高级别腺瘤样增生是早期细支气管肺泡腺癌吗？

Is high-grade adenomatous hyperplasia an early bronchioloalveolar adenocarcinoma?

作者信息

Ullmann R, Bongiovanni M, Halbwedl I, Fraire A E, Cagle P T, Mori M, Papotti M, Popper Helmut H

机构信息

Institute of Pathology, Laboratory for Molecular Genetics, University of Graz, Graz, Austria.

出版信息

J Pathol. 2003 Nov;201(3):371-6. doi: 10.1002/path.1460.

DOI:10.1002/path.1460

PMID:14595748

Abstract

Atypical adenomatous hyperplasia (AAH) is a probable forerunner of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma (AC) of mixed type. The present study analysed four low-grade AAHs, 13 high-grade AAHs, two BACs, nine mixed ACs, and one squamous cell carcinoma derived from 13 patients using comparative genomic hybridization. The average number of chromosomal aberrations was 1.2 in low-grade AAH, 9.6 in high-grade AAH, and 12.5 in AC. A high degree of overlap of genetic changes was found in high-grade AAH, BAC, and AC within individual patients. The high number of aberrations and the degree of shared aberrations found in high-grade AAH and AC raises questions about the separation of these two entities. In addition, in view of the monoclonal origin of multiple foci within the same patient, AAH may not be a precursor of AC in some cases, but rather may represent intraepithelial spread.

摘要

不典型腺瘤样增生（AAH）可能是细支气管肺泡癌（BAC）和混合型肺腺癌（AC）的前驱病变。本研究采用比较基因组杂交技术，分析了来自13例患者的4例低级别AAH、13例高级别AAH、2例BAC、9例混合型AC以及1例鳞状细胞癌。低级别AAH的平均染色体畸变数为1.2，高级别AAH为9.6，AC为12.5。在个体患者的高级别AAH、BAC和AC中发现了高度的基因变化重叠。高级别AAH和AC中发现的大量畸变以及共享畸变程度，引发了关于这两个实体分离的疑问。此外，鉴于同一患者内多个病灶的单克隆起源，在某些情况下AAH可能不是AC的前驱病变，而可能代表上皮内扩散。