结直肠扁平隆起型管状绒毛状腺瘤及腺癌的细胞动力学、p53和bcl-2表达以及c-Ki-ras突变：与息肉样病变的比较

Cell kinetics, p53 and bcl-2 expression, and c-Ki-ras mutations in flat-elevated tubulovillous adenomas and adenocarcinomas of the colorectum: comparison with polypoid lesions.

作者信息

Sada M, Mitomi H, Igarashi M, Katsumata T, Saigenji K, Okayasu I

机构信息

Dept. of Pathology, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan.

出版信息

Scand J Gastroenterol. 1999 Aug;34(8):798-807. doi: 10.1080/003655299750025732.

DOI:10.1080/003655299750025732

PMID:10499481

Abstract

BACKGROUND

Flat(-elevated) tubulovillous adenomas and adenocarcinomas of the colorectum constitute a specific type of neoplasm with superficial spreading growth. To establish their characteristics, a comparative investigation of a series of tumors was performed.

METHODS

A total of 56 flat tubulovillous tumors (39 adenomas, 17 invasive carcinomas) and 154 polypoid tubular or villous tumors (77 adenomas, 77 invasive carcinomas) were comparatively assessed for cell kinetics and molecular alterations.

RESULTS

Ki-67 labeling and p53 expression for both types of tumors increased along with degree of dysplasia or invasion, whereas bcl-2 expression showed an inverse decrease. However, apoptotic activity was invariably low in the flat tubulovillous tumors, as compared with the polypoid tumors, in which increase was apparent with tumor progression. The flat tubulovillous tumors also showed a higher frequency of c-Ki-ras mutations (92.9%) than the polypoid tubular tumors (40.0%).

CONCLUSIONS

The flat tubulovillous tumor can be considered a distinct entity, with characteristics different from the polypoid counterpart.

摘要

背景

结直肠扁平（隆起性）管状绒毛状腺瘤和腺癌是一种具有浅表扩散生长的特殊类型肿瘤。为明确其特征，对一系列肿瘤进行了对比研究。

方法

对56例扁平管状绒毛状肿瘤（39例腺瘤，17例浸润性癌）和154例息肉状管状或绒毛状肿瘤（77例腺瘤，77例浸润性癌）进行细胞动力学和分子改变的对比评估。

结果

两种类型肿瘤的Ki-67标记和p53表达均随发育异常或浸润程度增加而升高，而bcl-2表达则呈相反降低。然而，与息肉状肿瘤相比，扁平管状绒毛状肿瘤的凋亡活性始终较低，息肉状肿瘤的凋亡活性随肿瘤进展而明显增加。扁平管状绒毛状肿瘤的c-Ki-ras突变频率（92.9%）也高于息肉状管状肿瘤（40.0%）。