Aberrant crypt foci: endoscopic assessment and cell kinetics characterization

Abstract

Background and aims Aberrant crypt foci (ACF) are preneoplastic lesions in animal models of colorectal cancer. The aim of the study is to investigate if ACF are involved in human colorectal carcinogenic process and if they can be helpful in predicting the presence of a colorectal neoplasia. Methods The study included, between 2003 and 2005, 182 patients, 62 with adenoma, 55 with colorectal carcinoma, 53 without colorectal lesions, and 12 with nonneoplastic mucosal polyps. The number of rectal ACF was determined by colonoscopy. Proliferation and apoptosis indexes were evaluated by immunohistochemistry in rectal ACF, in normal rectal mucosa, and in carcinomatous tissue. Results The mean number of rectal ACF in patients with rectal neoplasia was 12.64, significantly higher than in patients with neoplastic lesions elsewhere in the colon (p= 0.01). The apoptosis index in ACF of patients with colorectal carcinoma or adenoma aged 50 years or older was significantly lower than in younger patients (1.3% vs 2.7%, p=0.01) and, in patients with carcinoma, lower than in normal mucosa (1.1% vs 2.1%, p=0.002). The proliferation index was significantly higher in ACF of patients with colorectal neoplasia aged less than 50 years than in normal mucosa (10.9% vs 7.7%, p=0.02). The apoptosis index in ACF foci of patients with carcinoma (1.1%) was significantly lower than in patients without lesions (2.2%) and than in normal mucosa (2%). The mean number of ACF is significantly higher in patients with polyps larger than 1 cm (11.28 vs 6.27, p=0.02). Conclusion Aberrant crypt foci probably precede the appearance of neoplasia and may be helpful in predicting the presence of a colorectal neoplastic lesion.

Altered Expression of Apoptosis Biomarkers in Human Colorectal Microadenomas

“…Indeed, some articles found a decreased apoptosis ratio (27) and others an increase (28). Moreover, several works strongly support the hypothesis that microadenomas are the earliest identifiable lesions in the adenoma-carcinoma sequence in humans because of their resistance to apoptosis, which can lead to a selective growth advantage and a transformed morphology (28,29). Turning the apoptotic machinery on and off is determined by the ratio of proapoptotic and antiapoptotic proteins.…”

Co-administration of a probiotic strain Lactobacillus plantarum LS/07 CCM7766 with prebiotic inulin alleviates the intestinal inflammation in rats exposed to N,N-dimethylhydrazine

“…In our study, solid tumors in the colon of DMH-challenged rats were not observed and changes were confined to the presence of inflammatory foci and the sporadic early pre-neoplastic lesions, typical for the development of colon cancer. The crypt cavitation in lymphoid tissues is one of the early pathological changes that could lead to the formation of adenoma in the presence of persisting uncontrolled inflammation [23]. Administration of DMH caused significant increase of CTMC numbers and decrease of the number of goblet cells.…”

The natural history of adenomas

“…Clinical, epidemiological and biological evidences support the role of ACF in human colorectal tumourigenesis as a putative precursor to colorectal adenomas [7] even if their fast yearly turnover indicates the dynamic nature of the process, and impairs their use as a clinical intermediate biomarker [8].…”