The Difference of Clinicopathologic Features according to Leptin Expression in Colorectal Adenoma

Kyung Sun Ok; You Sun Kim; Hyung Hun Kim; Soo Hyung Ryu; Jung Hwan Lee; Jeong Seop Moon; Yun Kyung Kang

doi:10.4166/kjg.2010.56.1.20

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Ok, Kim, Kim, Ryu, Lee, Moon, and Kang: The Difference of Clinicopathologic Features according to Leptin Expression in Colorectal Adenoma

Original Article

Korean J Gastroenterol 2010;56(1):20-26.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.56.1.20

The Difference of Clinicopathologic Features according to Leptin Expression in Colorectal Adenoma

Kyung Sun Ok, M.D., You Sun Kim, M.D., Hyung Hun Kim, M.D., Soo Hyung Ryu, M.D., Jung Hwan Lee, M.D., Jeong Seop Moon, M.D., Yun Kyung Kang, M.D.^∗

Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea

^∗Department of Pathology, Inje University College of Medicine, Seoul, Korea

Correspondence to: You Sun Kim, M.D. Department of Internal Medicine, Seoul Paik Hospital, 85, 2-ga, Geo-dong, Jung-gu, Seoul 100-032, Korea Tel: +82-2-2270-0012, Fax: +82-2-2270-0257 E-mail: yousunk69@korea.com

Received 12 January 2010 Accepted 17 May 2010

Abstract

Background/Aims

Colorectal adenoma and cancer are known to be associated with obesity. Leptin, an adipo-cyte-derived hormone that plays a crucial role in obesity has been suggested as a growth factor in colon cancer. However, the association between adenoma and leptin remains controversial. We evaluated the leptin expression in human colorectal adenoma and its correlation to clinicopathologic factors.

Methods

Leptin expression was assessed by immunohistochemistry in 91 samples of colorectal adenoma larger than 5 mm, which were removed by endoscopic polypectomy. All patients underwent colonoscopy for cancer screening at Seoul Paik Hospital from 2007 to 2008 and we only included the patients less than 50 years of age. Leptin expression and its relationship with clinicopathologic features were analyzed.

Results

Eighty samples were available for the interpretation of leptin expression and showed positive in 42 (52.5%) cases and negative in 38 (47.5%) cases. As body mass index (BMI) increased based on World Health Organization (WHO) classification the positivity of leptin expression also increased (p _trend=0.02). In leptin positive group, the correlation of leptin expression with adenoma size and histological showed positive tendency without statistical significance.

Conclusions

Leptin expression of colorectal adenoma was associated with BMI. The question of whether leptin contributes to colorectal adenoma development is unresolved and will require additional studies.

Keywords: Leptin, Colon, Adenoma, Obesity, Body mass index

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Fig. 1.

Immunohistochemical staining of leptin in colon adenomatous tissue. Leptin immunoreactivity was strongly identified in the cytoplasm of the colonic epithelial cells. (A) Positive leptin expression, (B) negative leptin expression (×200).

Fig. 2.

Correlation between leptin expression and BMI. As BMI increased, the positivity of leptin expression increased (p _trend=0.02). 1, BMI＜18.5; 2, 18.5≤ BMI＜25; 3, 25≤ BMI＜30; 4, BMI≥30. BMI, body mass index; WHO, World Health Organization.∗ BMI category was divided by WHO classification of obesity. ^† Chi-square test for linear trend.

Table 1.

Clinicopathologic Variables of 80 Patients with Colorectal Adenoma

	Variables	N (%)
Sex	Male	68 (85.0)
	Female	12 (15.0)
Age (years)		42.4±5.3^∗
BMI (kg/m²)		24.4±3.2^∗
Leptin	Positive	42 (52.5)
	Negative	38 (47.5)
Polyp size (cm)		0.9±0.9^∗
Polyp number		1.8±1.1^∗
Location	Left colon	47 (58.7)
	Rectum	18 (22.5)
	Sigmoid colon	21 (26.3)
	Descending colon	8 (10.0)
	Right colon	33 (41.2)
	Transverse colon	3 (3.8)
	Ascending colon	24 (30.0)
	Cecum	6 (7.5)
Pathology	Tubular	68 (85.0)
	Villotubular	11 (13.8)
	Villous	1 (1.3)
Dysplasia	Low	43 (53.8)
	Low to high	22 (27.5)
	High	15 (18.8)
BMI, body mass index.

^∗ Data expressed as mean± SD.

Table 2.

Correlation between Leptin Expression and Clinicopathologic Variables

Variables		Leptin expression, n (%)		OR (95% CI)	p-value
Variables		Negative	Positive	OR (95% CI)	p-value
BMI (kg/m²)	＜25 (n=42)	24 (57.1)	18 (42.9)	2.29 (0.93-5.61)	0.07
	≥25 (n=38)	14 (36.8)	24 (63.1)
		23.6±3.0^∗	25.0±3.3^∗		0.05
Gender	Male (n=68)	31 (45.6)	37 (54.4)	0.60 (0.17-2.07)	0.61
	Female (n=13)	7 (58.4)	5 (41.6)
Age	≤40 (n=26)	16 (61.6)	10 (38.4)	2.33 (0.89-6.07)	0.08
	＞40 (n=54)	22 (40.5)	32 (59.5)
		41.7±5.2^∗	43.1±5.38^∗		0.24
Size	＜1 cm (n=47)	24 (51.1)	23 (48.9)	1.42 (0.58-3.47)	0.44
	≥1 cm (n=33)	14 (42.4)	19 (57.6)
		0.8±0.3^∗	1.1±1.2^∗		0.21
Number	＜3 (n=67)	30 (44.8)	37 (55.2)	0.50 (0.15-1.71)	0.27
	≥3 (n=13)	8 (61.5)	5 (38.5)
Location	Left (n=47)	24 (51.1)	23 (48.9)	1.42 (0.58-3.47)	0.44
	Right (n=33)	14 (42.4)	19 (57.6)
Pathology	Tubular (n=68)	32 (47.1)	36 (52.9)	0.53 (0.14-2.03)	0.35
	Villotubular (n=11)	5 (45.5)	6 (54.5)
	Villous (n=1)	1 (100)	0 (0)
Dysplasia	Low (n=43)	22 (51.2)	21 (48.8)	1.46 (0.73-2.91)	0.28
	Low to high (n=22)	11 (50)	11 (50)
	High (n=15)	5 (33.3)	10 (66.7)

OR, odds ratio; CI, confidence interval; BMI, body mass index.

^∗ Data expressed as mean± SD.

Table 3.

Multivariate Analysis of Leptin Expression for Clinicopathologic Variables of Patients with Colorectal Adenoma

Variables	Coefficient	OR	95% CI	p-value
BMI^∗	0.85	2.34	0.98 to 5.58	0.05
Age	0.73	2.08	0.78 to 5.57	0.15
Size^†	0.30	1.35	0.50 to 3.68	0.56
Pathology	0.79	0.45	0.13 to 1.63	0.22
Dysplasia grade	0.42	1.52	0.77 to 2.98	0.23
Polyp number	0.35	0.71	0.43 to 1.16	0.17
Location^‡	0.13	1.14	0.41 to 3.20	0.80

OR, odds ratio; CI, confidence interval; BMI, body mass index; WHO, World Health Organization.

^∗ Categories according to the WHO classification of obesity.

^† Categories according to the size of 1 cm.

^‡ Categories according to the left colon (rectum, sigmoid colon, descending colon) and the right colon (transverse colon, ascending colon, cecum).

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