Roncucci L, Stamp D, Medline A, Cullen J B, Bruce W R
Department of Medical Biophysics, University of Toronto, Ontario, Canada.
Hum Pathol. 1991 Mar;22(3):287-94. doi: 10.1016/0046-8177(91)90163-j.
The objective of the present study was to determine whether aberrant crypt foci (ACF) similar to those observed in the colons of experimental animals exposed to colon carcinogens could be identified and quantified in the human colon. Twenty-seven colon resections from patients affected by familial adenomatous polyposis (FAP, five cases), colorectal cancer (CRC, 12 cases), and benign diseases of the large bowel (BD, 10 cases) were collected from a pathology repository or immediately after operation. Ten or more 1-cm2 formalin-fixed, methylene-blue--stained samples of colonic mucosa from each colon were scored under light microscopy for ACF. The number of ACF per cm2 and the number of crypts per ACF for each colon were calculated. The average number of ACF per cm2 in the FAP group (20 +/- 19, mean +/- SD) was significantly higher (P less than 0.01) than those of the CRC (0.37 +/- 0.41) and BD (0.18 +/- 0.35) groups. At least one ACF was found in every colon resection from CRC patients and in six out of 10 colon resections from the BD group. The average number of crypts per ACF ranged from five to 35 with absolute values from 1 to over 100. Fifty-five histologic specimens, 43 with ACF of various size and 12 without, were prepared by sectioning the colon parallel to the mucosal surface. There was a close correlation between the number of crypts per ACF in each specimen as scored by methylene-blue and histologic examination. Twenty-six aberrant crypt foci displayed dysplasia as evident by histologic analysis. In these instances we feel the term microadenoma is appropriate and, using this unique approach of examining the human colon, they can be easily identified and quantified. These lesions may well be precursors for adenomatous polyps and colorectal cancer.
本研究的目的是确定在暴露于结肠癌致癌物的实验动物结肠中观察到的那种异常隐窝灶（ACF）是否能在人类结肠中被识别和定量。从病理标本库或术后立即收集了27例结肠切除术标本，这些患者分别患有家族性腺瘤性息肉病（FAP，5例）、结直肠癌（CRC，12例）和大肠良性疾病（BD，10例）。对每个结肠的10个或更多1平方厘米经福尔马林固定、亚甲蓝染色的结肠黏膜样本在光学显微镜下进行ACF评分。计算每个结肠每平方厘米的ACF数量以及每个ACF中的隐窝数量。FAP组每平方厘米ACF的平均数量（20±19，平均值±标准差）显著高于CRC组（0.37±0.41）和BD组（0.18±0.35）（P＜0.01）。在CRC患者的每例结肠切除标本中以及BD组10例结肠切除标本中的6例中均发现了至少一个ACF。每个ACF中的隐窝平均数量在5至35个之间，绝对值从1到100多个不等。通过将结肠平行于黏膜表面切片制备了55个组织学标本，其中43个有不同大小的ACF，12个没有。亚甲蓝评分的每个标本中每个ACF的隐窝数量与组织学检查结果密切相关。组织学分析显示26个异常隐窝灶有发育异常。在这些情况下，我们认为微腺瘤这个术语是合适的，并且通过这种检查人类结肠的独特方法，可以很容易地识别和定量这些病变。这些病变很可能是腺瘤性息肉和结直肠癌的前驱病变。
