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Aberrant Crypt Foci
Colon cancer evolves through epithelial cell deregulation and inappropriate proliferation. These histopathological characteristics are exemplified in the biochemical, immunohistochemical, genetic and epigenetic elements detected within colonic mucosa. Early detection is paramount for the prevention...
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Published in: | Anticancer research 2006-01, Vol.26 (1A), p.107-119 |
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Main Authors: | , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
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Summary: | Colon cancer evolves through epithelial cell deregulation and inappropriate proliferation. These histopathological characteristics
are exemplified in the biochemical, immunohistochemical, genetic and epigenetic elements detected within colonic mucosa. Early
detection is paramount for the prevention of colon cancer deaths. Aberrant crypt foci (ACF) are thought to be the earliest
identifiable neoplastic lesions in the colon carcinogenetic model. The progression of ACF to polyp and, subsequently, to cancer
parallels the accumulation of several biochemical alterations and mutations whereby a small fraction of ACF evolve to colon
cancer. Recent data indicate that, not uncommonly, some ACF bypass the polyp stage in their carcinogenesis thus reinforcing
the importance of their early detection and our understanding of their pathogenesis. Since ACF were first detected in carcinogen-treated
mice, research efforts have focused on these microscopically visible lesions both in animal and human models. ACF show variable
histological features, characterized by Kudo (20) and, therefore, can be grouped into differing categories by in vivo examination
with high-magnification-chromoscopic-colonoscopy (HMCC). As expected, ACF are more frequently detected in distal animal and
human colons coinciding with the geographic distribution of colorectal cancer (CRC). Various proteomic (Prot) markers may
be altered within ACF suggesting possible prospective pathological changes. These markers include Calreticulin, Transgelin,
Serotransferrin, Triphosphate isomerase and Carbonic anhydrase II. Other markers of importance include carcinoembryonic antigen
(CEA), B-catenin, placental cadherin (P-cadherin), epithelial cadherin (E-cadherin), inducible nitric oxide synthase (iNOS),
cyclooxygenase (COX-2) and P16INK4a. Genetic mutations of K-ras, B-Raf, APC and p53 have been demonstrated in ACF as well
as the epigenetic alterations of CpG island methylation. Genomic instabilities (GI), illustrated by a higher GI Index (GII),
microsatellite instability (MSI), loss of heterozygosity (LOH) and defects in mismatch repair (MMR) systems, are also expressed.
These transformations may lead to the identification of the earliest pathological features initiating colon tumorigenesis.
In this review, the advances in ACF research as precursors of CRCs are highlighted. |
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ISSN: | 0250-7005 1791-7530 |