Rubio Carlos A
Department of Pathology, Karolinska Institute and Hospital, Stockholm, Sweden.
Pathol Res Pract. 2002;198(9):615-20. doi: 10.1078/0344-0338-00310.
Colorectal adenomas are histologically classified into two categories: tubular and villous adenomas. A mixed (tubulovillous) phenotype has also been recognized. Although two other histologic phenotypes, serrated and microtubular adenomas, were reported later, they have not yet been included in any of the larger series reported in the literature. In this study, we classified all colorectal adenomas registered at this department between 1993 and 2000 (n = 3135) into five histologic categories: tubular (66%; n = 2074), villous (9%; n = 281), mixed (18%; n = 551), serrated (6%; n = 202), and microtubular (1%; n = 27) . More than 80% of the tubular, villous, serrated and microtubular adenomas were located in the colon. None of the microtubular adenomas was found in the rectum. Cell proliferation in tubular and villous adenomas occurred initially in the upper part of the dysplastic glands, in serrated adenomas in the lower part of the dysplastic crypts, and in microtubular adenomas in the deeper part of the dysplastic "rings". Because of these distinctive morphologic features and cell-proliferative characteristics, serrated and microtubular adenomas should be regarded as independent phenotypes. To compare the frequency of these adenoma phenotypes, we suggest that serrated and microtubular adenomas be included in future reports on the histologic characteristics of colorectal polyps.
管状腺瘤和绒毛状腺瘤。也已认识到混合（管状绒毛状）表型。尽管后来报道了另外两种组织学表型，即锯齿状腺瘤和微管状腺瘤，但它们尚未被纳入文献中报道的任何较大系列研究。在本研究中，我们将1993年至2000年在本科室登记的所有结直肠腺瘤（n = 3135）分为五种组织学类型：管状（66%；n = 2074）、绒毛状（9%；n = 281）、混合性（18%；n = 551）、锯齿状（6%；n = 202）和微管状（1%；n = 27）。超过80%的管状、绒毛状、锯齿状和微管状腺瘤位于结肠。直肠中未发现微管状腺瘤。管状和绒毛状腺瘤中的细胞增殖最初发生在发育异常腺体的上部，锯齿状腺瘤中发生在发育异常隐窝的下部，微管状腺瘤中发生在发育异常“环”的深部。由于这些独特的形态学特征和细胞增殖特性，锯齿状和微管状腺瘤应被视为独立的表型。为了比较这些腺瘤表型的发生率，我们建议在未来关于结直肠息肉组织学特征的报告中纳入锯齿状和微管状腺瘤。
