Small Bowel Carcinomas Associated with Immune-Mediated Intestinal Disorders: The Current Knowledge
Open Access
- 29 December 2018
- Vol. 11 (1), 31
- https://doi.org/10.3390/cancers11010031
Abstract
Small bowel carcinomas (SBC) are uncommon neoplasms, whose predisposing conditions include hereditary syndromes and immune-mediated intestinal disorders including coeliac disease (CD) and Crohn’s disease (CrD). Although both CD-associated SBC (CD-SBC) and CrD-associated SBC (CrD-SBC) arise from an inflammatory background, they differ substantially in tumour cell phenotype, frequency of microsatellite instability and nuclear β-catenin expression, as well as in prognosis. For these patients, high tumour-infiltrating lymphocyte density and glandular/medullary histotype represent independent positive prognostic factors. Dysplasia adjacent to SBC is rare and characterized by intestinal phenotype and nuclear β-catenin in CD, while it is frequent and typified by gastro-pancreatobiliary marker expression and preserved membranous β-catenin in CrD. Recent evidence suggests that Epstein-Barr virus-positive dysplasia and SBC, albeit exceptional, do exist and are associated with CrD. In this review, we summarize the novel pathological and molecular insights of clinical and therapeutic interest to guide the care of CD-SBC and CrD-SBC.Keywords
This publication has 83 references indexed in Scilit:
- Small bowel adenocarcinomas—existing evidence and evolving paradigmsNature Reviews Clinical Oncology, 2013
- Combined Loss of E-cadherin and Aberrant β-Catenin Protein Expression Correlates With a Poor Prognosis for Small Intestinal AdenocarcinomasAmerican Journal of Clinical Pathology, 2013
- How I treat enteropathy-associated T-cell lymphomaBlood, 2012
- A Population-Based Comparison of Adenocarcinoma of the Large and Small Intestine: Insights Into a Rare DiseaseAnnals of Surgical Oncology, 2011
- Cetuximab in small bowel adenocarcinoma: a new friend?British Journal of Cancer, 2010
- High-Resolution Array Comparative Genomic Hybridization in Sporadic and Celiac Disease–Related Small Bowel AdenocarcinomasClinical Cancer Research, 2010
- Immunophenotype and molecular characterisation of adenocarcinoma of the small intestineBritish Journal of Cancer, 2009
- Coeliac diseaseThe Lancet, 2009
- Delayed diagnosis of coeliac disease increases cancer riskBMC Gastroenterology, 2007
- Risk factors for small bowel cancer in Crohn's diseaseDigestive Diseases and Sciences, 1992