Novel curative condition after endoscopic resection for colorectal T1 carcinoma using genome biomarker

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K08385
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Hiroshima University
• Principal Investigator: Oka Shiro 広島大学, 医系科学研究科(医), 教授 (30403538)
• Co-Investigator(Kenkyū-buntansha): 田中 信治 広島大学, 病院(医), 教授 (00260670) ; 卜部 祐司 広島大学, 病院(医), 寄附講座准教授 (10648033)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 大腸T1癌 / リンパ節転移 / 内視鏡切除 / 超音波内視鏡 / ゲノムバイオマーカー

Outline of Final Research Achievements

The risk of local recurrence might be low in T1 colorectal carcinoma with a tumor vertical margin >500 μm by endoscopic resection. The distance from the tumor invasive front to the muscle layer on EUS was defined as the tumor-free distance (EUS-TFD) and classified as Type I (EUS-TFD >1 mm) and II (<1 mm).EUS-TFD classification is a novel diagnostic indicator to predict VM >500 μm in ESD preoperatively.In addition, I examined the clonal progression of colorectal tumors for the purpose of establishing new endoscopic treatment curative criteria using the genome biomarker. The outbreak of Tis cancer occurred by WNT/TGFβ, p53, RTK/RAS/MAPK course and clarified that it was WNT/ TGF β course that was the most frequent and clarified the possibility that PIK course was the carcinogenesis pathway that participated in the T1 carcinoma.

Free Research Field

大腸癌の発育進展

Academic Significance and Societal Importance of the Research Achievements

内視鏡技術の進歩により，大腸粘膜下層浸潤（T1）癌の内視鏡的完全切除が可能となったが，大腸T1癌は約10%のリンパ節転移リスクがあり，内視鏡的切除後の追加外科手術の決定にはより正確なリンパ節転移予測が必須である。大腸T1癌関連遺伝子の網羅的解析を行うことによって，癌の浸潤や転移に関するドライバー変異を同定し，大腸T1癌の内視鏡的切除病変の取り扱いの基準となる転移リスクの層別化モデルを構築することである。本研究の成果により，浸潤・転移リスクの極めて低い大腸T1癌を明らかとし，不要なover-surgery症例をなくすことで，患者の生活の質の向上と医療費削減に貢献できる。