Limits of diagnosis and molecular markers for early detection of ulcerative colitis-associated colorectal neoplasia
Limits of diagnosis and molecular markers for early detection of ulcerative colitis-associated colorectal neoplasia
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DOI：
10.1159/000111482
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发表时间：
2008-01-01
期刊：
影响因子：
3.2
通讯作者：
Fujimori, Takahiro
中科院分区：
文献类型：
--
作者：
Fujii, Shigehiko;Katsumata, Daisuke;Fujimori, Takahiro
在长期和广泛的溃疡性结肠炎（UC）患者中，结直肠肿瘤的发病率一直在增加，因此广泛推荐进行结肠镜检查。然而，由于uc相关的肿瘤通常难以在内镜下发现，也难以在组织学上与炎性再生上皮区分，因此目前的监测效果仍然不令人满意。为了克服这些困难，已经介绍了诊断uc相关肿瘤的辅助方法，用于内镜诊断的彩色放大内窥镜和用于组织学诊断的p53改变分析。此外，如果有可能将长期和广泛结肠炎的UC患者区分为高风险和低风险的肿瘤亚组，这将使医生能够对高风险患者进行更密集的监测。UC伴瘤变患者非肿瘤性上皮的一些分子改变可能有望作为识别UC伴瘤变风险增加个体的标志物。我们评估了非肿瘤性结直肠上皮的雌激素受体（ER）甲基化，以阐明这种表观遗传改变是否有助于预测UC患者瘤变风险的增加，并证明肿瘤患者整个结直肠非肿瘤性上皮的ER甲基化水平高于非肿瘤性结直肠患者。这些结果表明，分析内质网基因甲基化可能有助于识别长期和广泛UC患者中肿瘤风险增加的个体。版权所有(c) 2008 S. Karger AG，巴塞尔。
The incidence of colorectal neoplasia has been increasing among patients with long-standing and extensive ulcerative colitis (UC), and therefore surveillance colonoscopy has been widely recommended. However, because UC-associated neoplasia is often difficult to detect endoscopically and to discriminate from inflammatory regenerative epithelium histologically, the efficacy of current surveillance remains unsatisfactory. In order to overcome these difficulties, adjunctive modalities for diagnosing UC-associated neoplasia, chromo-and magnifying endoscopy for endoscopic diagnosis and analysis of p53 alteration for histological diagnosis have been introduced. Furthermore, if it were possible to differentiate UC patients with long-standing and extensive colitis into subgroups with a high and a low risk of neoplasia, it would enable physicians to conduct more intensive surveillance with these modalities for patients at higher risk. Several molecular alterations of nonneoplastic epithelium in UC patients with neoplasia may be promising as markers for identifying individuals with UC at increased risk of neoplasia. We evaluated estrogen receptor (ER) methylation of nonneoplastic colorectal epithelium to clarify whether this epigenetic alteration can contribute to the prediction of increased neoplasia risk in UC patients and demonstrated that the ER methylation level in nonneoplastic epithelium was higher throughout the colorectum in patients with neoplasia than in those without. These results suggest that analysis of ER gene methylation may be potentially useful for identifying individuals at increased risk of neoplasia among patients with long-standing and extensive UC. Copyright (c) 2008 S. Karger AG, Basel.