Molecular Basis of Adenocarcinoma of the Small Bowel

  • Individuals with colorectal adenocarcinoma are at increased risk for developing small bowel adenocarcinoma:
    • Suggesting a possible common molecular pathway
  • Multiple mutations have been identified in small bowel adenocarcinomas:
    • Many of which are also implicated in colorectal cancer:
      • However:
        • The sequential genetic alterations in small bowel adenocarcinoma are less well understood than for colorectal adenocarcinoma
  • Several familial syndromes:
    • Are associated with increased incidence of small bowel adenocarcinoma:
      • Hereditary cancer syndromes including:
        • Lynch syndrome (hereditary nonpolyposis colorectal cancer)
        • FAP
        • Peutz-Jeghers syndrome:
          • All of this cancer syndromes are associated with elevated lifetime rates of small bowel adenocarcinomas:
            • As high as 2% to 8%, 3% to 5% (mostly in the duodenum), and 13%, respectively
  • Chronic inflammatory conditions:
    • Are also implicated in the etiology of small bowel adenocarcinoma, including:
      • Crohn disease
      • Celiac disease
        • The risk of adenocarcinoma in Crohn disease:
          • Is proportional to the extent and duration of small bowel disease:
            • With 0.2% risk at 10 years and 2.2% at 25 years
              • This is a 27- to 60-fold increased risk over the general population
      • Individuals with celiac disease:
        • Are also at 34-fold increased risk for small bowel adenocarcinoma than those without celiac disease

#Arrangoiz #CancerSurgeon #SurgicalOncologist #SmallBowelCancer #Teacher

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