Aberrant crypt foci as biomarkers predictive of colorectal carcinoma
Abstract
Background: Aberrant crypt foci (ACF) are the first neoplastic lesions of the colorectum that are seen by the use of a stereomicroscope or highmagnification chromscopic endoscopy. The association of ACF with colorectal carcinoma (CRC) is supported by shared histological features with colonic polyps and adenomas. ACF exhibit many of the molecular and genetic abnormalities that are involved in the patogenetic cascade of CRC development. Regarding histopathology, ACF are classified as hyperplastic and dysplastic. Hyperplastic ACF display characteristics similar to hyperplastic polyps. They are more common in sporadic cases than in familial adenomatous polyposis (FAP) patients, while dysplastic ACF are much more frequent in FAP patients. Dysplastic ACF are generally accepted as precursors to CRC, but the significance of hyperplastic ACF in tumor progression is less well established. However, ACF provide an opportunity to investigate and characterize the earliest genetic and molecular alterations in CRC development. As high-magnification chromoscopic colonoscopy (HMCC) now allows detection and biopsy of ACF in the mucosa of the large bowel, ACF might serve as a valid biomarker of subsequent adenoma and carcinoma formation. Conclusions: The present article describes the characteristics of ACF as well as their role as a potent biomarker of CRC risk in clinical practice by means of high-resolution chromoendoscopy.Downloads
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