ß-catenin, Cox-2 and p53 immunostaining in colorectal adenomas to predict recurrence after endoscopic polypectomy

• Published in: International journal of colorectal disease Vol. 28; no. 8; pp. 1091 - 1098
• Main Authors: Brand, Linda, Munding, Johanna, Pox, Christian P., Ziebarth, Wibke, Reiser, Markus, Hüppe, Dietrich, Schmiegel, Wolff, Reinacher-Schick, Anke, Tannapfel, Andrea
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2013; Springer; Springer Nature B.V
• Subjects: Adenoma - metabolism; Adult; Aged; beta Catenin - metabolism; Biomarkers, Tumor - metabolism; Cancer; Colonic Polyps - surgery; Colonoscopy; Colorectal cancer; Colorectal Neoplasms - metabolism; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Cyclooxygenase 2 - metabolism; Diseases; Female; Formaldehyde; Gastroenterology; Hepatology; Humans; Immunohistochemistry; Internal Medicine; Male; Medicine; Medicine & Public Health; Mesalamine; Middle Aged; Neoplasm Recurrence, Local - pathology; Original Article; Prevention; Proctology; Relapse; Risk Factors; Surgery; Tumor proteins; Tumor Suppressor Protein p53 - metabolism; Colorectal adenoma; p53 mutation; Adenoma recurrence; Cyclooxygenase-2
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-013-1667-z

Background Endoscopic polypectomy significantly reduces the incidence of colorectal cancer, but recurrence rates are high, especially for adenomas with advanced histology. The present guidelines recommend re-colonoscopy 3 to 5 years later. Due to limited resources, more precise predictions of adenoma recurrence are required. Design Lesions from 109 patients with colorectal adenomas recruited into a randomized, placebo-controlled chemoprevention trial with mesalazine were included. Formalin-fixed paraffin-embedded tissue sections were stained for ß-catenin, cyclooxygenase-2 (Cox-2), and p53 and scored. Adenoma recurrence rates were recorded after 3 years and associated with clinical and immunohistochemical parameters by contingency table analysis. Results After 3 years, adenomas recurred in 51.4 % of patients. Out of 109 adenomas, 95 met at least one criterion of advanced adenoma (size >1 cm, villous histology, high-grade intraepithelial neoplasia). There was no influence of age, sex, size or villous histology on adenoma reappearance, whilst the number of adenomas at baseline was positively associated with recurrence ( p  = 0.003). In contrast, ß-catenin nuclear localisation, Cox-2 expression and p53 nuclear expression were significantly associated with adenoma recurrence after 3 years (ß-catenin: p  = 0.002; Cox-2: p  = 0.001; p53: p  = 0.001). Combining these three markers led to a negative predictive value of 88.5 % and a sensitivity of 94.6 %. (OR = 13.54) Conclusions Scoring each single parameter and, more strongly, the combination of all three parameters of the expression of ß-catenin, Cox-2 and p53 in colorectal adenoma tissue may be a useful negative predictor for adenoma recurrence in patients with advanced colorectal adenomas.