Epithelial markers of colorectal carcinogenesis in ulcerative colitis and primary sclerosing cholangitis

作者：Wohl Pavel; Hucl Tomas; Drastich Pavel; Kamenar David; Spicak Julius; Honsova Eva; Sticova Eva; Lodererova Alena; Matous Jan; Hill Martin; Wohl Petr; Kucera Milos

来源：World Journal of Gastroenterology, 2013, 19(14): 2234-2241.

DOI：10.3748/wjg.v19.i14.2234

• Imunohistochemistry
• Ulcerative colitis
• Primary sclerosing cholangitis
• Colorectal carcinoma
• Liver transplantation
• p53
• bcl2
• Cyclooxygenase-2

AIM: To evaluate the expression of epithelial markers of colorectal carcinogenesis in patients with long-term ulcerative colitis (UC) and primary sclerosing cholangitis (PSC) before and after transplantation. %26lt;br%26gt;METHODS: Eight patients with UC and PSC prior to liver transplantation (PSC-UC), 22 patients with UC after liver transplantation for PSC (OLT), 9 patients with active ulcerative colitis without PSC (UCA), 7 patients with UC in remission (UCR) and 10 controls (N) underwent colonoscopy with multiple biopsies. Specimens were analysed histologically and semi-quantitatively immunohistochemically for p53, Bcl-2 and cyclooxygenase-2 (COX-2) markers. Statistical analysis was performed by Kruskal-Wallis and Fisher%26apos;s exact tests. %26lt;br%26gt;RESULTS: PSC-UC had a statistically significantly higher expression of p53 in the nondysplastic mucosa as compared to OLT, UCA, UCR and N (P %26lt; 0.05). We also found a statistically significant positive correlation between the incidence of PSC and the expression of p53 (P %26lt; 0.001). UCA had a higher p53 expression as compared to UCR. OLT had a significantly lower expression of p53 as compared with PSC-UC (P %26lt; 0.001). Bcl-2 had a significant higher bcl-2 expression as compared with controls. No difference in COX-2 expression between PSC-UC, UCR and UCA was found. UCA had higher COX-2 expression as compared to UCR. We also found a statistically significant positive correlation between the expression of COX-2 and p53. Patients after liver transplantation for PSC had a statistically significantly lower expression of the p53 compared with PSC-UC (P %26lt; 0.001). PSC-UC had the same inflammatory endoscopic activity as OLT and UCR when evaluated with the Mayo score. %26lt;br%26gt;CONCLUSION: Our study shows that the nondysplatic mucosa of UC patients with PSC is characterised by a higher expression of the tumour suppressor gene p53, suggesting a higher susceptibility of cancer. This p53 overexpression correlates with the presence of PSC whilst it is not present in patients with UC after liver transplantation for PSC.

• 出版日期2013-4-14