Expression Profile of p53 and p21 in Large Bowel Mucosa as Biomarkers of Inflammatory-Related Carcinogenesis in Ulcerative Colitis.

Cristiana Popp,Gianina Micu,Luciana Nichita,Gabriel Pop,Andreea Bengus,Alexandra Bastian,Theodor Voiosu,Mirela Cioplea,Liana Sticlaru,Andrei Voiosu,Radu Bogdan Mateescu

doi:10.1155/2016/3625279

Abstract

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease that slightly increases the risk of colorectal cancer in patients with long-standing extended disease. Overexpression of p53 and p21 in colonic epithelia is usually detected in UC patients when no dysplasia is histologically seen and it is used by pathologists as a discriminator between regenerative changes and intraepithelial neoplasia, as well as a tissue biomarker useful to predict the risk of evolution toward malignancy. We present a one-year prospective observational study including a cohort of 45 patients with UC; p53 and p21 were evaluated in epithelial cells. p53 was positive in 74 samples revealed in 5% to 90% of epithelial cells, while 63 biopsies had strong positivity for p21 in 5% to 50% of epithelial cells. Architectural distortion was significantly correlated with p53 overexpression in epithelial cells. Thus, we consider that architectural distortion is a good substitute for p53 and p21 expression. We recommend use of p53 as the most valuable tissue biomarker in surveillance of UC patients, identifying the patients with higher risk for dysplasia. Association of p21 is also recommended for a better quantification of risk and for diminishing the false-negative results.

Highlights

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease with increasing incidence and prevalence in Europe
Overexpression of p53 in colonic epithelia is usually detected in UC patients when no dysplasia is histologically seen and it is used by pathologists as a discriminator between regenerative changes and intraepithelial neoplasia, as well as a tissue biomarker useful to predict the risk of evolution toward malignancy
This study aimed to find subtle changes ratable before the occurrence of dysplasia, changes that can be used to identify patients with higher risk. (c) The studied group is pretty small, including only 45 patients, but this value is above the minimum needed for statistical significance, and all patients had a certain diagnosis of UC, and, all patients were submitted to a complex, multidisciplinary surveillance that offered significant data

Summary

Introduction

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease with increasing incidence and prevalence in Europe. The mortality of colorectal carcinoma in patients with UC is higher than that for sporadic cases [5,6,7,8] These data, along with the fact that there is an increasing number of older patients, with longstanding disease, history of multiple flares, and increased risk for epithelial malignancy, are emphasizing the importance of proper surveillance of UC patients in order to prevent and/or early-diagnose intraepithelial and invasive neoplasia. Since intraepithelial neoplasia is difficult to identify with usual colonoscopic techniques, the diagnosis requires advanced endoscopic procedures or multiple biopsies (minimum 36 each time) [10] Both alternatives are increasing the costs of this surveillance and have a significant risk of false-negative results. Studies of expression proteomics are needed to validate some

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Methods

Conclusion