OUP user menu

Frequent β-Catenin Nuclear Labeling in Sessile Serrated Polyps of the Colorectum With Neoplastic Potential

Julie M. Wu MD, Elizabeth A. Montgomery MD, Christine A. Iacobuzio-Donahue MD, PhD
DOI: http://dx.doi.org/10.1309/603UQKM7C2KELGJU 416-423 First published online: 1 March 2008


We obtained 22 sessile serrated adenomas (SSAs) and 19 hyperplastic polyps (HPs) and performed immunolabeling for cytokeratins (CKs) 7 and 20, CDX2, β-catenin, and p53 to determine the role of these markers in aiding distinction of lesions with neoplastic potential. Patients with SSAs more frequently had a prior or coexistent tubular adenoma (P = .004) that was right-sided (P = .00001) and larger (P = .03). No difference in CK7, CK20, or p53 labeling was found after correction for colonic location. However, CDX2 labeling was significantly lower in SSAs (P = .02) and was predominantly confined to the crypt bases, whereas it was diffusely positive in HPs (P < .001). Surprisingly, aberrant nuclear labeling for β-catenin was found in 9 (41%) of the SSAs but in none of the HPs (P < .002). We propose that β-catenin and/or CDX2 immunolabeling may have diagnostic usefulness in the evaluation of serrated polyps. These findings also suggest that Wnt signaling has a role in SSA development.

Key Words:
  • Serrated adenoma
  • Hyperplastic polyps
  • Wnt pathway
  • Colorectal