Hermanek P
Chirurgische Klinik mit Poliklinik, Universitätskrankenhaus Erlangen.
Zentralbl Chir. 1992;117(9):476-82.
The concept of dysplasia-carcinoma sequence has been established for the gastrointestinal tract. Dysplasia is defined as unequivocal neoplastic proliferation of epithelium without invasion and represents the precancerous lesions of the colon and rectum. The most common appearance of dysplasia is polypoid adenoma, however, flat adenomas are increasingly diagnosed. During the last 20 years, new pathological and biological methods including molecular genetics showed the stepwise evolution of colorectal carcinoma from normal mucosa to dysplasia of increasing grade and to invasive carcinoma. Of course, dysplasia-carcinoma sequence does not imply the development of carcinoma in every focus of dysplasia. In fact, the incidence of carcinomas from adenomas is 5-10%. A new molecular or genetic epidemiology promises an improved selection of high risk individuals.
发育异常-癌序列的概念已在胃肠道中确立。发育异常被定义为上皮细胞明确的肿瘤性增殖但无浸润，代表结肠和直肠的癌前病变。发育异常最常见的表现是息肉状腺瘤，然而，扁平腺瘤的诊断也越来越多。在过去20年中，包括分子遗传学在内的新的病理和生物学方法显示了结直肠癌从正常黏膜逐步发展为程度不断加重的发育异常并进而发展为浸润性癌的过程。当然，发育异常-癌序列并不意味着每个发育异常病灶都会发展为癌。事实上，腺瘤癌变的发生率为5%-10%。一种新的分子或遗传流行病学有望改善对高危个体的筛选。
