具有肿瘤发生潜能的结直肠无蒂锯齿状息肉中β-连环蛋白频繁核标记。

Frequent beta-catenin nuclear labeling in sessile serrated polyps of the colorectum with neoplastic potential.

作者信息

Wu Julie M, Montgomery Elizabeth A, Iacobuzio-Donahue Christine A

机构信息

Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.

出版信息

Am J Clin Pathol. 2008 Mar;129(3):416-23. doi: 10.1309/603UQKM7C2KELGJU.

DOI:10.1309/603UQKM7C2KELGJU

PMID:18285264

Abstract

We obtained 22 sessile serrated adenomas (SSAs) and 19 hyperplastic polyps (HPs) and performed immunolabeling for cytokeratins (CKs) 7 and 20, CDX2, beta-catenin, and p53 to determine the role of these markers in aiding distinction of lesions with neoplastic potential. Patients with SSAs more frequently had a prior or coexistent tubular adenoma (P = .004) that was right-sided (P = .00001) and larger (P = .03). No difference in CK7, CK20, or p53 labeling was found after correction for colonic location. However, CDX2 labeling was significantly lower in SSAs (P = .02) and was predominantly confined to the crypt bases, whereas it was diffusely positive in HPs (P < .001). Surprisingly, aberrant nuclear labeling for beta-catenin was found in 9 (41%) of the SSAs but in none of the HPs (P < .002). We propose that beta-catenin and/or CDX2 immunolabeling may have diagnostic usefulness in the evaluation of serrated polyps. These findings also suggest that Wnt signaling has a role in SSA development.

摘要

我们获取了22个无蒂锯齿状腺瘤（SSA）和19个增生性息肉（HP），并对细胞角蛋白（CK）7和20、尾型同源盒转录因子2（CDX2）、β-连环蛋白和p53进行免疫标记，以确定这些标志物在辅助鉴别具有肿瘤潜能的病变中的作用。患有SSA的患者更常伴有先前或同时存在的管状腺瘤（P = 0.004），该管状腺瘤位于右侧（P = 0.00001）且更大（P = 0.03）。校正结肠位置后，未发现CK7、CK20或p53标记有差异。然而，SSA中的CDX2标记明显较低（P = 0.02），且主要局限于隐窝底部，而在HP中则呈弥漫性阳性（P < 0.001）。令人惊讶的是，9个（41%）SSA中发现β-连环蛋白核标记异常，但在HP中均未发现（P < 0.002）。我们认为，β-连环蛋白和/或CDX2免疫标记在锯齿状息肉的评估中可能具有诊断价值。这些发现还表明，Wnt信号通路在SSA的发生发展中起作用。