Synchronous Colorectal Cancer: Improving Accuracy of Detection and Analyzing Molecular Heterogeneity—The Main Keys for Optimal Approach

Diagnostics

Zsolt Kovacs¹  Simona Gurzu²  Ioan Jung²  Laura Banias²  Iunius Simu³  Patricia Simu³  Tivadar Bara⁴  ZsoltZoltan Fulop⁴ 

[1] Department of Pathology, Clinical County Emergency Hospital, 530150 Targu Mures, Romania;Department of Pathology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania;Department of Radiology and Imaging, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania;Department of Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania;

关键词: synchronous tumors;    colorectal cancer;    microsatellite status;    KRAS;    BRAF;    E-cadherin;   

DOI  :  10.3390/diagnostics11020314

来源: DOAJ

【 摘 要 】

Background: In patients with synchronous colorectal cancer (SCRC), understanding the underlying molecular behavior of such cases is mandatory for designing individualized therapy. The aim of this paper is to highlight the importance of transdisciplinary evaluation of the pre- and post-operative assessment of patients with SCRCs, from imaging to molecular investigations. Methods: Six patients with SCRCs presented with two carcinomas each. In addition to the microsatellite status (MSS), the epithelial mesenchymal transition was checked in each tumor using the biomarkers β-catenin and E-cadherin, same as KRAS and BRAF mutations. Results: In two of the patients, the second tumor was missed at endoscopy, but diagnosed by a subsequent computed-tomography-scan (CT-scan). From the six patients, a total of 11 adenocarcinomas (ADKs) and one squamous cell carcinoma (SCC) were analyzed. All the examined carcinomas were BRAF-wildtype microsatellite stable tumors with an epithelial histological subtype. In two of the six cases, KRAS gene status showed discordance between the two synchronous tumors, with mutations in the index tumors and wildtype status in the companion ones. Conclusions: Preoperative CT-scans can be useful for detection of synchronous tumors which may be missed by colonoscopy. Where synchronous tumors are identified, therapy should be based on the molecular profile of the indexed tumors.

【 授权许可】

Unknown