Apoptosis in the development of colorectal neoplasia

Authors: D. Kohoutová 1;  J. Pejchal 2;  J. Cyrany 1;  P. Morávková 1;  S. Rejchrt 1;  J. Bureš 1
Authors‘ workplace: II. interní gastroenterologická klinika LF UK a FN Hradec Králové 1;  Katedra toxikologie a vojenské farmacie, FVZ UO, Hradec Králové 2
Published in: Gastroent Hepatol 2016; 70(4): 313-318
Category: Gastrointestinal Oncology: Original Article
doi: 10.14735/amgh2016313


The Czech Republic has one of the highest incidence rates of colorectal cancer. Cell proliferation, differentiation, and apoptosis play a key role in the development of this disease. The aim of our study was to assess the level of apoptosis at each stage of colorectal neoplasia.

Apoptosis was evaluated by examining mucosal biopsies of colorectal neoplasm and normal mucosa. This was performed in 20 patients with non-advanced adenoma, 20 patients with advanced adenoma, 20 patients with colorectal carcinoma, and 20 individuals with normal colorectal findings. The grade of apoptosis was assessed after hematoxylin-eosin staining (in three compartments: the superficial compartment and the upper and lower parts of the crypts) and by immunohistochemical methods (by detection of activated-caspase-3).

Apoptotic activity was reported as an apoptotic index. In healthy colorectal mucosa, low apoptotic activity was observed in the lower part of the crypts. In the upper part of the crypts, apoptotic activity decreased (to almost zero) and in the superficial compartment, there was an increase in apoptotic activity. Transformation of healthy mucosa into non-advanced colorectal adenoma was associated with a statistically significant increase in apoptotic activity in all three compartments (p ≤ 0.05), with the biggest increase in the upper part of the crypts. Transformation of non-advanced adenoma into advanced adenoma was related to further increases in apoptotic activity, again, mainly in the upper part of the crypts. There was a statistically significant decrease in apoptotic activity in all three comparments of carcinoma samples compared to advanced adenoma (p ≤ 0.05). Results of immunohistochemical methods confirmed this trend.

We have shown deregulation of apoptosis during the development of colorectal neoplasia. Being able to influence the degree of apoptosis, especially during the transformation of an advanced adenoma into a carcinoma, would have beneficial consequences in clinical practice.

Key words:
colorectal adenoma – colorectal carcinoma – apoptosis

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

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5. 7. 2016


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