PIK3CA Amplification Is Common in Left Side-Tubular Adenomas but Uncommon Sessile Serrated Adenomas Exclusively with

Hyunsu Lee1, Jae-Ho Lee1, Dae-Kwang Kim2

  • 11. Department of Anatomy, Keimyung University School of Medicine;

Insights

PIK3CA amplification is an early event in colorectal cancer development, particularly in left-sided tubular adenomas (TAs). This genetic change appears to drive TA growth independently of KRAS mutations.

Area of Science:

  • Oncology
  • Molecular Biology
  • Gastroenterology

Background:

  • Colorectal cancer (CRC) is a complex disease with distinct precancerous pathways, including tubular adenomas (TAs) and sessile serrated adenomas (SSAs).
  • Understanding the molecular drivers of these early lesions is crucial for targeted prevention and treatment strategies.

Purpose of the Study:

  • To investigate the frequency and significance of PIK3CA amplification in colorectal precancerous lesions (TAs and SSAs).
  • To determine the relationship between PIK3CA amplification and common mutations (KRAS, BRAF) in these adenomas.

Main Methods:

  • DNA analysis of paired normal and tumoral tissues from 64 TAs and 32 SSAs.
  • Real-time PCR and pyrosequencing were used to detect PIK3CA amplification, KRAS mutations, and BRAF mutations.

Main Results:

  • PIK3CA amplification was detected in 25% of TAs and 9.4% of SSAs.
  • KRAS and BRAF mutations were mutually exclusive in both adenoma types.
  • In TAs, PIK3CA amplification was associated with left-sided lesions and was mutually exclusive with KRAS mutations.

Conclusions:

  • PIK3CA amplification represents an early and potentially significant event in colorectal carcinogenesis.
  • This amplification may independently drive the development of left-sided TAs, distinct from KRAS mutation pathways.

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