Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients

Katsuhiko Nosho, Hisayoshi Igarashi, Miki Ito, Kei Mitsuhashi, Hiroyoshi Kurihara, Shinichi Kanno, Shinji Yoshii, Masashi Mikami, Hiroaki Takahashi, Takaya Kusumi, Masao Hosokawa, Yasutaka Sukawa, Yasushi Adachi, Tadashi Hasegawa, Kenji Okita, Koichi Hirata, Reo Maruyama, Hiromu Suzuki, Kohzoh Imai, Hiroyuki Yamamoto & 1 others Yasuhisa Shinomura

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The population in Japan is aging more rapidly than in any other country. However, no studies have determined the characteristics of the large population of elderly patients with colorectal tumors. Therefore, we examined the clinicopathological and molecular features of these tumors in elderly patients. Methods: In total, 1,627 colorectal tumors (393 serrated lesions, 277 non-serrated adenomas and 957 colorectal cancers) were acquired from patients. Tumor specimens were analyzed for BRAF and KRAS mutations, CpG island methylator phenotype-specific promoters (CACNA1G, CDKN2A, IGF2 and RUNX3), IGFBP7, MGMT, MLH1 and RASSF2 methylation, microsatellite instability (MSI) and microRNA- 31 (miR-31). Results: The frequency of elderly patients (aged ≥75 years) with sessile serrated adenomas (SSAs) with cytological dysplasia was higher than that of those with other serrated lesions and non-serrated adenomas (p < 0.0001). In elderly patients, all SSAs were located in the proximal colon (particularly the cecum to ascending colon). High miR-31 expression, MLH1 methylation and MSI-high status were more frequently detected in SSAs from elderly patients than in those from non-elderly patients. In contrast, no significant differences were found between older age of onset and high-grade dysplasia for traditional serrated adenomas or non-serrated adenomas in any of these molecular alterations. Conclusion: In elderly patients, all SSAs were located in the proximal colon. Furthermore, cytological dysplasia and molecular alterations were more frequently detected in elderly patients with SSAs than in non-elderly patients. Thus, careful colonoscopic examinations of the proximal colon are necessary for elderly patients because SSAs in those patients may exhibit malignant potential.

Original languageEnglish
Pages (from-to)57-63
Number of pages7
JournalDigestion
Volume91
Issue number1
DOIs
Publication statusPublished - 2015 Feb 6
Externally publishedYes

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Adenoma
Colorectal Neoplasms
Microsatellite Instability
Colon
MicroRNAs
Methylation
Ascending Colon
CpG Islands
Cecum
Population Characteristics
Age of Onset
Neoplasms
Japan
Phenotype
Mutation

Keywords

  • Aging
  • Colonoscopy
  • Colorectal cancer
  • Hyperplastic polyp

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Nosho, K., Igarashi, H., Ito, M., Mitsuhashi, K., Kurihara, H., Kanno, S., ... Shinomura, Y. (2015). Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients. Digestion, 91(1), 57-63. https://doi.org/10.1159/000368820

Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients. / Nosho, Katsuhiko; Igarashi, Hisayoshi; Ito, Miki; Mitsuhashi, Kei; Kurihara, Hiroyoshi; Kanno, Shinichi; Yoshii, Shinji; Mikami, Masashi; Takahashi, Hiroaki; Kusumi, Takaya; Hosokawa, Masao; Sukawa, Yasutaka; Adachi, Yasushi; Hasegawa, Tadashi; Okita, Kenji; Hirata, Koichi; Maruyama, Reo; Suzuki, Hiromu; Imai, Kohzoh; Yamamoto, Hiroyuki; Shinomura, Yasuhisa.

In: Digestion, Vol. 91, No. 1, 06.02.2015, p. 57-63.

Research output: Contribution to journalArticle

Nosho, K, Igarashi, H, Ito, M, Mitsuhashi, K, Kurihara, H, Kanno, S, Yoshii, S, Mikami, M, Takahashi, H, Kusumi, T, Hosokawa, M, Sukawa, Y, Adachi, Y, Hasegawa, T, Okita, K, Hirata, K, Maruyama, R, Suzuki, H, Imai, K, Yamamoto, H & Shinomura, Y 2015, 'Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients', Digestion, vol. 91, no. 1, pp. 57-63. https://doi.org/10.1159/000368820
Nosho K, Igarashi H, Ito M, Mitsuhashi K, Kurihara H, Kanno S et al. Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients. Digestion. 2015 Feb 6;91(1):57-63. https://doi.org/10.1159/000368820
Nosho, Katsuhiko ; Igarashi, Hisayoshi ; Ito, Miki ; Mitsuhashi, Kei ; Kurihara, Hiroyoshi ; Kanno, Shinichi ; Yoshii, Shinji ; Mikami, Masashi ; Takahashi, Hiroaki ; Kusumi, Takaya ; Hosokawa, Masao ; Sukawa, Yasutaka ; Adachi, Yasushi ; Hasegawa, Tadashi ; Okita, Kenji ; Hirata, Koichi ; Maruyama, Reo ; Suzuki, Hiromu ; Imai, Kohzoh ; Yamamoto, Hiroyuki ; Shinomura, Yasuhisa. / Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients. In: Digestion. 2015 ; Vol. 91, No. 1. pp. 57-63.
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abstract = "Background: The population in Japan is aging more rapidly than in any other country. However, no studies have determined the characteristics of the large population of elderly patients with colorectal tumors. Therefore, we examined the clinicopathological and molecular features of these tumors in elderly patients. Methods: In total, 1,627 colorectal tumors (393 serrated lesions, 277 non-serrated adenomas and 957 colorectal cancers) were acquired from patients. Tumor specimens were analyzed for BRAF and KRAS mutations, CpG island methylator phenotype-specific promoters (CACNA1G, CDKN2A, IGF2 and RUNX3), IGFBP7, MGMT, MLH1 and RASSF2 methylation, microsatellite instability (MSI) and microRNA- 31 (miR-31). Results: The frequency of elderly patients (aged ≥75 years) with sessile serrated adenomas (SSAs) with cytological dysplasia was higher than that of those with other serrated lesions and non-serrated adenomas (p < 0.0001). In elderly patients, all SSAs were located in the proximal colon (particularly the cecum to ascending colon). High miR-31 expression, MLH1 methylation and MSI-high status were more frequently detected in SSAs from elderly patients than in those from non-elderly patients. In contrast, no significant differences were found between older age of onset and high-grade dysplasia for traditional serrated adenomas or non-serrated adenomas in any of these molecular alterations. Conclusion: In elderly patients, all SSAs were located in the proximal colon. Furthermore, cytological dysplasia and molecular alterations were more frequently detected in elderly patients with SSAs than in non-elderly patients. Thus, careful colonoscopic examinations of the proximal colon are necessary for elderly patients because SSAs in those patients may exhibit malignant potential.",
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T1 - Clinicopathological and molecular characteristics of serrated lesions in Japanese elderly patients

