Intest Res  
Topographic, histological and molecular study of aberrant crypt foci identified in human colon in different clinical groups
Shouriyo Ghosh1, Brijnandan Gupta1, Pavan Verma1, Sreenivas Vishnubathla2, Sujoy Pal3, Nihar R Dash3, Siddhartha Datta Gupta1, Prasenjit Das1
Departments of 1Pathology, 2Biostatistics, and 3Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India
Correspondence to: Prasenjit Das, Department of Pathology, All India Institute of Medical Sciences, Room No. 3093, 3rd Floor, Teaching Block, New Delhi 110029, India. Tel: +91-011-26594979, Fax: +91-11-26588663 / 26588641, E-mail: prasenaiims@gmail.com
Received: May 7, 2017; Revised: September 23, 2017; Accepted: September 27, 2017; Published online: November 24, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Aberrant crypt foci (ACF) are early microscopic lesions of the colonic mucosa, which can be detected by magnified chromoendoscopy. Herein, we have investigated whether ACF identified in different clinical groups can be differentiated based on their characteristics. Methods: Macroscopically unremarkable mucosal flaps were collected from 270 fresh colectomies and divided into 3 clinical groups: colorectal carcinoma (group A), disease controls having known pre-neoplastic potential (group Bc), and disease controls without risk of carcinoma development (group Bn). Topographic and histologic analysis, immunohistochemistry, and molecular studies (high-resolution melt curve analysis, real-time polymerase chain reaction PCR, and Sanger sequencing) were conducted for certain neoplasia-associated markers. Results: ACF were seen in 107 cases, out of which 72 were left colonic ACF and 35 right colonic ACF (67.2% vs. 32.7%, P=0.02). The overall density of left colonic ACF was 0.97/cm, which was greater than the right colonic ACF density of 0.81/cm. Hypercrinia was present in 41 out of 72 left colonic ACF and in 14 out of 35 right colonic ACF (P=0.01). Immunohistochemical expression of p53 was also greater in left colonic ACF than in right colonic ACF (60.5% vs. 38.2%, P=0.03). However, ACF identified among the 3 clinical groups did not show any distinguishing topographic, histological, or genetic changes. Conclusions: Left colonic ACF appear to be high-risk based on their morphological and prototypic tumor marker signature. ACF identified in different clinical groups do not show significant genotypic or topographic differences. Further detailed genetic studies are required to elucidate them further.
Keywords: Aberrant crypt foci; Chromoendoscopy; KRAS; BRAF; MMR


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