Leedham SJ, Graham TA, Oukrif D et al.
Cancer Research UK, London, UK.
Gastroenterology 2009;136:542–50.e6.
Editor’s note: The pathogenesis of sporadic colon cancer is characterized by the consecutive accumulation of mutations in adenomatous polyposis coli (
APC), V-Ki-ras2Kirsten rat sarcoma viral oncogene homolog (
KRAS), and protein 53 (
p53)
, resulting in the conversion of a monoclonal abnormality into a neoplasm. In contrast, little is known about the clonality or the mutation sequence of ulcerative colitis-associated cancers (UCACs). UCACs are clinically different from sporadic cases because they arise in a chronically inflamed mucosa, and often occur in a background of flat rather than polypoid dysplastic lesions. In addition, UCACs affect a relatively younger patient population, and their histology is typically of a mucinous or signet-ring type.