Bernhard Tribukait

Molecular prostate cancer pathology: Current issues and achievements

Recent developments in the field of molecular techniques have provided new tools that have led to the discovery of many new promising biomarkers for prostate cancer. These biomarkers may be instrumental in the development of new tests that will have a high specificity for the diagnosis and prognosis of prostate cancer. A biomarker is defined as a molecular test that provides additional information to currently available clinical and pathological tests. Biomarkers should be reproducible (both within and between institutes) and have an impact on clinical management. For diagnostic purposes it is important that potential biomarkers are tested in terms of tissue specificity and their discrimination potential between prostate cancer, normal prostate and benign prostatic hyperplasia. The results of (multiple) biomarker-based assays may enhance the specificity of cancer detection. There is an urgent need for molecular prognostic biomarkers for predicting the biological behavior and outcome of cancer.

Colitis-associated DNA aneuploidy and dysplasia in Crohn's disease and risk of colorectal cancer

Background: There is uncertainty about how patients with Crohns colitis should be monitored for colorectal cancer (CRC). By analogy to ulcerative colitis, regular colonoscopy with biopsies for dysplasia has been used. We describe the occurrence of dysplasia and DNA aneuploidy in a cohort of patients with Crohns colitis. Methods: In all, 245 patients with extensive colitis (225 with a firm diagnosis of Crohns disease, and 20 diagnosed as indeterminate colitis) at Stockholm Söder Hospital and Karolinska University Hospital, Huddinge were included. They were followed with regular colonoscopies with biopsies both for dysplasia and DNA aneuploidy. The cumulative occurrence of DNA aneuploidy and dysplasia was estimated using Kaplan‐Meier curves. Time sequences and interactions between DNA aneuploidy, dysplasia, and CRC were studied using Cox regression analysis, adjusted for age, sex, and age at diagnosis. Results: During a median follow‐up time of 9.2 person‐years, DNA aneuploidy was found in 53 patients (22%), with 10 patients having multifocal aneuploidy and high S‐phase values. Dysplasia was found in 42 patients (17%), 10 having multifocal dysplasia. Relative risk (RR) of dysplasia given DNA aneuploidy was 5.3 (95% confidence interval [CI] 2.3‐12). RR of CRC given dysplasia was 10 (95% CI 2‐50), and RR of CRC given aneuploidy was 1.5 (95% CI 0.3‐9.3). Conclusions: Dysplasia and DNA aneuploidy including S‐phase analysis may complement stratification of patients with Crohns colitis with respect to risk of CRC and thus the need for surveillance. (Inflamm Bowel Dis 2010)