine patients for control tissue from the excision of a colonic segment for benign conditions. We determined the clinicopathological features and evaluated the immunohistochemical expression pattern of B2A receptors as well as the morphological changes of the enteric nervous system (ENS). In order to assess statistical differences, we used the studentt-test for comparing the means of two groups and one-way analysis of variance with Bonferroni'spost hocanalysis for comparing the means of more than two groups. Correlations were assessed using the Pearson's correlation coefficient.
  
  
  RESULTS
  B2A receptors were significantly associated with tumor grading, tumor size, tumor invasion, lymph node metastasis (P< 0.05), while there were no statistically significant associations with gender, CRC location and gross appearance (P> 0.05). We observed, on one hand, a decrease of the relative area for both Auerbach and Meissner plexuses with the increase of the tumor grading, and on the other hand, an increase of the relative area of other nervous elements not in the Meissner plexus or in the Auerbach plexus with the tumor grading. For G1 tumors we found that epithelial B2A area showed an inverse correlation with the Auerbach plexus areas [r(14) = -0.531,P< 0.05], while for G2 tumors, epithelial B2A areas showed an indirect variation with both the Auerbach plexus areas [r(14) = -0.453,P< 0.05] and the Meissner areas [r(14) = -0.825,P< 0.01]. For G3 tumors, the inverse dependence increased for both Auerbach [r(14) = -0.587,P< 0.05] and Meissner [r(14) = -0.934,P< 0.05] plexuses.
  
  
  CONCLUSIONS
  B2A receptors play an important role in colorectal carcinogenesis and can be utilized as prognostic factors. Furthermore, study of the ENS in colorectal cancer may lead to targeted molecular therapies.
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Raluca Niculina
authors.initials: RN
authors.lastname: Ciurea
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Ion
authors.initials: I
authors.lastname: Rogoveanu
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pirici
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Georgică-Costinel
authors.initials: GC
authors.lastname: Târtea
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Costin Teodor
authors.initials: CT
authors.lastname: Streba
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Florescu
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Cătălin
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Ileana
authors.initials: I
authors.lastname: Puiu
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Elena-Anca
authors.initials: EA
authors.lastname: Târtea
authors.affiliation: Raluca Niculina Ciurea, Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
authors.forename: Cristin Constantin
authors.initials: CC
authors.lastname: Vere
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism*; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000378:metabolism*; D017615:Enteric Nervous System / Q000473:pathology*; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009197:Myenteric Plexus / Q000378:metabolism; D060787:Neoplasm Grading; D011379:Prognosis; D018343:Receptors, Adrenergic, beta-2 / Q000378:metabolism*
chemical_list: D018343:Receptors, Adrenergic, beta-2
keywords: Beta-2 adrenergic receptors; Colorectal adenocarcinoma; Enteric nervous system; Spectral unmixing immunohistochemistry; Tumor grading