Sakamoto Hirotsugu, Mutoh Hiroyuki, Ido Kenichi, Satoh Kiichi, Hayakawa Hiroko, Sugano Kentaro
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi 329-0 431, Japan.
Hum Pathol. 2007 Jan;38(1):66-71. doi: 10.1016/j.humpath.2006.06.010. Epub 2006 Sep 25.
We previously reported a case of a human gallbladder with cholelithiasis consisting of intestinal metaplasia with the expression of caudal-related homeobox transcription factor (Cdx2). However, it is unclear how often intestinal metaplasia and Cdx2 expression occur in human, nontumorous gallbladders with cholelithiasis. We studied the incidence of intestinal metaplasia and Cdx2 expression in human gallbladders with cholelithiasis. Gallbladders were resected under laparoscopy from 103 patients with cholelithiasis between September 2003 and March 2005. The mean age of the patients was 59.6 +/- 15.0 years (range, 22-92 years). We retrospectively reviewed these cases to look for the presence of intestinal metaplasia and the expression of Cdx2. In addition, the characteristics of intestinal metaplasia were examined by immunostaining for Muc2, chromogranin A, and serotonin. Intestinal metaplasia was found in 11.7% (12/103) of the gallbladders with cholelithiasis. The mean ages of patients with and without intestinal metaplasia were 60.8 +/- 15.4 and 59.4 +/- 14.9 years, respectively. Cdx2, Muc2, chromogranin A, and serotonin were expressed in 91.7% (11/12), 91.7% (11/12), 83.3% (10/12), and 50.0% (6/12) in intestinal metaplastic mucosa, respectively. Only one case (1.1%) that expressed Cdx2 without intestinal metaplasia did not express Muc2, chromogranin A, and serotonin. We found that 10.7% (11/103) of nontumorous gallbladders resected because of cholelithiasis under laparoscopy revealed intestinal metaplasia with Cdx2 expression.
我们之前报道过一例患有胆石症的人类胆囊病例，其存在肠化生并伴有尾型相关同源盒转录因子（Cdx2）的表达。然而，目前尚不清楚在患有胆石症的人类非肿瘤性胆囊中，肠化生和Cdx2表达的发生频率如何。我们研究了患有胆石症的人类胆囊中肠化生和Cdx2表达的发生率。在2003年9月至2005年3月期间，通过腹腔镜手术从103例胆石症患者身上切除胆囊。患者的平均年龄为59.6±15.0岁（范围为22 - 92岁）。我们对这些病例进行回顾性分析，以寻找肠化生的存在情况以及Cdx2的表达情况。此外，通过对Muc2、嗜铬粒蛋白A和血清素进行免疫染色来检查肠化生的特征。在患有胆石症的胆囊中，11.7%（12/103）发现有肠化生。有和没有肠化生的患者平均年龄分别为60.8±15.4岁和59.4±14.9岁。在肠化生黏膜中，Cdx2、Muc2、嗜铬粒蛋白A和血清素的表达率分别为91.7%（11/12）、91.7%（11/12）、83.3%（10/12）和50.0%（6/12）。仅1例（1.1%）在没有肠化生的情况下表达Cdx2，且不表达Muc2、嗜铬粒蛋白A和血清素。我们发现，因胆石症在腹腔镜下切除的非肿瘤性胆囊中，10.7%（11/103）显示有伴有Cdx2表达的肠化生。
