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Negro S, Bao QR, Scarpa M, Scognamiglio F, Pucciarelli S, Remo A, Agostini M, D'Angelo E, Mammi I, Schiavi F, Rossi S, Zingone F, Ferrara F, Fantin A, Cristofori C, Guido E, Rizzotto ER, Intini R, Bergamo F, Fassan M, Salviati L, Urso EDL. Multiple colorectal adenomas syndrome: The role of MUTYH mutation and the polyps' number in clinical management and colorectal cancer risk. Dig Liver Dis 2024; 56:1087-1094. [PMID: 38071180 DOI: 10.1016/j.dld.2023.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/03/2023] [Accepted: 11/22/2023] [Indexed: 05/28/2024]
Abstract
BACKGROUND & AIMS Multiple colorectal adenomas (MCRAs) can result from APC (AFAP) or biallelic MUTYH (MAP) mutations, but most patients are wild type and referred to as non-APC/MUTYH polyposis (NAMP). We aim to examine the risk of colorectal cancer (CRC) and the role of endoscopy in managing patients with MCRAs, with a specific focus on clinical features and genotype. METHODS Records of MRCAs between 2000 and 2022 were retrospectively analysed. Patients were divided according to the genotype (MAP vs. NAMP) and the number of categorised polyps' burden (group 1: 10-24, group 2: 25-49, and group 3: 50-99 adenomas). Predictors of outcome were CRC-free survival (CRC-FS) and Surgery free-survival (S-FS). RESULTS 220 patients were enrolled (NAMP n = 178(80.0%)). CRC at diagnosis was more frequent in group 3 (p = 0.01), without significant differences between the genotypes (p = 0.20). At a follow-up of 83(41-164) months, 15(7%) patients developed CRC during surveillance. CRC-FS was not correlated to genotype (p = 0.07) or polyps' number (p = 0.33), while S-FS was similar in MAP and NAMP (p = 0.22) and lower in groups 2 and 3 (p = 0.0001). CONCLUSIONS MAP and NAMP have the same CRC risk and no difference in treatment. Endoscopic surveillance compared favorably with surgery in avoiding CRC risk, even in patients with more severe colorectal polyposis.
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Affiliation(s)
- Silvia Negro
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Quoc Riccardo Bao
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy.
| | - Marco Scarpa
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Federico Scognamiglio
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Salvatore Pucciarelli
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Andrea Remo
- Department of Pathology, ULSS 9 "Scaligera", Verona, Italy
| | - Marco Agostini
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Edoardo D'Angelo
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Isabella Mammi
- Familial Cancer Clinic and Oncoendocrinology, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Francesca Schiavi
- Familial Cancer Clinic and Oncoendocrinology, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Silvia Rossi
- Familial Cancer Clinic and Oncoendocrinology, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Fabiana Zingone
- Gastroenterology Unit, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Francesco Ferrara
- Gastroenterology Unit, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
| | - Alberto Fantin
- Gastroenterology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Chiara Cristofori
- Gastroenterology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Ennio Guido
- Gastroenterology Unit, Azienda Ospedaliera Università di Padova, University of Padova, Padua, Italy
| | - Erik Rosa Rizzotto
- Gastroenterology Unit, Azienda Ospedaliera Università di Padova, University of Padova, Padua, Italy
| | - Rossana Intini
- Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | - Matteo Fassan
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padua, Italy
| | - Leonardo Salviati
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padua, Italy
| | - Emanuele D L Urso
- General Surgery 3, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padua, Italy
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Urso EDL, Ponz de Leon M, Vitellaro M, Piozzi GN, Bao QR, Martayan A, Remo A, Stigliano V, Oliani C, Lucci Cordisco E, Pucciarelli S, Ranzani GN, Viel A. Definition and management of colorectal polyposis not associated with APC/MUTYH germline pathogenic variants: AIFEG consensus statement. Dig Liver Dis 2021; 53:409-417. [PMID: 33504457 DOI: 10.1016/j.dld.2020.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
An expert consensus panel convened by the Italian Association for Inherited and Familial Gastrointestinal Tumors (Associazione Italiana per lo Studio della Familiarità ed Ereditarietà dei Tumori Gastrointestinali, AIFEG) reviewed the literature and agreed on a number of position statements regarding the definition and management of polyposis coli without an identified pathogenic mutation on the APC or MUTYH genes, defined in the document as NAMP (non-APC/MUTYH polyposis).