AU - Nosho, Katsuhiko

AU - Igarashi, Hisayoshi

AU - Ito, Miki

AU - Mitsuhashi, Kei

AU - Kurihara, Hiroyoshi

AU - Kanno, Shinichi

AU - Yoshii, Shinji

AU - Mikami, Masashi

AU - Takahashi, Hiroaki

AU - Kusumi, Takaya

AU - Hosokawa, Masao

AU - Sukawa, Yasutaka

AU - Adachi, Yasushi

AU - Hasegawa, Tadashi

AU - Okita, Kenji

AU - Hirata, Koichi

AU - Maruyama, Reo

AU - Suzuki, Hiromu

AU - Imai, Kohzoh

AU - Yamamoto, Hiroyuki

AU - Shinomura, Yasuhisa

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N2 - Background: The population in Japan is aging more rapidly than in any other country. However, no studies have determined the characteristics of the large population of elderly patients with colorectal tumors. Therefore, we examined the clinicopathological and molecular features of these tumors in elderly patients. Methods: In total, 1,627 colorectal tumors (393 serrated lesions, 277 non-serrated adenomas and 957 colorectal cancers) were acquired from patients. Tumor specimens were analyzed for BRAF and KRAS mutations, CpG island methylator phenotype-specific promoters (CACNA1G, CDKN2A, IGF2 and RUNX3), IGFBP7, MGMT, MLH1 and RASSF2 methylation, microsatellite instability (MSI) and microRNA- 31 (miR-31). Results: The frequency of elderly patients (aged ≥75 years) with sessile serrated adenomas (SSAs) with cytological dysplasia was higher than that of those with other serrated lesions and non-serrated adenomas (p < 0.0001). In elderly patients, all SSAs were located in the proximal colon (particularly the cecum to ascending colon). High miR-31 expression, MLH1 methylation and MSI-high status were more frequently detected in SSAs from elderly patients than in those from non-elderly patients. In contrast, no significant differences were found between older age of onset and high-grade dysplasia for traditional serrated adenomas or non-serrated adenomas in any of these molecular alterations. Conclusion: In elderly patients, all SSAs were located in the proximal colon. Furthermore, cytological dysplasia and molecular alterations were more frequently detected in elderly patients with SSAs than in non-elderly patients. Thus, careful colonoscopic examinations of the proximal colon are necessary for elderly patients because SSAs in those patients may exhibit malignant potential.

AB - Background: The population in Japan is aging more rapidly than in any other country. However, no studies have determined the characteristics of the large population of elderly patients with colorectal tumors. Therefore, we examined the clinicopathological and molecular features of these tumors in elderly patients. Methods: In total, 1,627 colorectal tumors (393 serrated lesions, 277 non-serrated adenomas and 957 colorectal cancers) were acquired from patients. Tumor specimens were analyzed for BRAF and KRAS mutations, CpG island methylator phenotype-specific promoters (CACNA1G, CDKN2A, IGF2 and RUNX3), IGFBP7, MGMT, MLH1 and RASSF2 methylation, microsatellite instability (MSI) and microRNA- 31 (miR-31). Results: The frequency of elderly patients (aged ≥75 years) with sessile serrated adenomas (SSAs) with cytological dysplasia was higher than that of those with other serrated lesions and non-serrated adenomas (p < 0.0001). In elderly patients, all SSAs were located in the proximal colon (particularly the cecum to ascending colon). High miR-31 expression, MLH1 methylation and MSI-high status were more frequently detected in SSAs from elderly patients than in those from non-elderly patients. In contrast, no significant differences were found between older age of onset and high-grade dysplasia for traditional serrated adenomas or non-serrated adenomas in any of these molecular alterations. Conclusion: In elderly patients, all SSAs were located in the proximal colon. Furthermore, cytological dysplasia and molecular alterations were more frequently detected in elderly patients with SSAs than in non-elderly patients. Thus, careful colonoscopic examinations of the proximal colon are necessary for elderly patients because SSAs in those patients may exhibit malignant potential.

KW - Aging

KW - Colonoscopy

KW - Colorectal cancer

KW - Hyperplastic polyp

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