Colorectal carcinomas in MUTYH-associated polyposis display histopathological similarities to microsatellite unstable carcinomas

<p>Abstract</p> <p>Background</p> <p>MUTYH-associated polyposis (MAP) is a recessively inherited disorder which predisposes biallelic carriers for a high risk of polyposis and colorectal carcinoma (CRC). Since about one third of the biallelic MAP patients in population based CRC series has no adenomas, this study aimed to identify specific clinicopathological characteristics of MAP CRCs and compare these with reported data on sporadic and Lynch CRCs.</p> <p>Methods</p> <p>From 44 MAP patients who developed ≥ 1 CRCs, 42 of 58 tumours were analyzed histologically and 35 immunohistochemically for p53 and beta-catenin. Cell densities of CD3, CD8, CD57, and granzyme B positive lymphocytes were determined. <it>KRAS2</it>, the mutation cluster region (MCR) of <it>APC, p53</it>, and <it>SMAD4 </it>were analyzed for somatic mutations.</p> <p>Results</p> <p>MAP CRCs frequently localized to the proximal colon (69%, 40/58), were mucinous in 21% (9/42), and had a conspicuous Crohn's like infiltrate reaction in 33% (13/40); all of these parameters occurred at a higher rate than reported for sporadic CRCs. Tumour infiltrating lymphocytes (TILs) were also highly prevalent in MAP CRCs. Somatic <it>APC </it>MCR mutations occurred in 14% (5/36) while 64% (23/36) had <it>KRAS2 </it>mutations (22/23 c.34G>T). G>T tranversions were found in <it>p53 </it>and <it>SMAD4</it>, although the relative frequency compared to other mutations was low.</p> <p>Conclusion</p> <p>MAP CRCs show some similarities to micro-satellite unstable cancers, with a preferential proximal location, a high rate of mucinous histotype and increased presence of TILs. These features should direct the practicing pathologist towards a MAP aetiology of CRC as an alternative for a mismatch repair deficient cause. High frequent G>T transversions in <it>APC </it>and <it>KRAS2 </it>(mutated in early tumour development) but not in <it>P53 </it>and <it>SMAD4 </it>(implicated in tumour progression) might indicate a predominant MUTYH effect in <it>early </it>carcinogenesis.</p

New stomatal flux-based critical levels for ozone effects on vegetation

The critical levels for ozone effects on vegetation have been reviewed and revised by the LRTAP Convention. Eight new or revised critical levels based on the accumulated stomatal flux of ozone (PODY, the Phytotoxic Ozone Dose above a threshold flux of Y nmol m−2 PLA s−1, where PLA is the projected leaf area) have been agreed. For each receptor, data were combined from experiments conducted under naturally fluctuating environmental conditions in 2–4 countries, resulting in linear dose–response relationships with response variables specific to each receptor (r2 = 0.49–0.87, p < 0.001 for all). For crops, critical levels were derived for effects on wheat (grain yield, grain mass, and protein yield), potato (tuber yield) and tomato (fruit yield). For forest trees, critical levels were derived for effects on changes in annual increment in whole tree biomass for beech and birch, and Norway spruce. For (semi-)natural vegetation, the critical level for effects on productive and high conservation value perennial grasslands was based on effects on important component species of the genus Trifolium (clover species). These critical levels can be used to assess protection against the damaging effects of ozone on food security, important ecosystem services provided by forest trees (roundwood production, C sequestration, soil stability and flood prevention) and the vitality of pasture