Mori Hideki, Yamada Yasuhiro, Kuno Toshiya, Hirose Yoshinobu
Department of Tumor Pathology, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500-8705, Japan.
Mutat Res. 2004 May;566(3):191-208. doi: 10.1016/j.mrrev.2003.08.002.
Preneoplastic or precancerous lesions in the large bowel have been characterized in terms of morphology and histochemical phenotype. However, the detailed histogenesis and relation of particular lesions to malignancies has not yet to be unequivocally clarified. Aberrant crypt foci (ACF), identified in whole-mount preparations of colonic mucosa in rodents and also recognized in human colon, are now frequently used as effective surrogate biomarkers for experimentally detection of chemopreventive agents against colorectal cancers, but the preneoplastic or precancerous nature of ACF in rodents and humans still remains inconclusive. Relatively recently, early appearing beta-catenin accumulated crypts (BCAC) have been described in en face preparations of colonic mucosa in rodents which differ from ACF in many features. BCAC are suggested to be premalignant rather than preneoplastic. The pathological significance of both lesions, including their advantages and disadvantages as surrogate end points for large bowel neoplasms, and roles in colorectal carcinogenesis are discussed here.
大肠的癌前病变已根据形态学和组织化学表型进行了特征描述。然而，特定病变的详细组织发生过程及其与恶性肿瘤的关系尚未得到明确阐明。在啮齿动物结肠黏膜的整装标本中发现并在人类结肠中也得到确认的异常隐窝灶（ACF），现在经常被用作实验性检测结直肠癌化学预防剂的有效替代生物标志物，但ACF在啮齿动物和人类中的癌前或癌前病变性质仍无定论。相对较新的是，在啮齿动物结肠黏膜的表面标本中描述了早期出现的β-连环蛋白积聚隐窝（BCAC），其在许多特征上与ACF不同。BCAC被认为是癌前病变而非癌前病变。本文讨论了这两种病变的病理意义，包括它们作为大肠肿瘤替代终点的优缺点，以及在结直肠癌发生中的作用。
