Croucher Lisa J, Bury Jonathan P, Williams Elizabeth A, Riley Stuart A, Corfe Bernard M
Human Nutrition Unit, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK.
BMC Gastroenterol. 2008 Nov 14;8:54. doi: 10.1186/1471-230X-8-54.
Markers of crypt cell proliferation are frequently employed in studies of the impact of genetic and exogenous factors on human colonic physiology. Human studies often rely on the assessment of tissue acquired at endoscopy. Modulation of cell proliferation by bowel preparation with oral laxatives may confound the findings of such studies, but there is little data on the impact of commonly used bowel preparations on markers of cell proliferation.
Crypt length, crypt cellularity and crypt cell proliferation were assessed in biopsies acquired after preparation with either Klean-Prep or Picolax. Crypt cell proliferation was assessed by whole-mount mitotic figure count, and by two different immunohistochemical (IHC) labelling methods (Ki-67 and pHH3). Subsequent biopsies were obtained from the same patients without bowel preparation and similarly assessed. Parameters were compared between groups using analysis of variance and paired t-tests.
There were significant differences in labelling indices (LI) between biopsies taken after Klean-prep and those taken after Picolax preparation, for both Ki67 (p = 0.019) and pHH3 (p = 0.017). A similar trend was seen for whole-mount mitotic figure counts. Suppression or elevation of proliferation parameters by bowel preparation may mask any effect due to an intervention or disease.
Commonly used bowel preparations may have significant and different effects on crypt cell proliferation. This should be taken into account when designing studies and when considering the findings of existing studies.
隐窝细胞增殖标志物常用于研究遗传和外源性因素对人类结肠生理的影响。人体研究通常依赖于对内镜检查获取的组织进行评估。口服泻药进行肠道准备对细胞增殖的调节可能会混淆此类研究的结果，但关于常用肠道准备对细胞增殖标志物影响的数据很少。
在用Klean-Prep或Picolax进行准备后获取的活检组织中评估隐窝长度、隐窝细胞密度和隐窝细胞增殖。通过全层有丝分裂计数以及两种不同的免疫组织化学（IHC）标记方法（Ki-67和pHH3）评估隐窝细胞增殖。随后从相同患者未进行肠道准备的情况下获取活检组织并进行类似评估。使用方差分析和配对t检验比较组间参数。
对于Ki67（p = 0.019）和pHH3（p = 0.017），Klean-prep后获取的活检组织与Picolax准备后获取的活检组织之间的标记指数（LI）存在显著差异。全层有丝分裂计数也呈现出类似趋势。肠道准备对增殖参数的抑制或升高可能会掩盖因干预或疾病导致的任何影响。
常用的肠道准备可能对隐窝细胞增殖有显著且不同的影响。在设计研究以及考虑现有研究结果时应考虑到这一点。
