Prognostic relevance and putative histogenetic role of cytokeratin 7 and MUC5AC expression in Crohn's disease-associated small bowel carcinoma
- Creators
- Arpa G.
- Vanoli A.
- Grillo F.
- Fiocca R.
- Klersy C.
- Furlan D.
- Sessa F.
- Ardizzone S.
- Sampietro G.
- Macciomei M. C.
- Nesi G.
- Tonelli F.
- Capella C.
- Latella G.
- Ciardi A.
- Caronna R.
- Lenti M. V.
- Ciccocioppo R.
- Barresi V.
- Malvi D.
- D'Errico A.
- Rizzello F.
- Poggioli G.
- Mescoli C.
- Rugge M.
- Luinetti O.
- Paulli M.
- Di Sabatino A.
- Solcia E.
- Others:
- Arpa, G.
- Vanoli, A.
- Grillo, F.
- Fiocca, R.
- Klersy, C.
- Furlan, D.
- Sessa, F.
- Ardizzone, S.
- Sampietro, G.
- Macciomei, M. C.
- Nesi, G.
- Tonelli, F.
- Capella, C.
- Latella, G.
- Ciardi, A.
- Caronna, R.
- Lenti, M. V.
- Ciccocioppo, R.
- Barresi, V.
- Malvi, D.
- D'Errico, A.
- Rizzello, F.
- Poggioli, G.
- Mescoli, C.
- Rugge, M.
- Luinetti, O.
- Paulli, M.
- Di Sabatino, A.
- Solcia, E.
Description
Most Crohn's disease-associated small bowel carcinomas (CrD-SBCs) are diagnosed in advanced stage and have poor prognosis. To improve diagnosis and therapy, a better knowledge of tumour precancerous lesions, histotypes and prognostic factors is needed. We investigated histologically and immunohistochemically 52 CrD-SBCs and 51 small bowel carcinomas unrelated to inflammatory disease, together with their tumour-associated mucosa, looking for Crohn-selective changes. Histologic patterns and phenotypic markers potentially predictive of CrD-SBC histogenesis and prognosis were analysed. Cytokeratin 7 or MUC5AC-positive metaplastic changes were found in about half of investigated CrD-SBCs, significantly more frequently than in CrD-unrelated SBCs. They correlated with metaplastic changes of their associated mucosa, while being absent in normal ileal mucosa. Histologic patterns suggestive for progression of some cytokeratin 7 and/or MUC5AC-positive metaplastic lesions into cancer of the same phenotype were also observed. Patient survival analyses showed that tumour cytokeratin 7 or MUC5AC expression and non-cohesive histotype were adverse prognostic factors at univariable analysis, while cytokeratin 7 and non-cohesive histotype were also found to predict worse survival in stage- and age-inclusive multivariable analyses. Besides conventional dysplasia, hyperplasia-like non-conventional lesions were observed in CrD-SBC-associated mucosa, with patterns suggestive for a histogenetic link with adjacent cancer. In conclusion the cytokeratin 7 and/or MUC5AC-positive metaplastic foci and the non-conventional growths may have a role in cancer histogenesis, while tumour cytokeratin 7 and non-cohesive histotype may also predict poor patient survival. Present findings are worth being considered in future prospective histogenetic and clinical studies.
Additional details
- URL
- https://hdl.handle.net/11567/1133895
- URN
- urn:oai:iris.unige.it:11567/1133895
- Origin repository
- UNIGE