CANCER ARISING IN INTESTINAL ADENOMA: % OF LYMPH NODE METASTASIS Low risk0-7% High risk 12- 35%

Presentazione sul tema: "CANCER ARISING IN INTESTINAL ADENOMA: % OF LYMPH NODE METASTASIS Low risk0-7% High risk 12- 35%"— Transcript della presentazione:

1 CANCER ARISING IN INTESTINAL ADENOMA: % OF LYMPH NODE METASTASIS Low risk0-7% High risk 12- 35%

2 Sm1: Invasion from the mucosa to 300 : no limph node mts 1 3 2 HAGGITTHAGGITT KUDO 123123 KIKUCHI 95

3 RISK FACTORS FOR METASTASIS FROM A CANCER ARISING IN INTESTINAL ADENOMA SIZE: > 2.5 – 3.5 cm (Nusco 97) TUMOR/DYSPLASIA AT THE RESECTION MARGIN <2 mm (Cooper 95) POORLY DIFFERENTIATED CARCINOMA (Coverlizza- Risio 89) LYMPHATIC INVASION: grade 1-3 (Jap Res Soc Canc 85) HIGH TUMOR BUDDING (Prall, Nizze, Barten 2005)

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11 SEQUENZA ADENOMA- CARCINOMA CANCRO CON FENOTIPO MSS

12 Deletions of 17p are associated with transition from early to advanced colorectal cancer M. Risio 2003 20 adenomas with early carcinoma: 15% 20 advanced adenocarcinomas: 60%

13 SEQUENZA ADENOMA- CARCINOMA CANCRO CON FENOTIPO MSI MSH2 MLH1 Microsatellite instability Mutation TGFbeta, BAX

14 TREATMENT OF DYSPLASIA IN IBD SPORADIC ADENOMA DALM WITH EARY CANCER Dysplasia Associated Lesions or Masses POLIPECTOMYCOLECTOMY R. Odze 03

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17 RISK FACTORS FOR METASTASES FROM A CANCER ARISING IN INTESTINAL ADENOMA SIDE: RECTUM SESSILE (Nicholls_Binda 04, Kikuchi 95) SIZE > 2.5-3.5 cm (Nusco 97) TUMOR/DYSPLASIA AT THE RESECTION MARGIN <2 mm (Cooper 95) POORLY DIFFERENTIATED CARCINOMA (Coverlizza- Risio 89) LYMPHATIC INVASION (Morson 77, Coper 98) HIGH BUDDING (Prall, Nizze, Barten 2005)

18 Ca colon-retto Instabilità Cromosomica perdita di eterozigosi diffusa Aneuploidie o poliploidie Localiz. prefer. lato sinistro colon Aspetto istol. molto differenziato Scarsa infiltraz. linfocitaria Raramente mucinoso Prognosi peggiore Instabilità Microsatelliti instabilità dei microsatelliti Diploidie Localiz. prefer. lato destro colon Aspetto istol. scars. differenziato Infiltraz. linfocitaria Spesso mucinoso Prognosi migliore inattivato MLH1 epigeneticam. 15 %85 % 10 % 5 % mutato gene del Mismatch Repair

19 Robert Odze, Mod Pathol 2003;16(4):347–358

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