Serrated adenoma of the colorectum undergoes a proliferation versus differentiation process: new conceptual interpretation of morphogenesis

Oncology. 2008;74(3-4):127-34. doi: 10.1159/000151359. Epub 2008 Aug 18.

Abstract

Objective: Serrated adenoma (SA) consists of glands both with intraluminal projection of tall columnar cells, which resemble the terminally differentiated cells in the surface epithelium, and with concave short cells, which resemble progenitor crypt cells of the colon. The aim of this study was to clarify the relationship between the serrated architecture and proliferation/differentiation process in SAs.

Methods: The expressions of both terminally differentiated markers, such as p21, cytokeratin 20 and carbonic anhydrase I, and progenitor/proliferative markers, such as beta-catenin, CD44 and Ki-67, were immunohistochemically examined in 43 SAs and 20 tubular adenomas.

Results: P21-positive cells were more abundant in SAs than in tubular adenomas. Cytokeratin 20 and carbonic anhydrase I expressions were confined to the tall cells, while nuclear beta-catenin and CD44 were expressed in the short cells in SAs. The Ki-67 labeling indices were significantly lower in tall cells than in short ones.

Conclusions: SAs might undergo both proliferation and terminal differentiation, which is associated with unique serrated configuration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma / classification
  • Adenoma / metabolism
  • Adenoma / pathology*
  • Adenomatous Polyps / metabolism
  • Adenomatous Polyps / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Carbonic Anhydrase I / metabolism
  • Cell Differentiation*
  • Colonic Polyps / metabolism
  • Colonic Polyps / pathology*
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / pathology*
  • Cyclin-Dependent Kinase Inhibitor p21 / metabolism
  • Female
  • Humans
  • Hyaluronan Receptors / metabolism
  • Immunoenzyme Techniques
  • Keratin-20 / metabolism
  • Ki-67 Antigen / metabolism
  • Male
  • Middle Aged
  • Morphogenesis
  • beta Catenin / metabolism

Substances

  • CD44 protein, human
  • CDKN1A protein, human
  • Cyclin-Dependent Kinase Inhibitor p21
  • Hyaluronan Receptors
  • Keratin-20
  • Ki-67 Antigen
  • beta Catenin
  • Carbonic Anhydrase I