Histomorphology of Colorectal Superficially Serrated Adenoma and the Role of RSPO2 and RSPO3 in its Carcinogenic Mechanism
10.3969/j.issn.1008-7125.2025.01.006
- VernacularTitle:结直肠表浅锯齿状腺瘤组织形态学分析以及RSPO2、RSPO3在其癌变机制中的作用
- Author:
Suming GAO
1
;
Lin WANG
;
Meiyan LIANG
;
Zhenhua ZHANG
;
Xiaosai CHEN
;
Li LI
Author Information
1. 山西医科大学第三医院(山西白求恩医院 山西医学科学院同济山西医院)病理科(030032)
- Publication Type:Journal Article
- Keywords:
Colorectal Neoplasms;
Superficially Serrated Adenoma;
Carcinogenesis;
RSPO2;
RSPO3;
Immunohistochemistry
- From:
Chinese Journal of Gastroenterology
2025;30(1):32-37
- CountryChina
- Language:Chinese
-
Abstract:
Background:Colorectal cancer(CRC)is a major cause of cancer death worldwide,and about 30%to 35%of CRC arises from the serrated pathway.Aims:To analyze the clinicopathological and histomorphological characteristics of colorectal superficially serrated adenoma(SuSA),and to investigate the malignant transformation potential of SuSA and further elucidate the role of RSPO2 and RSPO3 in its carcinogenic mechanism.Methods:A total of 169 serrated colorectal lesions confirmed pathologically and fulfilling the inclusion criteria were collected from Shanxi Bethune Hospital from February 2019 to May 2023.Among them,there were 84 cases of SuSA,23 sessile serrated lesions(SSL),32 traditional serrated adenomas(TSA),and 30 hyperplastic polyps(HP).Thirty-nine cases of tubular adenoma(TA),32 CRC,and 33 normal colorectal mucosal tissues were served as controls.The clinicopathological and histomorphological parameters were collected and recorded.Immunohistochemical staining was used to detect the protein expressions of RSPO2,RSPO3,p53,MLH1 and β-catenin.Results:Patients with SuSA were male predominance,with a mean age of 51.89 years.The average diameter of the lesions was 0.20 cm,predominantly located in the left colon and rectum,and frequently complicated with other polyps/adenomas.The histomorphological features of SuSA were as follows:the glandular necks and crypt bases exhibited straight tubular structure with low-grade dysplasia;the superficial layer demonstrated a serrated architecture,with or without dysplasia,and contained a variable number of goblet cells.Immunohistochemically,there were no statistically significant differences in RSPO2,RSPO3,and p53 expressions between SuSA and TSA(all P>0.05).A strong positive correlation was observed between RSPO2 and RSPO3 in colorectal lesions,excluding HP.Expressions of MLH1 and β-catenin showed no statistically significant differences between SuSA and other colorectal lesions(all P>0.05).Conclusions:SuSAs are more common in males,occur mostly in the left colon and rectum,and are often associated with other polyps/adenomas.They might be precursors of KRAS-mutated TSA and microsatellite stable CRC with high malignant potential.RSPO2 and RSPO3 might play an important role in the carcinogenesis of SuSA.
