Stenling Roger, Lindberg Jan, Rutegård Jörgen, Palmqvist Richard
Dept. of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden.
APMIS. 2007 Nov;115(11):1219-26. doi: 10.1111/j.1600-0643.2007.00664.x.
This study is based on all patients with ulcerative colitis from a defined catchment area in Northern Sweden in a still ongoing colonoscopy surveillance programme, which started in 1977. From this material we selected tissue from eight groups of patients consisting of normal control biopsies (5), inactive colitis (10), active colitis (10), findings of low-grade dysplasia (10), high-grade dysplasia (6), aneuploidy (without dysplasia and with subsequent dysplasia) (10), and ulcerative colitis-associated cancers (5). The samples were evaluated according to immunohistochemical expression of CK7 and CK20. Colonic mucosa from normal controls and inactive colitis was found to be completely negative for CK7. In 9 out of 10 patients with active colitis, CK7 was sparsely expressed in a patchy manner and connected with active epithelial inflammatory areas. 7 out of 10 patients with low-grade dysplasia and 3 out of 6 with high-grade dysplasia were positive for CK7. Samples with aneuploidy without dysplasia were completely negative, while 2 out of 6 showing subsequent dysplasia were positive. Of the five cancers, two were positive for CK7. CK20 was expressed in nearly all samples but relatively more in the lower part of the crypts in neoplasia-associated lesions. Our results indicate a possible relationship between expression of CK7 and CK20 and neoplastic development of colorectal mucosa in patients with ulcerative colitis. Further studies are needed to elucidate whether these findings have clinical significance.
本研究基于瑞典北部一个特定集水区内所有患有溃疡性结肠炎的患者，该患者群体参与了一项始于1977年且仍在进行的结肠镜监测项目。从该样本库中，我们选取了八组患者的组织，包括正常对照活检组织（5例）、静止期结肠炎组织（10例）、活动期结肠炎组织（10例）、低级别异型增生组织（10例）、高级别异型增生组织（6例）、非异型增生性及随后出现异型增生的非整倍体组织（10例），以及溃疡性结肠炎相关癌组织（5例）。根据细胞角蛋白7（CK7）和细胞角蛋白20（CK20）的免疫组化表达对样本进行评估。发现正常对照和静止期结肠炎的结肠黏膜CK7完全阴性。10例活动期结肠炎患者中有9例，CK7呈散在稀疏表达，并与活跃的上皮炎症区域相关。10例低级别异型增生患者中有7例，6例高级别异型增生患者中有3例CK7呈阳性。无非异型增生的非整倍体样本CK7完全阴性，而6例随后出现异型增生的样本中有2例呈阳性。5例癌组织中，有2例CK7呈阳性。CK20在几乎所有样本中均有表达，但在肿瘤相关病变的隐窝下部表达相对较多。我们的结果表明，CK7和CK20的表达与溃疡性结肠炎患者结直肠黏膜的肿瘤发生发展之间可能存在关联。需要进一步研究以阐明这些发现是否具有临床意义。
