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Transl Oncol. 2016 Aug;9(4):280-6. doi: 10.1016/j.tranon.2016.06.002. Epub 2016 Jul 9.

Colorectal Cancer with Residual Polyp of Origin: A Model of Malignant Transformation.

Author information

1
Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905.
2
Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 55905.
3
Center for Individualized Medicine, Mayo Clinic, Rochester, MN, 55905.
4
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905.
5
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109.
6
Anatomic Pathology, Mayo Clinic, Rochester, MN, 55905.
7
Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905. Electronic address: boardman.lisa@mayo.edu.

Abstract

The majority of colorectal cancers (CRCs) arise from adenomatous polyps. In this study, we sought to present the underrecognized CRC with the residual polyp of origin (CRC RPO+) as an entity to be utilized as a model to study colorectal carcinogenesis. We identified all subjects with biopsy-proven CRC RPO+ that were evaluated over 10 years at Mayo Clinic, Rochester, MN, and compared their clinical and pathologic characteristics to CRC without remnant polyps (CRC RPO-). Overall survival and disease-free survival overlap with an equivalent hazard ratio between CRC RPO+ and RPO- cases when age, stage, and grade are adjusted. The somatic genomic profile obtained by whole genome sequencing and the gene expression profiles by RNA-seq for CRC RPO+ tumors were compared with that of age -and gender-matched CRC RPO- evaluated by The Cancer Genome Atlas. CRC RPO+ cases were more commonly found with lower-grade, earlier-stage disease than CRC RPO-. However, within the same disease stage and grade, their clinical course is very similar to that of CRC RPO-. The mutation frequencies of commonly mutated genes in CRC are similar between CRC RPO+ and RPO- cases. Likewise, gene expression patterns are indistinguishable between the RPO+ and RPO- cases. We have confirmed that CRC RPO+ is clinically and biologically similar to CRC RPO- and may be utilized as a model of the adenoma to carcinoma transition.

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