Department of Pediatric and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan,
Department of Pediatric and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Digestion. 2022;103(2):150-158. doi: 10.1159/000519559. Epub 2021 Oct 29.
Long-term disease duration of ulcerative colitis (UC) is known to increase the risk of developing colorectal cancer in adults; however, this association has not been genetically analyzed in children with UC. Herein, we examined the expression of cancer-related genes in the colonic mucosa of pediatric UC patients and their risk of developing colorectal cancer.
Microarray analysis of cancer-related gene expression was conducted on rectal mucosa biopsy specimens randomly selected from pediatric cases, including 4 active-phase UC cases, 3 remission-phase UC cases, and 3 irritable bowel syndrome control cases. The subject pool was then expanded to 10 active-phase cases, 10 remission-phase cases, and 10 controls, which were analyzed by real-time polymerase chain reaction (PCR) and immunohistochemical staining.
The microarray results indicated significantly higher expression levels of cancer-related genes PIM2 and SPI1 in the active group than in the remission and control groups (p < 0.05). Real-time PCR confirmed that PIM2 and SPI1 expression levels were significantly higher, whereas TP53 and APC expression levels were significantly lower, in the active-phase group than in the remission and control groups (p < 0.05). Immunohistochemical staining for PIM2, SPI1, TP53, and APC proteins supported the real-time PCR results.
Expression levels of previously unreported cancer-related genes in adult UC patients were significantly higher in pediatric UC patients than in controls. Inflammation of the gastrointestinal mucosa increased the expression levels of cancer-related genes even in childhood-onset UC cases, suggesting that chronic inflammation from childhood may increase the risk of colorectal cancer development.
溃疡性结肠炎(UC)的长期疾病病程已知会增加成人罹患结直肠癌的风险;然而,在患有 UC 的儿童中,尚未对此关联进行基因分析。在此,我们研究了儿科 UC 患者结肠黏膜中与癌症相关的基因表达及其罹患结直肠癌的风险。
对随机选择的来自儿科病例的直肠黏膜活检标本进行与癌症相关的基因表达的微阵列分析,包括 4 例活动期 UC 病例、3 例缓解期 UC 病例和 3 例肠易激综合征对照病例。随后将研究对象扩展至 10 例活动期病例、10 例缓解期病例和 10 例对照,通过实时聚合酶链反应(PCR)和免疫组织化学染色进行分析。
微阵列结果表明,活动期组中与癌症相关的基因 PIM2 和 SPI1 的表达水平明显高于缓解期和对照组(p<0.05)。实时 PCR 证实,与缓解期和对照组相比,活动期组中 PIM2 和 SPI1 的表达水平明显更高,而 TP53 和 APC 的表达水平明显更低(p<0.05)。PIM2、SPI1、TP53 和 APC 蛋白的免疫组织化学染色支持实时 PCR 结果。
与成人 UC 患者中先前未报道的癌症相关基因的表达水平相比,儿科 UC 患者的表达水平明显更高。即使在儿童发病的 UC 病例中,胃肠道黏膜的炎症也会增加与癌症相关的基因的表达水平,这表明儿童时期的慢性炎症可能会增加结直肠癌发展的风险。