Avoiding restorative proctocolectomy for colorectal cancer in patients with ulcerative colitis based on preoperative diagnosis involving p53 immunostaining: report of a case

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• 作者：Haruki Sada (1)
  Manabu Shimomura (1)
  Takao Hinoi (1)
  Hiroyuki Egi (1)
  Koji Kawaguchi (1)
  Takuya Yano (1)
  Hiroaki Niitsu (1)
  Yasufumi Saitou (1)
  Hiroyuki Sawada (1)
  Masashi Miguchi (1)
  Tomohiro Adachi (1)
  Hideki Ohdan (1)
  
  1. Department of Gastroenterological and Transplant Surgery ; Applied Life Sciences ; Institute of Biomedical and Health Science ; Hiroshima University ; 1-2-3 Kasumi ; Minami-ku ; Hiroshima ; 734-8551 ; Japan
  
• 关键词：Sporadic cancer ; Ulcerative colitis ; p53 overexpression
• 刊名：World Journal of Surgical Oncology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：13
• 期：1
• 全文大小：1,551 KB
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• 刊物主题：Surgical Oncology;
• 出版者：BioMed Central
• ISSN：1477-7819

文摘

The standard operation for colitic cancer in ulcerative colitis (UC) is restorative proctocolectomy; however, sporadic colorectal cancer (CRC) can coincidentally arise in patients with UC and the optimal procedure remains controversial. Therefore, it is crucial to preoperatively determine whether the CRC in UC is a sporadic or colitic cancer. We report a case of avoiding proctocolectomy for sporadic CRC in a patient with UC based on preoperative diagnosis involving p53 immunostaining. A 73-year-old man with CRC in UC had undergone sigmoid colectomy with lymphadenectomy because of the submucosal deep invasion pathologically after endoscopic mucosal resection. The cancer was diagnosed sporadic cancer preoperatively not only based on the endoscopic, clinical, and histological patterns but also that the colon epithelium was unlikely to develop dysplasia as the circumference and unaffected UC mucosa did not detect p53 protein overexpression. Recent reports have shown that the immunohistochemical detection of p53 protein overexpression can be useful for a differential diagnosis and as a predictor of dysplasia and colitic cancer. The analysis of p53 mutation status based on immunostaining of p53 protein expression in the unaffected UC mucosa can be useful for the decision regarding a surgical procedure for CRC in patients with UC.