Akshay K Gupta1, Robert E Schoen. 1. Department of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
PURPOSE OF REVIEW: There is a wealth of literature, both from epidemiological and molecular studies, which support the role of aberrant crypt foci (ACF) as a putative precursor to colorectal adenomas and a potential biomarker for colorectal carcinoma. In this review, we critically examine the evidence on employing ACF as an intermediate endpoint. RECENT FINDINGS: Recent, larger-scale, multicenter studies of ACF have raised questions about ACF. The prevalence of ACF has not correlated with colorectal adenomas, and the technique for ACF detection using high-magnification chromoendoscopy has demonstrated considerable variability across endoscopists and over time. Dysplastic ACF, once postulated as the ACF destined for adenomatous transformation, have been rarely identified in US individuals, in contrast to European and Japanese investigations. A substantial percentage of purported, endoscopically detected ACF have not been confirmed on histologic review. Finally, molecular characterization of ACF has been studied on only a limited basis. SUMMARY: ACF remain a potential biomarker for colorectal cancer, but similar to other biomarkers under development, additional study of ACF is needed before reliable, clinical application can be assured.
PURPOSE OF REVIEW: There is a wealth of literature, both from epidemiological and molecular studies, which support the role of aberrant crypt foci (ACF) as a putative precursor to colorectal adenomas and a potential biomarker for colorectal carcinoma. In this review, we critically examine the evidence on employing ACF as an intermediate endpoint. RECENT FINDINGS: Recent, larger-scale, multicenter studies of ACF have raised questions about ACF. The prevalence of ACF has not correlated with colorectal adenomas, and the technique for ACF detection using high-magnification chromoendoscopy has demonstrated considerable variability across endoscopists and over time. Dysplastic ACF, once postulated as the ACF destined for adenomatous transformation, have been rarely identified in US individuals, in contrast to European and Japanese investigations. A substantial percentage of purported, endoscopically detected ACF have not been confirmed on histologic review. Finally, molecular characterization of ACF has been studied on only a limited basis. SUMMARY: ACF remain a potential biomarker for colorectal cancer, but similar to other biomarkers under development, additional study of ACF is needed before reliable, clinical application can be assured.
Authors: Paul J Limburg; Michelle R Mahoney; Katie L Allen Ziegler; Stephen J Sontag; Robert E Schoen; Richard Benya; Michael J Lawson; David S Weinberg; Elena Stoffel; Michael Chiorean; Russell Heigh; Joel Levine; Gary Della'Zanna; Luz Rodriguez; Ellen Richmond; Christopher Gostout; Sumithra J Mandrekar; Thomas C Smyrk Journal: Cancer Prev Res (Phila) Date: 2011-01-05
Authors: David A Drew; Allen Mo; James J Grady; Richard G Stevens; Joel B Levine; Bruce M Brenner; Joseph C Anderson; Faripour Forouhar; Michael J O'Brien; Thomas J Devers; Daniel W Rosenberg Journal: Mol Cancer Res Date: 2017-12-08 Impact factor: 5.852
Authors: Massimo Mascolo; Stefania Staibano; Gennaro Ilardi; Maria Siano; Maria Luisa Vecchione; Dario Esposito; Gaetano De Rosa; Giovanni Domenico De Palma Journal: Gastroenterol Res Pract Date: 2012-04-08 Impact factor: 2.260
Authors: Daniel Sliva; Jagadish Loganathan; Jiahua Jiang; Andrej Jedinak; John G Lamb; Colin Terry; Lee Ann Baldridge; Jiri Adamec; George E Sandusky; Shailesh Dudhgaonkar Journal: PLoS One Date: 2012-10-30 Impact factor: 3.240