Gastroenterology Division, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004 Japan.
Cancer Epidemiol Biomarkers Prev. 2011 Sep;20(9):1918-24. doi: 10.1158/1055-9965.EPI-11-0104. Epub 2011 Jul 12.
Aberrant crypt foci (ACF) are considered to be useful as surrogate biomarker for colorectal cancer (CRC), but the biological significance of ACF remains controversial. We attempted to investigate the relationship between the presence of ACF and human colorectal carcinogenesis using a relatively large sample size.
We carried out high-magnification chromoscopic colonoscopy to identify ACFs in 861 subjects undergoing a diagnostic endoscopy at the Yokohama City University Hospital. The present study compared the prevalence and number of ACFs in three subject groups (normal subjects, adenoma cases, and CRC cases). The correlations between the demographic and behavioral characteristics of the subjects and the prevalence of ACFs were also assessed.
The prevalence of ACF was 64%, 88%, and 95%, and the mean number of ACF was 3.6, 6.2, and 10.1, in normal subjects, adenoma cases, and CRC cases, respectively. When differences in the prevalence and number of ACFs among age- and sex-stratified subject groups were examined, significant stepwise increments from normal subjects to adenoma cases to CRC cases were apparent (P < 0.001). Moreover, an age- and sex-adjusted multiple logistic regression analysis revealed that smoking and alcohol habits had a synergistic effect, increasing the prevalence of ACFs as well as the risk of CRC (P < 0.001).
These results suggested that ACF may serve as a reliable surrogate biomarker for human colorectal carcinogenesis.
The use of ACF as an endpoint may enable the size, duration, and cost of CRC chemoprevention studies to be reduced.
异常隐窝病灶（ACF）被认为是结直肠癌（CRC）的有用替代生物标志物，但 ACF 的生物学意义仍存在争议。我们试图使用相对较大的样本量来研究 ACF 的存在与人类结直肠癌变之间的关系。
我们对在横滨市立大学医院进行诊断性内镜检查的 861 例患者进行了高倍放大 chromoscopic 结肠镜检查，以确定 ACF 的存在。本研究比较了三组受试者（正常受试者、腺瘤病例和 CRC 病例）中 ACF 的患病率和数量。还评估了受试者的人口统计学和行为特征与 ACF 患病率之间的相关性。
ACF 的患病率分别为 64%、88%和 95%，正常受试者、腺瘤病例和 CRC 病例的平均 ACF 数分别为 3.6、6.2 和 10.1。当按年龄和性别分层的受试者组之间的 ACF 患病率和数量差异进行检查时，从正常受试者到腺瘤病例到 CRC 病例的明显呈阶梯式递增（P <0.001）。此外，年龄和性别调整的多因素逻辑回归分析表明，吸烟和饮酒习惯具有协同作用，增加了 ACF 的患病率以及 CRC 的风险（P <0.001）。
这些结果表明，ACF 可能是人类结直肠癌变的可靠替代生物标志物。
使用 ACF 作为终点可能会降低 CRC 化学预防研究的规模、持续时间和成本。
