Aberrant crypt foci: are they intermediate endpoints of colon carcinogenesis in humans?
Aberrant crypt foci: are they intermediate endpoints of colon carcinogenesis in humans?
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DOI：
10.1097/mog.0b013e32831db286
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发表时间：
2009-01-01
影响因子：
2.5
通讯作者：
Schoen, Robert E.
中科院分区：
文献类型：
--
作者：
Gupta, Akshay K.;Schoen, Robert E.
综述目的来自流行病学和分子研究的大量文献支持异常隐窝病灶（ACF）作为结直肠腺瘤的假定前体和结直肠癌的潜在生物标志物的作用。在这篇综述中，我们批判性地审查了使用 ACF 作为中间终点的证据。 最新发现 ACF 的最新大规模多中心研究提出了关于 ACF 的问题。 ACF 的患病率与结直肠腺瘤无关，并且使用高倍染色内窥镜进行 ACF 检测的技术已经证明，不同内窥镜医师之间以及随着时间的推移存在相当大的差异。与欧洲和日本的研究相比，发育不良的 ACF 一度被认为是注定会发生腺瘤转化的 ACF，但在美国个体中很少被发现。据称，内窥镜检测到的 ACF 中很大一部分尚未得到组织学检查的证实。最后，ACF 的分子表征仅在有限的基础上进行了研究。总结 ACF 仍然是结直肠癌的潜在生物标志物，但与正在开发的其他生物标志物类似，在确保可靠的临床应用之前，需要对 ACF 进行进一步的研究。
Purpose of reviewThere is a wealth of literature, both from epidemiological and molecular studies, which support the role of aberrant crypt foci (ACF) as a putative precursor to colorectal adenomas and a potential biomarker for colorectal carcinoma. In this review, we critically examine the evidence on employing ACF as an intermediate endpoint.Recent findingsRecent, larger-scale, multicenter studies of ACF have raised questions about ACF. The prevalence of ACF has not correlated with colorectal adenomas, and the technique for ACF detection using high-magnification chromoendoscopy has demonstrated considerable variability across endoscopists and over time. Dysplastic ACF, once postulated as the ACF destined for adenomatous transformation, have been rarely identified in US individuals, in contrast to European and Japanese investigations. A substantial percentage of purported, endoscopically detected ACF have not been confirmed on histologic review. Finally, molecular characterization of ACF has been studied on only a limited basis.SummaryACF remain a potential biomarker for colorectal cancer, but similar to other biomarkers under development, additional study of ACF is needed before reliable, clinical application can be assured.