Adenoma-carcinoma sequence: a reappraisal with immunohistochemical expression of ferritin

To examine the biological significance of ferritin (FRN) expression, a retrospective immunohistochemical study was performed in normal colonic mucosae (n = 8), adenomas (n = 88), and colorectal carcinomas (n = 104). FRN was present in some epithelia in the crypt base of normal colonic mucosae. Significant cytoplasmic staining for FRN was revealed in 26 (29.5%) cases of adenoma and 54 cases (51.9%) of adenocarcinoma. The cancer cells had a higher proportion of FRN expression than those of adenomas or non-neoplastic mucosae (P < 0.001). Expression of FRN showed a positive association with the degree of dysplasia (P = 0.039) and the distal location of adenoma (P = 0.013). FRN expression tended to be associated with the tumor size (P = 0.083), but no substantial difference was observed among the histologic types of adenoma (P = 0.754). The results suggest that cytoplasmic FRN expression is associated with cellular proliferation. The proliferative index shows a significant difference through the adenoma-carcinoma sequence. Further investigation is necessary to clarify the clinical implication of FRN expression in tumor cells and normal-appearing mucosae.