Sistema de Salut de Catalunya
[Musulen E] Pathology Department, Hospital Universitari General de Catalunya-Grupo QuironSalud, Sant Cugat Del Vallès, Spain. Institut de Recerca Contra La Leucèmia Josep Carreras (IJC), Badalona, Spain. [Gené M] Pathology Department, Hospital Universitari Joan XXIII, Tarragona, Spain. Surgery Department, Programme of Surgery and Morphological Sciences, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. [Cuatrecasas M] Pathology Department, Hospital Clínic, Barcelona, Spain. Department of Basic Clinical Practice, University of Barcelona (UB), Barcelona, Spain. [Amat I] Pathology Department, Complejo Hospitalario de Navarra, Navarra, Spain. [Veiga JA] Pathology Department, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain. [Fernández-Aceñero MJ] Pathology Department, Hospital Clínico San Carlos, Madrid, Spain. [Jurado I] Pathology Department, Consorci Sanitari de Terrassa, Terrassa, Spain
Consorci Sanitari de Terrassa
2024-03-25T14:21:09Z
2024-03-25T14:21:09Z
2023
2024-01
Displasia convencional; Metaplasia gástrica; Enfermedad inflamatoria convencional
Conventional dysplasia; Gastric metaplasia; Inflammatory bowel disease
Displàsia convencional; Metaplàsia gàstrica; Malaltia inflamatòria convencional
Gastric metaplasia in colonic mucosa with inflammatory bowel disease (IBD) develops as an adaptation mechanism. The association between gastric metaplasia and nonconventional and/or conventional dysplasia as precursors of colitis-associated colorectal cancer is unknown. To address this question, we retrospectively reviewed a series of 33 IBD colectomies to identify gastric metaplasia in 76 precursor lesions. We obtained 61 nonconventional and 15 conventional dysplasias. Among nonconventional dysplasia, 31 (50.8 %) were low-grade (LGD), 4 (6.5 %) were high-grade (HGD), 9 (14.8 %) had both LGD and HGD, and 17 (27.9 %) had no dysplasia (ND), while 14 (93 %) conventional dysplasias had LGD, and 1 (7 %) had LGD and HGD. Gastric metaplasia was assessed by concomitant immunoexpression of MUC5AC and loss of CDX2 staining. Expression of a p53-mut pattern was considered as a surrogate for gene mutation, and complete loss of MLH1 staining as presence of MLH1 hypermethylation. In nonconventional dysplasia, MUC5AC immunoexpression decreased as the degree of dysplasia increased, being 78 % in LGD and 39 % in HGD (p = 0.006). CDX2 was lost in epithelial glands with high expression of MUC5AC (p < 0.001). The p53-mut pattern was observed in 77 % HGD, 45 % LGD, and in 6 % with ND (p < 0.001). Neither nonconventional nor conventional dysplasia showed complete loss of MLH1 staining. Gastric metaplasia was also present in mucosa adjacent to nonconventional dysplasia with chronic changes or active inflammation. Our results show that gastric metaplasia appears in IBD-inflamed colon mucosa, it is the substrate of most nonconventional dysplasia and occurs prior to p53 alterations.
This work was supported by Roche, Switzerland (activity code: SP210830002).
Article
Published version
English
Intestins - Inflamació; Còlon - Càncer; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Metaplasia; DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Inflammatory Bowel Diseases; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms; Inflamación; Enfermedad; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::metaplasia; ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedad inflamatoria intestinal; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales::neoplasias del colon
Elsevier
Human Pathology;143
http://doi.org/10.1016/j.humpath.2023.11.011
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
