Medical Student Research Fellowship for Summer 2008
Mentor: Samir Gupta, MD
Department: Digestive and Liver Diseases
Room number: 520.D
Mail Code: 8887
Phone number: 214.645.6344
E-mail: samir.gupta@utsouthwestern.edu
Project title: "Molecular markers of carcinogenesis for risk stratification
of individuals with
colorectal polyps"
Human subjects IRB approved project number (where applicable): IRB#112007-005
Animal subjects IRB approved project number (where applicable): Not applicable
Project Type : Patient-based
Brief Description of Project:
Most colorectal cancers (CRC) develop through colorectal polyps, and polyp characteristics
(e.g. size and histology) are currently used as biomarkers of future CRC risk.
However, current tools used to predict risk are suboptimal for CRC prevention:
new strategies are required. Characterization of molecular markers of carcinogenesis
(i.e. markers of cancer development) in polyps may offer more precise risk stratification,
and optimize CRC prevention. Polyps from individuals with concurrent polyps
and CRC are ideal for assessment of new risk assessment strategies. We hypothesize
that: 1) Strategies that incorporate biomarkers of carcinogenesis may optimize
risk assessment, and therefore that a candidate panel of molecular markers of
carcinogenesis, measured using simple immunohistochemistry, will distinguish
polyps from individuals with colorectal cancer from polyps from individuals
without CRC with high sensitivity and specificity, 2) Polyps and colorectal
cancer present in the same individual share expression of selected molecular
markers of carcinogenesis, as measured by immunohistochemistry, and 3) Patterns
of expression of molecular markers of carcinogenesis, measured via immunohistochemistry,
exhibit high intra-variable reproducibility, both within-polyps and within-colorectal
cancers, such that this approach can be generalizable for future studies and
clinical implementation. Our specific aims are: 1) To determine the diagnostic
accuracy of a panel of molecular markers of carcinogenesis, measured via immunohistochemistry,
for distinguishing polyps from individuals with CRC from polyps from individuals
without CRC, 2) To compare patterns of expression of molecular markers of carcinogenesis,
measured via immunohistochemistry, between polyps and colorectal cancer among
subjects who have concurrent polyps and cancer, and 3) To determine the within-polyp,
and within-cancer, reproducibility of expression patterns of molecular markers
of carcinogenesis, measured via immunohistochemistry, in colorectal polyps and
colorectal cancers, respectively. If successful, we envision a future validation-phase,
diagnostic case-control study, as well as prospective studies of risk stratification
using our strategy that may dramatically improve CRC prevention.
The student-researcher role in this project will be as follows:
1. Electronic and Medical Chart review to screen potential subjects for inclusion
in the study
2. Data entry
3. Interaction with pathology lab personnel to identify and process archived
paraffin embedded samples for analysis
The student-researcher benefits from participation in the project will be:
1. An appreciation for the clinical research process
2. Opportunity to for directed readings regarding colon cancer and colon polyp
epidemiology, biology, and prevention
3. One-on-one mentorship on the process of developing and executing clinical
research questions, including in depth review of "Designing Clinical Research,
3rd edition" Hully et al eds.
Previous Research Activities or Publications with Medical Students:
None.