Clinicopathologic and genetic analysis on histogenesis and development of colorectal carcinoma

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(1) MUC1 expression, E-cadherin reduced expression, a high MVC, and a high Ki-67 LI at the site of deepest tumor invasion are significant for advanced colorectal cancer prognosis.(2) Cathepsin D expression patterns in cancer cells significantly correlates with histologic differentiation and metastatic potential of tumors. In contrast, cathepsin D expression in stromal cells may be involved in the stromal reactions occurring in cancer tissue and may facilitate cancer cell invasion and metastasis.(3) Microvessel count (MVC) at the site of deepest penetration was an independent risk factor for lymph node metastasis in submucosal colorectal carcinoma (CRC). Lesions with low MVC (<40) and submucosal invasion up to 1500 μm had no lymph node metastasis, regardless of histologic grade.(4) Glut1 expression at the site of deepest tumor invasion is an important predictor of a higher malignant potential and poorer prognosis of advanced CRC, and more useful than other clinicopathologic factors commonly used, except for lymph node metastasis. Furthermore, combined analysis of Glut1 and Ki-67 expression can be more useful in predicting the prognosis of patients who have undergone curative surgery for advanced CRC.(5) VEGF-C expression at the site of deepest tumor invasion is an important predictor of a higher malignant potential and poorer prognosis of advanced CRC and is closely related to angiogenesis. Our study results suggest that MVD and VEGF-C may play an important role in angiogenesis and lymphangiogenesis in CRC.(6) In ulcerative colitis (UC)-associated carcinoma, p53 overexpression is a useful marker of neoplasia, whereas, pS2 apparently becomes involved near the point where carcinoma develops from dysplasia. MUC1 expression may be an later event in the process of neoplastic transformation in UC-associated carcinoma than it is in the sporadic adenoma-carcinoma sequence.