Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 129, Issue 3, Pages 416-423Publisher
AMER SOC CLINICAL PATHOLOGY
DOI: 10.1309/603UQKM7C2KELGJU
Keywords
serrated adenoma; hyperplastic polyps; Wnt pathway; colorectal
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Funding
- NCI NIH HHS [CA106610] Funding Source: Medline
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We obtained 22 sessile serrated adenomas (SSAs) and 19 hyperplastic polyps (HPs) and performed immunolabeling for cytokeratins (CKs) 7 and 20, CDX2, beta-catenin, and p53 to determine the role of these markers in aiding distinction of lesions with neoplastic potential. Patients with SSAs more frequently had a prior or coexistent tubular adenoma (P =.004) that was right-sided (P =.00001) and larger (P =.03). No difference in CK7, CK20, or p53 labeling was found after correction for colonic location. However, CDX2 labeling was significantly lower in SSAs (P =.02) and was predominantly confined to the crypt bases, whereas it was diffusely positive in HPs (P <.001). Surprisingly, aberrant nuclear labeling for beta-catenin was found in 9 (41%) of the SSAs but in none of the HPs (P <.002). We propose that beta-catenin and/or CDX2 immunolabeling may have diagnostic usefulness in the evaluation of serrated polyps. These findings also suggest that Wnt signaling has a role in SSA development.
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