A 50-year-old woman undergoes screening colonoscopy as part of a routine health maintenance work-up. An isolated 1-cm pedunculated polyp is found in the sigmoid colon. The excised polyp histologically shows well-differentiated glands with no invasion of the stalk. Which of the following investigational research procedures can distinguish most clearly whether the polyp represents hyperplasia of the colonic mucosa or a tubular adenoma?
A true neoplasm is a monoclonal proliferation of cells, whereas a reactive proliferation of cells is not monoclonal. Molecular genetic analysis, such as allelotype analysis with microsatellite markers, shows clonality. Reactive and neoplastic cellular proliferation may have similar histochemical and immunohistochemical staining patterns based on the type of cells and proteins that are present. Flow cytometry is effective at indicating the DNA content, aneuploidy, and growth fraction, but does not indicate clonality.
Flow cytometry to quantitate cells in the S phase
Histochemical staining for mucin
Immunohistochemical staining for keratin
Molecular marker of clonality
Neoplasia