Do Colorectal Serrated and Non-Serrated Adenocarcinomas Differ in Somatic Mutations and Clinicopathologic Features?

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Sağnak Yılmaz Z., Keçeci S. D., Aydın Mungan S., Saygın İ., Sağol Ö., Sarıoğlu S.

MEDICINA (KAUNAS, LITHUANIA), vol.61, no.1032, pp.1-14, 2025 (SCI-Expanded)

  • Publication Type: Article / Article
  • Volume: 61 Issue: 1032
  • Publication Date: 2025
  • Journal Name: MEDICINA (KAUNAS, LITHUANIA)
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals
  • Page Numbers: pp.1-14
  • Karadeniz Technical University Affiliated: Yes

Abstract

Abstract: Background and Objectives: Serrated adenocarcinoma (SAC) is a distinctive neoplasm

that is histopathologically characterized by the presence of epithelial serration, an

eosinophilic cytoplasm, and a vesicular nucleus. However, the literature data concerning

somatic mutations in SACs remain extremely limited. Materials and Methods: A total of

159 colon resection cases diagnosed with adenocarcinoma whose DNA mutations were

analyzed by next-generation sequencing (NGS) were retrospectively reviewed. In 23 cases,

the SAC area exceeded 50%. A chi-square test was used to evaluate histopathologic characteristics

and somatic mutations in SACs and non-serrated adenocarcinomas (non-SACs).

Results: A significant difference was found in histological grade (p = 0.019) between SACs

and non-SACs. TP53, KRAS, and PIK3CA genes have been identified as the most frequently

mutated genes in both SACs and non-SACs. No statistically significant difference in somatic

mutations was observed between the two groups (p > 0.05). Conclusions: In the

present study, a higher prevalence of KRAS mutations was observed in SACs compared

to BRAF mutations (KRAS: 39.1%, BRAF: 4.3%). This finding is consistent with the recent

literature reporting a higher prevalence of KRAS mutations in colorectal SACs, in contrast

to previous studies. The somatic mutation results of our study and the previous literature

data suggest the potential importance of epigenetic alterations documented in the literature

in the development of SACs.