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From the Division of Anatomic Pathology, Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
DPC4 is a candidate tumor suppressor
gene on chromosome 18q21, a region that shows high frequencies
of allelic losses in pancreatic and colorectal adenocarcinomas.
Biallelic inactivation of DPC4 has been reported in half
of pancreatic cancers, but are relatively infrequent in other
tumor types. The role of DPC4 inactivation in colorectal
neoplasms has not been fully characterized. An immunohistochemical
assay for Dpc4 protein expression has been recently developed and shown
to be a sensitive and specific surrogate for alterations in the
DPC4 gene. In this study we examined the expression of
Dpc4 protein in formalin-fixed archival tissue from 83 colorectal
lesions, including 19 adenomas and 64 sporadic adenocarcinomas
(11 stage I, 13 stage II, 17 stage III, and 23
stage IV cancers). None of the adenomas or stage I adenocarcinomas
showed loss of Dpc4 expression, whereas one of 13 (8%) stage
II, one of 17 (6%) stage III, and five of 23 (22%) of
stage IV cancers showed loss of Dpc4 expression. There was a borderline
significant difference in loss of Dpc4 reactivity in colorectal tumors
with distant metastasis at presentation (22%) versus
primary tumors without distant metastasis (5%) (Fisher’s exact
test, P = 0.05;
2 = 0.04). Poorly differentiated histology
or status of pericolonic lymph nodes did not affect Dpc4 expression.
Alterations in DPC4 are involved in the progression of a
subset of colorectal carcinomas, especially those that present
with advanced disease. In the sequential pathogenesis of colorectal
tumors, inactivation of DPC4 is likely to be a
late event.
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