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Affiliation(s)
- Emanuele Damiano Luca Urso
- Clinica Chirurgica I, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University Hospital of Padua, Italy
| | - Maurizio Ponz de Leon
- Department of Internal Medicine, University of Modena and Reggio Emilia. Retired, Italy
| | - Marco Vitellaro
- Unit of Hereditary Digestive Tract Tumors, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - Guglielmo Niccolò Piozzi
- Colorectal Surgery Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Quoc Riccardo Bao
- Clinica Chirurgica I, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University Hospital of Padua, Italy
| | - Aline Martayan
- Clinical Pathology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Remo
- Pathology Unit, Services Department, ULSS9 Scaligera, Verona, Italy
| | - Vittoria Stigliano
- Division of Gastroenterology and Digestive Endoscopy, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Salvatore Pucciarelli
- Clinica Chirurgica I, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University Hospital of Padua, Italy
| | | | - Alessandra Viel
- Functional Oncogenomics and Genetics Unit, IRCCS Centro di Riferimento Oncologico di Aviano (CRO), Aviano, Italy
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Li T, Leong MH, Harms B, Kennedy G, Chen L. MicroRNA-21 as a potential colon and rectal cancer biomarker. World J Gastroenterol 2013; 19:5615-5621. [PMID: 24039353 PMCID: PMC3769897 DOI: 10.3748/wjg.v19.i34.5615] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 07/03/2013] [Accepted: 07/19/2013] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common malignant diseases worldwide and the prognosis is still poor although much progress has been achieved in recent years. In order to reduce CRC-related deaths, many studies are aimed at identifying novel screening- and prognosis-related biomarkers. MicroRNAs (miRNAs) are a class of 18-27-nucleotide single-stranded RNA molecules that regulate gene expression at the post-transcriptional level. It has been demonstrated that miRNAs regulate a variety of physiological functions, including development, cell differentiation, proliferation, and apoptosis. They play important roles in various physiologic and developmental processes and in the initiation and progression of various human cancers. It has been shown that miRNAs can critically regulate tumor cell gene expression, and evidence suggests that they may function as both oncogenes and tumor suppressor genes. In CRC, miRNAs-21 is one of the most important miRNAs and is rapidly emerging as a novel biomarker in CRC, with good potential as a diagnostic and therapeutic target. In this review, we summarize the latest research findings of the clinicopathological relevance of miRNAs-21 in CRC initiation, development, and progress, highlighting its potential diagnostic, prognostic, and therapeutic application, as well as discussing future prospects.
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Przybylowska K, Kabzinski J, Sygut A, Dziki L, Dziki A, Majsterek I. An association selected polymorphisms of XRCC1, OGG1 and MUTYH gene and the level of efficiency oxidative DNA damage repair with a risk of colorectal cancer. Mutat Res 2013; 745-746:6-15. [PMID: 23618615 DOI: 10.1016/j.mrfmmm.2013.04.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 03/25/2013] [Accepted: 04/09/2013] [Indexed: 06/02/2023]
Abstract
Oxidative damage has been implicated in the pathogenesis of colorectal cancer (CRC). The base excision repair (BER) pathway is the major DNA repair pathway for oxidative DNA damage and genetic variation associated with impaired BER might thus increase a risk of CRC. In this work, we evaluated associations between the repair efficiency of oxidative DNA lesions and single-nucleotide polymorphisms of BER genes: the 194Trp/Arg and the 399Arg/Gln XRCC1, the 326Ser/Cys OGG1 and the 324Gln/His MUTYH and CRC occurrence in a Polish population. These polymorphisms were genotyped in 182 CRC patients and 245 control subjects, using a PCR-RFLP approach. The level of oxidative damage and DNA repair capacity in lymphocytes and CRC tissue samples was evaluated by comet assay using FPG and Nth glycosidases. The 326Ser/Cys OGG1 and the 324Gln/His as well as the 324His/His MUTYH genotypes were found to be associated with an increased CRC risk, while no association was found for the XRCC1 gene polymorphisms. It was also demonstrated the reduced capacity of oxidative damage repair in CRC patients in comparison to healthy controls. Moreover, the decrease efficiency of DNA repair were correlated with the 399Gln/Gln XRCC1 and the 324His/His MUTYH genotypes occurrence in CRC patients. The results obtained in our study indicated an association of OGG1 and MUTYH genes polymorphisms involved in oxidative DNA lesions repair with the risk occurrence of colorectal cancer in Polish patients. It was also found that studied polymorphisms might affect DNA repair capacity suggesting their role in CRC pathogenesis. Finally, we conclude that BER pathway may be an important target for the diagnosis and treatment of colorectal patients.
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Affiliation(s)
- Karolina Przybylowska
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Poland
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