Gastric metaplasia as a precursor of nonconventional dysplasia in inflammatory bowel disease
Musulén, Eva (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Gené, Míriam (Hospital Universitari Joan XXIII de Tarragona)
Cuatrecasas, Miriam (Hospital Clínic i Provincial de Barcelona)
Amat, Irene (Complejo Hospitalario de Navarra)
Veiga, Jesús Alberto (Complejo Hospitalario Universitario de Ferrol)
Fernández-Aceñero, María Jesús (Hospital Clínico San Carlos (Madrid))
Chimisana, Victòria Fusté (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Tarragona, Jordi (Hospital Arnau de Vilanova (Lleida, Catalunya))
Jurado, Ismael (Consorci Sanitari de Terrassa)
Fernández-Victoria, Rebeca (Hospital Álvaro Cunqueiro (Vigo))
Martínez-Ciarpaglini, Carolina (Hospital Clínic Universitari (València))
Alenda González, Cristina (Hospital General Universitario Dr. Balmis)
Zac, Carlos (Hospital Universitari i Politècnic La Fe de València)
Fernández-Figueras, María Teresa (Universitat Internacional de Catalunya)
Esteller, M (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)

Date:	2024
Abstract:	Gastric metaplasia in colonic mucosa with inflammatory bowel disease (IBD) develops as an adaptation mechanism. The association between gastric metaplasia and nonconventional and/or conventional dysplasia as precursors of colitis-associated colorectal cancer is unknown. To address this question, we retrospectively reviewed a series of 33 IBD colectomies to identify gastric metaplasia in 76 precursor lesions. We obtained 61 nonconventional and 15 conventional dysplasias. Among nonconventional dysplasia, 31 (50. 8 %) were low-grade (LGD), 4 (6. 5 %) were high-grade (HGD), 9 (14. 8 %) had both LGD and HGD, and 17 (27. 9 %) had no dysplasia (ND), while 14 (93 %) conventional dysplasias had LGD, and 1 (7 %) had LGD and HGD. Gastric metaplasia was assessed by concomitant immunoexpression of MUC5AC and loss of CDX2 staining. Expression of a p53-mut pattern was considered as a surrogate for gene mutation, and complete loss of MLH1 staining as presence of MLH1 hypermethylation. In nonconventional dysplasia, MUC5AC immunoexpression decreased as the degree of dysplasia increased, being 78 % in LGD and 39 % in HGD (p = 0. 006). CDX2 was lost in epithelial glands with high expression of MUC5AC (p < 0. 001). The p53-mut pattern was observed in 77 % HGD, 45 % LGD, and in 6 % with ND (p < 0. 001). Neither nonconventional nor conventional dysplasia showed complete loss of MLH1 staining. Gastric metaplasia was also present in mucosa adjacent to nonconventional dysplasia with chronic changes or active inflammation. Our results show that gastric metaplasia appears in IBD-inflamed colon mucosa, it is the substrate of most nonconventional dysplasia and occurs prior to p53 alterations.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Gastric metaplasia ; Nonconventional dysplasia ; Conventional dysplasia ; Inflammatory bowel disease ; CRC serrated pathway
Published in:	Human Pathology, Vol. 143 (january 2024) , p. 50-61, ISSN 1532-8392

DOI: 10.1016/j.humpath.2023.11.011

12 p, 16.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Josep Carreras Leukaemia Research Institute
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Articles > Published articles