[Is p53 immunohistochemistry useful for optimal decision for treatment of polypoid lesions in ulcerative colitis?]

Usefulness of p53 staining for the differentiation between adenoma and DALM has been reported recently, so recognizable lesions stained positively can be diagnosed as DALMs. For the cases with DALMs, total colectomy has been thought to be necessary.

Immunohistochemical staining for p53 was performed in 4 adenocarcinomas and 4 adenomas in ulcerative colitis.

Three carcinomas and 3 adenomas were positive. One carcinoma (protruded mucosal cancer) and 3 adenomas (1 flat elevated lesion and 2 laterally spreading tumors) stained positively for p53 were treated only by polypectomy or local excision. The patients have been under surveillance for periods ranging from 1 to 10 years, during which no metachronous dysplasia has developed.

These findings suggest that some groups of the polypoid lesions can be resected locally even if stained positively by p53 immunohistochemistry.