Korean J Gastroenterol.  2012 Jul;60(1):36-41. 10.4166/kjg.2012.60.1.36.

The Effects of Family History of Colorectal Cancer on the Development of Colorectal Adenoma

• Choi MY
• Kim BG
• Kim JW
• Lee KL
• Jeong JB
• Lee JK
• Jung YJ
• Kim W
• Ahn DW
• Kim YH
• Joo SK
• Chang MS
• Kwon HJ

• KMID: 1718464
• DOI: http://doi.org/10.4166/kjg.2012.60.1.36

Abstract

BACKGROUND/AIMS
Early detection of polyp is important for the prevention of colorectal cancer (CRC). There have been few studies to investigate the relationship between colorectal adenoma and family history of CRC (FHCRC) in Korea. The aim of this study was to identify the relationship between colorectal adenoma and FHCRC.
METHODS
Between March 2009 and September 2010, 225 patients with adenomatous polyps were included. Their medical records with clinical history and size, numbers, histology of polyps were reviewed. Immunohistochemical staining using Bcl-2, Bax, p-AKT, NF-kappaB, and beta-catenin antibodies were performed. We compared the histology of adenoma and expression of immunohistochemical staining according to the existence of FHCRC.
RESULTS
The incidence of colorectal adenoma increased in case of FHCRC (p=0.029). In patients with FHCRC, the mean age of patients was 49 years old and younger than patients without FHCRC. In addition in patients with FHCRC, the incidence of advanced adenoma was significantly higher than in patients without FHCRC (p=0.001). The expression of Bax was significantly lower in patients with FHCRC than without FHCRC (p=0.046).
CONCLUSIONS
There was a tendency for polyp to develop in their younger ages and to be more advanced adenomas in patients with FHCRC. The low expression of Bax, tumor suppressor gene, might be associated with the development of polyps in patient with FHCRC. Therefore, patients with FHCRC may be better to start screening colonoscopy earlier than patient without FHCRC.

Keyword

Colorectal neoplasms; Colorectal adenoma; Family history of colorectal cancer; Bcl-2-associated X protein

MeSH Terms

Adenoma/*diagnosis/epidemiology/metabolism
Adult
Age Factors
Aged
Colonoscopy
Colorectal Neoplasms/*diagnosis/epidemiology/metabolism
*Family Health
Female
Humans
Immunohistochemistry
Incidence
Male
Middle Aged
Proto-Oncogene Proteins c-akt/metabolism
Proto-Oncogene Proteins c-bcl-2/metabolism
Retrospective Studies
Risk Factors
Transcription Factor RelA/metabolism
bcl-2-Associated X Protein/metabolism
beta Catenin/metabolism

Figure

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  Fig. 1 Immunohistochemical expression of Bax in patient with family history of colorectal cancer. The picture showed lower expression than those of control group (H&E, ×100). Bax, Bcl-2-associated X protein.

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  Fig. 2 Immunohistochemical expression of Bax in patient without family history of colorectal cancer. The picture showed higher expression than those of patient group (H&E, ×100). Bax, Bcl-2-associated X protein.

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