Rubio Carlos A
Gastrointestinal and Liver Pathology Research Laboratory, Department of Pathology, Karolinska Institute and University Hospital 17176, Stockholm, Sweden.
Int J Clin Exp Pathol. 2009;2(2):149-53. Epub 2008 Jul 10.
Eighty-three duodenal adenomas were stained with hematoxylin-eosin (H&E) and with anti-lysozyme immunostain. Mature Paneth cells were those showing coarse brightly red cytoplasmic granules in H&E stain and Paneth cell precursors were those lysozyme-expressing cells that had remained undetected in H&E stain. In the adenomas, the number of mature Paneth cells/high power field varied from 4 to 12 (mean 6.5) in H&E stain, and of lysozyme-expressing cells from 32 to 62 (mean 46.5) (p<0.05). Lysozyme-expressing cells were found haphazardly distributed within the histological profile of the lesion, even in the most superficial cell layer of the dysplastic glands. The latter suggests that if the innate programmed vector of cell migration were valid for duodenal adenomas (from stem cells towards the bottom of the crypts for Paneth cells) the stem cells, normally overlaying Paneth cells, would have been exfoliated into the lumen. Another, less likely option, is that mutated stem cells at the bottom of duodenal adenomas translocate, in an unprecedented manner, the ontogenic signals of migration for Paneth cells. This stochastic molecular option would imply a total reversal of the normal migratory vector for Paneth cells, to a more aberrant, paradoxical migration flow, from stem cells to the villus domain, before exfoliation. Because of the unique migratory direction of the Paneth cells in the crypts of Lieberkühn, the duodenal adenoma emerges as a suitable histo-biological model to monitor the fate of stem cells. It is suggested that stem cells, together with the other recordable mature cells, namely dysplastic enterocytes, Paneth cells and goblet cells, participate in the cell turnover of duodenal adenomas. Further studies are necessary to definitively validate the abovementioned suggested hypothesis.
83个十二指肠腺瘤用苏木精-伊红（H&E）染色以及抗溶菌酶免疫染色。成熟的潘氏细胞是指在H&E染色中显示出粗大鲜红色胞质颗粒的细胞，而潘氏细胞前体是指在H&E染色中未被检测到的表达溶菌酶的细胞。在腺瘤中，H&E染色下每高倍视野成熟潘氏细胞的数量在4至12个之间（平均6.5个），表达溶菌酶的细胞数量在32至62个之间（平均46.5个）（p<0.05）。表达溶菌酶的细胞在病变的组织学结构中呈随机分布，即使在发育异常腺体的最表层细胞层也是如此。后者表明，如果细胞迁移的固有程序性载体对十二指肠腺瘤有效（从干细胞向隐窝底部迁移形成潘氏细胞），那么通常覆盖在潘氏细胞上方的干细胞就会脱落到管腔中。另一种可能性较小的情况是，十二指肠腺瘤底部的突变干细胞以前所未有的方式转移潘氏细胞的个体发生迁移信号。这种随机分子情况意味着潘氏细胞正常迁移载体的完全逆转，变为从干细胞到绒毛区域的更异常、矛盾的迁移流，然后再脱落。由于潘氏细胞在利伯kühn隐窝中独特的迁移方向，十二指肠腺瘤成为监测干细胞命运的合适组织生物学模型。有人提出，干细胞与其他可记录的成熟细胞，即发育异常的肠上皮细胞、潘氏细胞和杯状细胞一起，参与十二指肠腺瘤的细胞更新。需要进一步研究来明确验证上述提出的假设。
